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COPE – BRANT

COPE – BRANT. Community Overdose Prevention and Education Shawna Wilson Public Health Nurse Sexual Health and Infectious Disease. “In less than 3 minutes he came back to life”.

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COPE – BRANT

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  1. COPE – BRANT Community Overdose Prevention and Education Shawna Wilson Public Health Nurse Sexual Health and Infectious Disease

  2. “In less than 3 minutes he came back to life” After entering the brain, the drug binds to the body’s opioid receptors with an attraction so strong that it can remain locked in place for hours. Some of these receptors switch on the brain’s reward circuits – they generate feelings of pleasure, some are involved in pain transmission – heroin causes the receptors to dampen down pain signals entering the brain from the spinal cord. There are also opioid receptors on neurons that control breathing. Take too much heroin, and these neurons will dangerously slow down respiration. Starved of oxygen, the lips and fingers turn blue, the person falls unconscious and stops breathing. Death can occur within minutes. Naloxone reverses the process, by shoving the opiate out of the way and binding to the receptor itself. This sends the user into immediate withdrawal.

  3. What is Naloxone (Narcan)? • Naloxone is a safe antidote to opioid overdose • Naloxone takes 1-5 minutes to work • Naloxone displaces or “kicks out” the opioids from the receptors, then blocks those receptors and the effects of the opiate for approximately 30-90 minutes Why is it used? • Opioid overdose is the leading cause of accidental death • Opioids are a family of pain management drugs with a high potential for addiction and subsequent misuse

  4. Naloxone Kits • Contents of Naloxone Kit: • 2 – ampules of 1cc (.4mg) Naloxone Hydrochloride • 2 -1cc 25g 1 inch,1-3cc 25g safety engineered syringes • Alcohol swabs • Naloxone identifier card • Non-latex gloves • Naloxone Step by Step instructions • Mouth barrier

  5. Drug Categories Depressant Drugs: slow down the brain and nervous system activity Stimulant Drugs: will speed up the communication between the brain and the nervous system Hallucinogens: Interferes with the brain and results in hallucinations

  6. Drug Categories …continued

  7. Drug Categories…continued • *Naloxone only reverses the effects of opioids such as heroin, methadone, morphine, opium, codeine, or hydrocodone. • It does not counter the effect of other types of drugs, such as benzodiazepines (as above), antihistamines, alcohol, or other sedatives (drugs such as phenobarbital) or stimulants such as cocaine and amphetamines. • But if the person is not breathing it will not hurt to administer naloxone. If there is an opioid involved they will likely start breathing again–though they will still be sedated from the other drugs. • Many overdoses happen due to mixing opioids with other drugs, which is common practice. In the worst case scenario, naloxone will simply do nothing, but in the best case scenario it will save a life.

  8. What is an overdose? • An Overdose can occur when a person has used too much of one drug or multiple drugs and the body is not able to withstand the substance and/or the amount used. • Overdose causes a depression of the respiratory system that can lead to death. • Over dose can occur suddenly or over several hours • Overdose can happen to anyone, there is no exact formula to determine the amount or combination of drugs that could lead to an overdose.

  9. Who is at risk? Those who may be at risk for an overdose include; • Individuals with a reduced tolerance to the drug: for example those just released from jail, treatment facilities or hospital • Those who may be using a supply of drugs that has changed from the norm; for example buying from a new dealer • Individuals who rely on someone else to inject them with a drug • Those who use drugs alone It’s a no-brainer - get these kits in to the people most likely to be on the scene, which is other users.

  10. STIMULANTS • Seizures • Sweating • Difficulty breathing/chest tightness • Foaming at mouth, Vomiting • Sudden collapse, unconsciousness • Racing pulse • Headache, dizziness, ringing in ear How would I recognize an overdose? HALLUCINOGENS • Psychosis • Seizures • Nausea, Vomiting • Catatonic Syndrome (Trance-Like) STIMULANTS OPIODS • Breathing is slow/absent • Deep snoring or gurgling • Finger nails look blue or purple • Unresponsive to stimuli • Vomiting • Loss of consciousness

  11. Responding to an opioid overdose

  12. 1. Stimulation • Try to wake the person • Shout their name, shake their shoulders

  13. 2. Call 911 • When speaking with the 911 dispatcher: • Remain quiet, speak calmly and quietly. • Tell them the victim is unresponsive • Tell them the address, if you can, have someone wait outside • Never leave the victim alone • When help arrives, tell them as much as you know about the situation • Tell them that NALOXONE was given

  14. Give Naloxone How to administer Naloxone: • Look at the Naloxone vial, if there is liquid in the top of the vial gently tap with your finger until the liquid drops below the neck of the vial • Break open the Naloxone vial (you may use an alcohol swab to protect your fingers) • Insert a new syringe into the ampule and slowly draw up ALL of the Naloxone into the syringe • Inject ALL of the Naloxone into the upper arm muscle or thigh muscle at a 90 degree angle • If you cannot remove the clothing, the needle is long enough to go through light clothing.

  15. Make sure to lay the person on a hard • flat surface • Find the middle of the person’s chest • Hands one on top of the other, elbows locked, push down hard and fast with heels of hands • Push at least 2 inches with each compression • Continue until EMS arrives • If you are able to switch with another person, change every few minutes in order to rest between 4. Start Chest Compressions

  16. 5. Check… is it working? • Naloxone should work in 3-5 minutes • When Naloxone starts working the person may: • Wake up suddenly • Wake up slowly • Be confused • Be angry and agitated and combative • Want to use more drugs WARNING! Naloxone may cause MILD to SEVERE withdrawal symptoms that could include; nausea, vomiting, sweating, muscle aches, anxiety and agitation.

  17. 6. Reassess • If the person has not started breathing on their own in 3-5 minutes, give a SECOND dose of NALOXONE • Continue chest compressions until EMS arrives • If the person wakes, explain to them that they have overdosed and should NOT use more drugs as this will increase their chance of having another overdose when the Naloxone wears off. • WATCH for signs of the OVERDOSE returning Place the person in the recovery position which allows the mouth and nose to drain, keeps tongue from blocking the airway.

  18. What not to do!

  19. It can be a traumatic event for everyone involved in an overdose. • Talk with the people around you who support you, like family or a friend, a health professional that you may have connected with, share your experience. • Ensure that everyone in your life knows that you carry a Naloxone kit • Seek support • Please contact us at the Brant County Health Unit and we will provide you with new supplies and a refill of Naloxone FOLLOW UP! After an overdose…

  20. Store Naloxone in a cool dark place • Check the expiry date on the ampoules of Naloxone, if it has expired or is near to the expiry; take it back for a refill. • Check your kit supplies regularly Naloxone Kit Care

  21. Adapted with permission from materials produced by City of Hamilton Health Services Department September 2015

  22. Naloxone nasal spray – Jan 2017

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