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YOU Can Help Someone Overdosing on an Opiate. HHCLA Overdose Prevention and Response Program. The Goal of this Project:. To keep opiate users alive. Purpose of Training. TO LEARN: Facts About Opiates Facts About Opiate Overdose When to Use Naloxone How to Use Naloxone
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YOU Can Help Someone Overdosing on an Opiate HHCLA Overdose Prevention and Response Program
The Goal of this Project: To keep opiate users alive.
Purpose of Training TO LEARN: • Facts About Opiates • Facts About Opiate Overdose • When to Use Naloxone • How to Use Naloxone • How to Give Rescue Breathing • How to Get the Necessary Help
All Opiates • Are made from the opium poppy • Affect the same part of the brain • Cause you to stop breathing if you overdose
Effects of Some Opiates OPIATE DURATION INTENSITY Methadone 24 hours ++++ Heroin 6 to 8 hours +++++ Oxycontin 3 to 6 hours ++++ Codeine 3 to 6 hours + Demerol 2 to 4 hours ++ Morphine 3 to 6 hours +++
Did you know… Overdosing is an occupational hazard for heroin injectors. More injection drug users die from heroin overdose than from any other cause including AIDS, hepatitis or homicide. Overdoses are rarely suicide attempts. People who have overdosed, say “I didn’t mean to do it; I just wanted to get high.” It is just as common among men as women. It is just as common among seasoned injectors as new injectors.
Have you ever overdosed? Have you ever seen someone OD?
From Overdose to Death Breathing stops Heart stops Brain stops
Signs of Overdose 1. Can’t be awakened - Unresponsive Test: Call name, sternum or upper lip rub - do they respond? - or - 2. Very slow or no breathing Test: Ear to mouth - can you feel breath? - or - 3. Change in color of lips or fingers Test: Nails or lips are blue, purple, or ashy
Preventing Overdose • Don’t mix alcohol or sedatives with heroin • Don’t inject alone • Start with smaller doses • after a period of abstinence • (e.g., after getting out of jail or drug treatment, or after taking a break) • with heroin from a new source
Naloxone (Narcan) Naxolone temporarily reverses an opiate OD by kicking out the heroin from the brain’s opiate receptors to allow breathing to be restored. The effect lasts for 30 – 60 minutes
Effects of Naloxone • Naloxone usually takes effect in 1 to 2 minutes • It could take up to five minutes • Naloxone lasts about 30 to 60 minutes, then the overdose effects can return • Naloxone puts the OD’r into withdrawal • Don’t let someone who you treat with Naloxone use again - the OD can come back!
Storage of Naloxone • Naloxone must be stored out of direct sunlight and be kept as cool as possible. • Keep it in its box and in the bag it’s given to you in. • You do not need to refrigerate it. • Naloxone expires • Check the expiration date and ask for a new dose if it’s close to the date. • Don’t store ANY drugs or paraphernalia in the bag with your Naloxone!!! • The police in the Skid Row area are aware of the HHCLA program
Naloxone Does Not Work for Overdoses of: 1. Non-opioid Sedatives 2. Stimulants
Other uses for Naloxone Naloxone has NO other uses! • It cannot be used to get high • If the person is not overdosing on an opiate it will have no effect
The SCARE ME Technique Call their name and shake him/her Rub sternum or upper lip Stimulation Call 911 and say ”my friend is not breathing” Callfor help Make sure there is nothing in the throat and the airway is clear of blockage Airway If s/he is not breathing, breath for him/her – 2 slow breaths RescueBreathing Is s/he any better? Can you get Naloxone prepared quick enough so they don’t go too long with a breath. Evaluate Inject 1cc of Naloxone into a muscle – Upper arm, thigh or buttock Muscularinjection Is s/he breathing on own? Is another dose of Naxolone needed? Seek help and stay. Evaluate& Support
Call his/her name loudly • Rub your knuckles on his/her sternum (breastbone) • Don’t • Hit, slap or punch • Rub with ice or put in a cold shower • Inject with water, milk, or salt These things won’t get the heroin out of his/her system, and might cause injury Stimulation
“My friend has stopped breathing” Call 911 for help Avoiding Police Involvement • Speak clearly and concisely • Keep room quiet • Try not to lie, if asked, tell them you think the person took something, but you’re not sure what it was.
Airway Check for gum, food, the tongue, or anything else that might be blocking the airway. Check to see if there’s anything blocking the person’s airway - can air get through?
Rescue Breathing BLOW Tilt the head back and listen for breathing. If not breathing normally, pinch nose and cover the mouth with yours and blow until you see the chest rise. Give 2 slow breaths. Each breath should take 1 second.
Evaluate • Has anything changed? • Is person breathing on their own? • If not: • get the Naloxone ready • continue rescue breathing
Muscular Injection If the person is still not breathing Give 1cc of Naloxone into a muscle (one shot from the pre-filled syringe = 1cc) Keep giving rescue breathing
Evaluate • Is person breathing on their own? • If not: • Give 5 more breaths, one breath every 5 seconds • Inject another vial of Naloxone with a new needle • Continue rescue breathing until the paramedics arrive
Recovery Position If you must leave the overdoser alone and he is breathing normally, place him on his side in the recovery position • Mouth down, head turned so vomit cannot block airway; • Brain at same level of/lower than heart We always recommend that you stay until the paramedics arrive. Picture available at: http://www.justoneshot.org.uk/help.htm
Don’t Leave! Even if the person wakes up and starts breathing, the OD could come back. The effects of heroin last much longer than Narcan. The person who OD’d needs to go to the hospital to be observed. S/he will probably feel dope sick - don’t let him/her use again - the heroin is still there.
Wait for EMS When they arrive: • If you know, tell them what the person took • Tell them how much Naloxone you administered • Encourage overdoser to go to hospital
Addressing your concerns about responding to an OD • Could I catch something (e.g., HIV or HCV)? • Will I be able to remember how to do it right? • Could I get arrested? • What are the side effects of Naloxone? • Side effects could include: Allergic reactions, Palpitations, Arrhythmia, Seizure
Talk with your friends Who do you use with? Do they have Naloxone and know how to use it? • Talk with your friends about getting trained to use Naloxone • Show them the Naloxone video • Make a plan - tell them where you keep your Naloxone and what you want them to do if you OD
Review SCARE ME We created this training with the help of others. Thank you to: The Chicago Recovery Alliance (developers of the SCARE ME technique) The DOPE Project