Transcript YOU Can Help Someone Overdosing On an Opiate

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:
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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
QuickTime™ and a
TIFF (Uncompressed) decompressor
are needed to see this picture.
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.
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.
More injection drug users die from heroin overdose
than from any other cause including AIDS, hepatitis or
homicide.
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
1. Don’t mix alcohol or sedatives with heroin
2. Don’t inject alone
3. 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
What Do You Know About
Naloxone (Narcan)?
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
 Valium
 Xanax
 Clonopin
 Ativvan
 Clonidine
 Elavil
2. Stimulants
 Cocaine
 Amphetamines
 Alcohol
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
Stimulation
Call for help
Airway
Rescue Breathing
Evaluate
Muscular injection
Evaluate
& Support
Call their name and shake him/her
Rub sternum or upper lip
Call 911 and say ”my friend is not breathing”
Make sure there is nothing in the throat and
the airway is clear of blockage
If s/he is not breathing, breath for him/her –
2 slow breaths
Is s/he any better? Can you get Naloxone
prepared quick enough so they don’t go too
long with a breath.
Inject 1cc of Naloxone into a muscle –
Upper arm, thigh or buttock
Is s/he breathing on own? Is another dose of
Naxolone needed? Seek help and stay.
Stimulation
 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
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 you’re
not sure what it was.
Airway
Check to see if there’s anything blocking the person’s airway
- can air get through?
Check for gum, food, the tongue, or anything else that
might be blocking the airway.
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
QuickTime™ and a
TIFF ( Uncompressed) dec ompressor
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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
Your Turn - Demonstration and
Practice
Review
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