YOU Can Help Someone Overdosing on an Opiate

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YOU Can Help Someone Overdosing on an Opiate
HHCLA Overdose Prevention and Response Program
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The Goal of this Project
To keep opiate users alive.
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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

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All Opiates

• Are made from the opium poppy
• Affect the same part of the brain
• Cause you to stop breathing if you overdose

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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

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Did you know
Overdosing is an occupational hazard for heroin
injectors.
Overdoses are rarely suicide attempts. People
who have overdosed, say I didnt 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.

• More injection drug users die from heroin
  overdose than from any other cause including
  AIDS, hepatitis or homicide.

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Have you ever overdosed?
Have you ever seen someone OD?
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From Overdose to Death
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Signs of Overdose
1. Cant 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
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Preventing Overdose

• Dont mix alcohol or sedatives with heroin
• Dont 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

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What Do You Know About Naloxone (Narcan)?
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Naloxone (Narcan)
Naxolone temporarily reverses an opiate OD by
kicking out the heroin from the brains opiate
receptors to allow breathing to be restored.
The effect lasts for 30 60 minutes
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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 ODr into withdrawal
• Dont let someone who you treat with Naloxone use
  again - the OD can come back!

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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 its given to
  you in.
• You do not need to refrigerate it.

• Naloxone expires
• Check the expiration date and ask for a new dose
  if its close to the date.

• Dont store ANY drugs or paraphernalia in the bag
  with your Naloxone!!!
• The police in the Skid Row area are aware of the
  HHCLA program

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Naloxone Does Not Work for

• Overdoses of

1. Non-opioid Sedatives
2. Stimulants
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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

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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
Call for 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
Rescue Breathing
Is s/he any better? Can you get Naloxone
prepared quick enough so they dont go too long
with a breath.
Evaluate
Inject 1cc of Naloxone into a muscle Upper arm,
thigh or buttock
Muscular injection
Is s/he breathing on own? Is another dose of
Naxolone needed? Seek help and stay.
Evaluate Support
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• Stimulation

• Call his/her name loudly
• Rub your knuckles on his/her sternum (breastbone)
• Dont
• Hit, slap or punch
• Rub with ice or put in a cold shower
• Inject with water, milk, or salt
• ?These things wont get the heroin out of his/her
  system, and might cause injury

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• Call 911 for help

My friend has stopped breathing
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 youre not sure what
  it was.

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Airway
Check to see if theres anything blocking the
persons airway - can air get through?

• Check for gum, food, the tongue, or anything else
  that might be blocking the airway.

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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.
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Evaluate

• Has anything changed?
• Is person breathing on their own?
• If not
• get the Naloxone ready
• continue rescue breathing

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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
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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

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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.u
k/help.htm
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Dont 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 ODd
needs to go to the hospital to be observed. S/he
will probably feel dope sick - dont let him/her
use again - the heroin is still there.
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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

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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

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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

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Your Turn - Demonstration and Practice
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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