1. Bystander Naloxone Training Saves Lives

2. Death rates are spiraling out of control--for both prescription opioids and heroin! Graphic: Nytimes.com

3. The scope of the problem Over the past decade, rates of heroin use increased by over 60%, while heroin overdose deaths nearly quadrupled, climbing by 286%. Graphic: Drugabuse.gov

4. The CDC has classified overdose deaths as a national epidemic. Graphic: teens.drugabuse.gov

5. Locally, trends are increasing dramatically as well. An additional 9 deaths are directly attributable to prescription opioids in 2014 Graphic: Fredericknewspost.com

6. Reversing the trend Graphic: www.CDC.gov Increased funding is leading to new public service efforts. Increased prescription opioid monitoring. Increased access to treatment. Reversing acute overdose.

7. Policy Statement Naloxone has been proven safe and efficacious in the emergent reversal of opioid overdose by lay rescuers. Increased naloxone training and availability of this drug in the community is advantageous. Naloxone has been proven safe and efficacious in the emergent reversal of opioid overdose by lay rescuers. Increased naloxone training and availability of this drug in the community is advantageous. Naloxone has been proven safe and efficacious in the emergent reversal of opioid overdose by lay rescuers. Increased naloxone training and availability of this drug in the community is advantageous.

8. Studies show… Bystanders (including other users) are willing to help. Intranasal Naloxone is safe and effective. Formal, in-class training increases confidence and competence. When naloxone is available, it is used to save lives! Graphic: Static1.squarespace.com

9. Emergency treatment: Recognize the overdose. Stimulate the person. Call for help. Administer naloxone. Perform rescue breathing. Graphic: thatoregonlife.com

10. Overdose response training includes: Identification of an opioid Overdose recognition Responding to an overdose Detailed naloxone administration instructions Question and Answer session Skills practice Graphic: bha.dhmh.maryland.gov

11. Graphic: http://bha.dhmh.maryland.gov The Details:

12. Implementation Graphic: wvgazettemail.com Space and training provided by entity free of charge as community service. Naloxone training materials have been provided by emergency department personnel. Other supplies, such as atomizers and certificates, provided free of charge by entity. Training curriculum provided by State of Maryland.

13. Trainings have no associated cost to attendees. They are geared specifically to family and friends, although anyone may attend. Upon successful completion attendees will receive a certificate which will allow purchase of naloxone from a local pharmacy without a prescription. Graphic: choppersguide.com

14. CarpenterCPRsolutions.com Spread the word... Register now on the course calendar at:

15. Other local training entities: Frederick County Health Department also offers some bystander training. Many trainings at this entity are directed toward local law enforcement. Mountain Manor Treatment Center in Emmitsburg offers training to inpatients and family members only at this time. Graphic: EMSworld.com

16. THANK YOU! Thank you for your time and support with the implementation of this project. Your efforts will save lives!

17. References American Public Health Association. (2016). Reducing opioid overdose through education and naloxone distribution. Retrieved from https://www.apha.org/policies- and-advocacy/public-health-policy-statements/policy- database/2014/07/16/13/08/reducing-opioid-overdose-through-education-and- naloxone-distribution American Society for Addiction Medicine. (2016). Opioid addiction 2016 facts and figures [Fact sheet]. Retrieved from http://www.asam.org/docs/default- source/advocacy/opioid-addiction-disease-facts-figures.pdf Behavioral Health Administration, Department of Health and Mental Hygiene, State of Maryland (2015). Maryland overdose response program: Educational training program core curriculum [PowerPoint slides]. Retrieved from http://bha.dhmh.maryland.gov/Documents/MD_ORP_CoreCurriculum_Updated_Dec% 202015v2.pdf Centers for Disease Control and Prevention (2014). The 10 essential public health services: An overview [Lecture notes]. Retrieved from http://www.cdc.gov/nphpsp/documents/essential-phs.pdf Centers for Disease Control and Prevention. (2015). Today’s heroin epidemic [Issue brief]. Retrieved from http://www.cdc.gov/vitalsigns/heroin/ Clark, A. (2014, August 17). Legislative: Responding to the fatal opioid overdose epidemic: A call to nurses. OJIN: The Online Journal of Issues in Nursing, 19(3).

18. References Frederick County Health Department. (2012). Opioid overdose prevention plan. Retrieved from https://frederickcountymd.gov/DocumentCenter/View/265401 Giglio, R. E., Li, G., & DiMaggio, C. J. (2015). Effectiveness of bystander naloxone administration and overdose education programs: A meta-analysis. Injury Epidemiology, 2(1). http://dx.doi.org/10.1186/s40621-015-0041-8 Jones, P. (2015, March 29). Police: Prescription drug abuse in county pervasive, but pales to heroin epidemic. Frederick News Post. Retrieved from http://www.fredericknewspost.com/news/crime_and_justice/police-prescription-drug- abuse-in-county-pervasive-but-pales-to/article_ccf5b5f2-632b-5527-8031- b9d5efd77a84.html Kerr, D., Kelly, A., Dietze, P., Jolley, D., & Barger, B. (2009). Randomized controlled trial comparing the effectiveness and safety of intranasal and intramuscular naloxone for the treatment of suspected heroin overdose. Addiction, 104(12), 2067-2074. http://dx.doi.org/10.1111/j.1360-0443.2009.02724.x Maryland Department of Health and Mental Hygiene. (2015). Drug and alcohol-related intoxication deaths in Maryland, 2014 [Annual report]. Retrieved from http://dhmh.maryland.gov/data/Documents/Annual%20OD%20Report%202014_merg ed%20file%20final.pdf National Institute on Drug Abuse. (2014). Abuse of prescription pain medications risks heroin use [Infographic]. Retrieved from https://www.drugabuse.gov/related- topics/trends-statistics/infographics/abuse-prescription-pain-medications-risks-heroin- use

19. References Statistica. (2016). Drug overdose death rate in the United States in 2015, by state (per 100,000 population). Retrieved from http://www.statista.com/statistics/246637/top-ten- leading-states-concerning-death-rate-of-drug-overdose-in-the-us/ Strang, J. (2015). Death matters: Understanding heroin/opiate overdose risk and testing potential to prevent deaths. Addiction, 110(S2), 27-35. http://dx.doi.org/10.1111/add.12904 The Network for Public Health Law. (2015). Legal interventions to reduce overdose mortality: Naloxone access and overdose good samaritan laws. Retrieved from https://www.networkforphl.org/_asset/qz5pvn/network-naloxone-10-4.pdf Wheeler, E., Jones, T.S., Gilbert, M.K., Davidson, P.J., & Centers for Disease Control and Prevention (CDC). (2015). Opioid overdose prevention programs providing naloxone to laypersons - United States, 2014. MMWR. Morbidity and Mortality Weekly Report, 64(23), 631. Retrieved from http://search.proquest.com/docview/1693339571?accountid=14793 Williams, A. V., Marsden, J., & Strang, J. (2014). Training family members to manage heroin overdose and administer naloxone: Randomized trial effects on knowledge and attitudes. Addiction, 109(2), 250-259. http://dx.doi.org/10.1111/add.12360