Transcript Naloxone Training - indianarecoveryalliance.org

Thank You For Attending Our
NALOXONE TRAINING
Goals Of Training
 Indiana Recovery Alliance
 Identify and Prevent Opiate Overdoses
 What is Naloxone
 How To Administer Naloxone
 Practice Administering Naloxone
 Review
So What Is The IRA ?
WHAT IS THE IRA?
Indiana Recovery Alliance
What Is The IRA?
What Are Our Values?
 Grassroots
 Direct Action
 Non-profit
 All volunteer
 Participatory
Decision Making
 Participant-Driven
 Voluntary Association
 Non-coercive
 Respect And Dignity
for Participants
 “Any Positive Change”
 Education & Advocacy
with elected officials
Enough About The IRA…
OVERDOSES
(OD)
What is the leading cause of
accidental death in adults in America ?

Physiology Of An OD

How To ID An OD

Risk Factors For OD

How To Prevent An OD
Physiology
Physiology Of An Overdose
 After you ingest opiates,
opiate receptors in brain are filled
 Depressed breathing results
 The more of the drug taken, the more
breathing becomes depressed
to the point 0f not breathing at all
(overdose)
 More than 5 minutes of not breathing
could lead to permanent brain damage
 Rescue breathing
will keep a person alive
An Important Point:
RESCUE BREATHING
DURING
AN OPIATE OD
CAN SAVE A LIFE
Signs Of Overdose?
What Are Some
Signs Of An
Opiate Overdose?
Call ‘em out…
How To Identify An OD
 Awake but unable to talk
 Body is very limp
 Face is Pale, clammy
 Lips, fingernails skin blue for
lighter skinned people
Unresponsive
to outside stimulus
 Yell “The cops are here!”
 Yell “Narcan”
 Do a Sternal Rub
 Lips, fingernails turn gray for
darker skinned people
 Breathing is very slow, shallow,
Act
Right Away!!
erratic or has stopped
 Choking or gurgling sounds
 Vomiting, foaming
 Loss of consciousness
Rescue
Breathing!
Risks Increasing OD?
What Risk Factors
Increase
The Possibility
Of An Overdose?
Call ‘em out…
Increased Risk of Overdose

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
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

Low Tolerance (been clean for as little as three days)
Mixing with other drugs (Either uppers or downers)
Hot loading
Type of drug / potency
Using alone (Stigma)
Age and physical health
Previous, non-fatal OD
Confusion
Old age
Mode of administration
(snort, oral, skin pop, muscle, vein)
 Shame Kills / Stigma
Prevent Overdoses?
What Can A Person Do
To Reduce
The Chances
of An Opiate Overdose?
Call ‘em out…
Prevent Opiate Overdoses

Have naloxone
on hand

Don’t mix drugs

Educate on
OD prevention

Know Your Source

Don’t use alone
(Sober Sitter)

Partner Agreement
Checklist
 “Taste” the shot
 Use less if
tolerance is low
 Don’t use opiates
What Is A Partner Agreement Checklist?
Partner Agreement Checklist
 knows OD prevention practices
 Knows if and when you want
them to call 911 / go to ER
 Knows if, when and how
you want them to use naloxone
 Has agreed to stay with you for support
 Knows your commitment to not use again
while you wait for naloxone to wear off
Tell Them That:
ASSISTED
BREATHING
DURING AN
OPIATE OD CAN
SAVE YOUR LIFE
Head Tilt / Chin Lift / Pinch Nose / Breath every 5 Seconds
What is Naloxone?
WHAT IS NALOXONE?
 Opiate Overdose Reversal Drug
- that’s it
- just that
- nothing else
Naloxone and Narcan are the same drug
Why Can The IRA Distribute Naloxone?
The IRA And Naloxone
 Three Things IRA Must Do
to Distribute Naloxone
1. Instruct how to use naloxone
2. Offer treatment referral
3. Instruct to call 911
 Aaron’s Law/Standing Order
1.
No special certification needed
for Indiana resident to carry
and administer naloxone
How Naloxone Works
How Does Naloxone Work?
 Antagonist




Stronger affinity for opiate receptors than opiates
Kicks opiates out for up to 90 minutes
Allows resumption of breathing
No euphoria
 Many ways to administer
 IV fastest
 intramuscular next fastest
 subcutaneous slowest,
but longest lasting
 Works on ALL opiates
What ‘s That Look Like?
Different Forms Of Naloxone
What are common opiates?
What Are Some
Common Opiates?
What Drugs
Are NOT Opiates?
Call ‘em out…
Does Naloxone Work On All Opiates?
Naloxone ONLY works on Opiates
Opiates
NOT 0piates
 Heroin
 Demerol
 Cocaine
 Opana
 Morphine
 DMX
 Vicodin
 Suboxone
 Spice
 Tylenol 3
 Oxycontin
 Percocet
 Methadone
 Fentanyl
 Hydrocodon
e
 Alcohol
 Antihistamine
 Benzodiazepine
 Methamphetamine
Should I use Naloxone If I’m Not Sure What They’ve Taken?
Use Naloxone
Even If You Aren’t Sure
If Opiates Are Involved
 Naloxone is harmless
 Only reverses opiate overdose
 Does not interact with other illicit drugs
 Take opiates out of equation
Is Naloxone Safe?
Naloxone Is Very Safe
 used when delivering babies if too much
sedative administered
 not known to interact with any other drugs
 invented in 1961, FDA approved in 1971
 no potential for abuse
 we could safely inject or ingest it right now
What Do I Do If I Find An Opiate Overdose?
Keep the Naloxone Safe
 Keep it in the brown bag
 Keep it above Freezing
 Keep it under 80 degrees
 Notice the expiration
What To Do In Case Of An OD
S.C.A.R.E. M.E.
 Stimulate
 Muscular injection
 Call 911
 Evaluate and Support
 Airway Cleared
 Rescue Breathing
 Evaluate if Naloxone would help
SC A R E
ME
Stimulation
Call for help
 Can they be awakened?
 If the person is not
 Yell “Cops!”
 Yell “Narcan!”
responsive
 Call 911
 Sternal Rub
 Tell them your friend is not
breathing
S C AR E M E ( A & B o f L i f e )
Airway:
 Roll on back  Tilt head
 Clear airway  Pinch Nose
Rescue Breathing
 First: 2 quick breaths
 Then: 1 big breath
every 5-7 seconds
 Make sure: Watch the chest
to make sure it rises & falls
You are NOT doing CPR
just rescue breaths
Don’t forget…
ASSISTED BREATHING
DURING
AN OPIATE OD CAN
SAVE A LIFE
SCARE
ME
Evaluate for Naloxone Muscular Injection

Are they better?
 Can you get naloxone quick
enough for them so they
don’t go too long without
assisted breathing?
 Only 1cc / 1ml
 Could safely do
2, or 3, or 10 cc/ml
 BUT they will be more sick
and possibly combative
 Thigh, upper arm or ass / hip
 Needle will go through
clothing, leather, etc
 THIS IS NOT PULP FICTION
SCARE ME
Evaluate And Support
 Is the person breathing on their own?
 Is another dose needed?
 They will start feeling better in about 15 minutes
 30 - 90 minutes naloxone will wear off, OD could come back on
long acting opioids (methadone, oxy, very rare to return)
 Support them and stop them from using again, Naloxone works
for 30-40 minutes, so on long lasting opiates (methadone, oxy)
overdose may return
 RECOVERY POSITION (lying on the side)
is used to prevent aspiration
What’s the Recovery Position?
SCARE ME
SCARE ME
Coming out of an OD with Naloxone
 ER uses IV Naloxone with a concentration of 2mg,
severe withdrawals
 We use IM Naloxone with 0.4 – 0.9 mg
- Much more gentle
- Only a few people have reported vomiting
- Wears off in 30-40 minutes
*Note the difference between dosage and concentration
SCARE ME(after
5 minutes)
Are they coming around?
YES: Support them, help them, don’t let them use
NO: Re-administer naloxone, after 3 doses, call 911
One hour later, are they getting sleepy again?
YES: May need another dose of naloxone
NO: Watch closely for at least another hour
These Techniques DO NOT Work
If Someone Is Not Breathing
 Milk
 Salt water
 Beat 'em Silly
 Ice water
Video time!
Watch it
Youtube Video
LIVE! Using Nalxone to Reverse Opiate Overdose
Chicago Harm Reduction Coalition
https://www.youtube.com/watch?v=U1frPJoWtkw
Practice time!
Practice Time!
1. Uncap naloxone vial
2. Tighten syringe with a twist
3. One cc of air in syringe
4. Put needle into liquid
5. Draw up 1 cc naloxone
6. Hit ‘em in the arm, ass or thigh
7. Recap the syringe safely
8. Dispose of syringe
While you are doing all of this…
DON’T FORGET
TO
BREATH
FOR
THEM!
Practice Time!
• Auto Injector Trainer
• Dispose of Auto Injector
Review of what to do:
S.C.A.R.E. M.E.
 Stimulate
 Muscular injection
 Call 911
 Evaluate and Support
 Airway Cleared
 Rescue Breathing
 Evaluate if Naloxone would help
Dead Addicts Don’t Recover
 “It used to be, you talked about
overdose in the past tense:
‘I HAD a friend who OD’d.’
 Now, overdose is in the present tense:
‘I HAVE a friend who OD’d last week,
but it’s OK. He’s all right.”
Where And How To Get Naloxone
How to get Naloxone
Where to find it
How to Pay for it
 IRA
 IRA (free!!)
 Lucky’s Market
 Insurance
 CVS
 Commercial
 Walgreens
 HIP
 Williams Brothers
 Overdose Lifeline
 Self-Pay
Where To Get Help
Get Clean
Stay Healthy
 IRA
 Positive Link
 Centerstone
 Volunteers in Medicine
 Amethyst House
 Futures
Family Planning
 Recovery
Engagement Center
 Restorative Solutions
 Planned Parenthood
 Primary Physician
Contact – Volunteer, Donate, Get Help, Get Educated
Indiana Recovery Alliance
PO Box 394
Bloomington, IN 47402
812-964-9497
indianarecoveryalliance.org
facebook.com/indianarecoveryalliance
Be careful
out there,
and let us
know if we
can be helpful.
