How to use Naloxone to save a life. OVERDOSE PREVENTION How to use Naloxone to save a life. OOPS | Oasis Overdose Prevention Service

What is an opioid overdose? Overdose (OD) = toxic amount of one or more drugs Body stops working properly (breathing, heart beat, temperature control) If nothing is done, the person can die Opioids = morphine, methadone, fentanyl, codeine, heroin, hydromorphone (Dilaudid), buprenorphine, hydrocodone, pentazocine (Talwin)

Overdose risk factors DECREASED TOLERANCE MIXING DRUGS USING ALONE If you have not used in a few days… - Use less than usual - Do tester dose - Change route (from IV to smoking or oral) MIXING DRUGS Danger = mixing with alcohol and benzos - Use one drug at a time - Use less of each drug if you’re mixing USING ALONE If you overdose, no one can help you. - Use safely with someone - Know your limit - Make sure help can get to you

Overdose risk factors DRUG QUALITY & POTENCY HEALTH STATUS ROUTE Drugs can have added ingredients - Test a small dose first - Know your dealer - Watch out for community drug alerts HEALTH STATUS Some conditions can put you at higher risk (such as Hep C) - Sleep, eat and drink lots of fluids - Use less if you are sick - Talk to your doctor or nurse regularly Ex of Health conditions = Head trauma, liver disease, kidney, sleep deprivation, dehydration, malnourishment ROUTE

Signs of opioid overdose Can’t be woken up Slow breathing or no breathing Blue lips and nails X

Signs of opioid overdose Snoring or gurgling sounds Skin feels cold Very small pupils (pinpoint/pinned) No response to noise or hard rub on chest bone

What is Naloxone? Naloxone is a medication that can temporarily reverse the effects of an overdose It is injected into a muscle It stops the opioids (drugs) from acting in your brain Helps the person breathe better while help is on the way

What is Naloxone? Only works for opioid overdose Will not work for benzos, alcohol, crack Naloxone works quickly, usually within 5 minutes Naloxone will start wearing off 30 min after injection Person might need more Naloxone

What is Naloxone? The drug is still in the body. Image:  Harm Reduction Coalition / Graphics by Maya Doe-Simkins

The Naloxone Kit 2 ampules of Naloxone 3 syringes 1 breathing mask Gloves Alcohol swabs Ampule snapper Step-by-step instructions ID card Image: Luc Cormier, Sandy Hill Community Health Centre

In case of an overdose Shake at the shoulders & Shout their name (show sternal rub) Call 911 if unresponsive Naloxone Inject 1 ampule (1ml) of Naloxone into arm or leg muscle

In case of an overdose Opening the Naloxone Drawing the Naloxone Images: http://www.agarscientific.com/media/catalog/product/cache/1/image/17f82f742ffe127f42dca9de82fb58b1/C/8/C808_Ampoule-snappers.jpg; http://apps.hesperian.org/app/#Injection_from_ampule2

In case of an overdose Inject at 90 degree angle Images: http://www.brooksidepress.org/Products/Administer_IM_SQ_and_ID_Injections/PDF/IM_SQ_ID_Injections/images/MD0552_img_20.jpg http://www.brooksidepress.org/Products/Administer_IM_SQ_and_ID_Injections/PDF/IM_SQ_ID_Injections/images/MD0552_img_21.jpg Inject at 90 degree angle

In case of an overdose 4. CPR 30 compressions, 2 breaths with mask Heart & Stroke Foundation (2010) Frequently asked questions (FAQ): 2010 Guidelines for CPR & ECC. “Studies have shown that CPR that combines chest compressions and ventilations is the most effective method for treating children and infants, because cardiac arrest in children and infants is typically secondary to conditions that compromise or prevent breathing (hypoxia). A combination of compressions and breaths is also the most effective in the treatment of adult cardiac arrest caused by near-drowning, trauma, drug overdose and other non-cardiac causes.” (p. 3)

In case of an overdose 5. Better? If the person is not doing better after 3-5 minutes (not breathing, not waking up), give a second dose of Naloxone and continue CPR until paramedics arrive.

Recovery position If you have to leave the person alone at any time, put them in the recovery position.

CALL 9-1-1 It is important to call 9-1-1, even if that’s the only thing you do The person might need more Naloxone or other treatments They might have a reaction to the Naloxone (this is very rare) Tell the paramedics as much as possible

Do you feel ready? If you don’t feel comfortable doing one of the steps, it’s OK Just call 9-1-1. It could save a life. Stay with the person, stay calm and talk to them Sign up for a CPR training

If you use your kit... You can get a new kit at _______** Let us know how it went We can offer you emotional support ** In Ottawa, Naloxone kits can be acquired through the Peer Overdose Prevention Program (POPP) at Ottawa Public Health. The person must self-disclose that they use opioids or have an opioid prescription. Hours and venues of service Site Needle & Syringe Program, 179 Clarence Street, Ottawa Monday to Friday 8:30 am to 4:30 pm   Site mobile van travels to various locations within the City of Ottawa 7 days a week 5 pm to 11:30 pm 613-232-3232 (Collect calls accepted) Venue Days Hours Telephone 613-232-3232 Collect calls accepted Clients of the Oasis Program (Sandy Hill Community Health Centre) can access naloxone kits trough the Oasis Overdose Prevention Service (OOPS) during walk-in hours.