1. OPIOID OVERDOSE PREVENTION FOR FIRST RESPONDERS TRAIN THE TRAINERS

2. GOALS DESCRIBE THE QUALIFICATIONS OF INDIVIDUALS WHO CAN PROVIDE THE DRUG OVERDOSE PREVENTION TRAINING (INCLUDING THE USE OF NALOXONE) TO POTENTIAL RESPONDERS; DESCRIBE THE DURATION AND FREQUENCY REQUIREMENTS OF TRAINING; DESCRIBE ANY REQUIRED SUPERVISION OR MONITORING OF DRUG OVERDOSE RESPONDERS AND PROGRAM TRAINERS; USE AVAILABLE REFERENCE MATERIAL TO ENHANCE TRAINING CONTENT; STRESS THE IMPORTANCE THAT DRUG USE IS ILLEGAL AND HIGHLY DANGEROUS AND THAT COMPLETE ABSTINENCE FROM ILLEGAL DRUG USE IS THE HEALTHIEST CHOICE; AND DESCRIBE THE TRAINING OVERSIGHT RESPONSIBILITIES OF THE PROGRAM'S OFFICIAL DESIGNEE AND HCP.

3. OFFICERS WILL LEARN… THE MINIMUM CONTENT TO BE INCLUDED IN THE DRUG OVERDOSE PREVENTION TRAINING IS: WHAT ARE OPIOIDS AND HOW DO THEY WORK? OVERVIEW OF OPIOID DRUG OVERDOSE. OTHER DRUGS THAT CAN CAUSE DRUG OVERDOSE. RISK FACTORS FOR OPIOID DRUG OVERDOSE. SIGNS OF OPIOID DRUG OVERDOSE. WHAT IS NALOXONE AND HOW IS IT TO BE USED AND STORED. STEPS TO TAKE WHEN RESPONDING TO AN OPIOID DRUG OVERDOSE. COMPLICATIONS THAT MAY OCCUR IN OVERDOSE PREVENTION AND HOW TO HANDLE THEM. THE IMPORTANCE OF ABSTINENCE AND HOW TO SUPPORT ACCESS TO TREATMENT FOR DRUG PROBLEMS. IMPORTANT ELEMENTS OF THE DRUG OVERDOSE PREVENTION PROGRAM.

4. PRACTICAL/SKILL LAB AN ESSENTIAL COMPONENT OF DRUG OVERDOSE PREVENTION TRAINING IS "HANDS ON" DEMONSTRATION AND PRACTICE OF THE SKILLS NEEDED TO HELP AN INDIVIDUAL WHO HAS OVERDOSED. PRACTICING THESE SKILLS DURING TRAINING WILL GIVE THE OVERDOSE RESPONDER CONFIDENCE THAT THEY CAN PERFORM THEM IN A REAL LIFE AND DEATH SITUATION. DRUG OVERDOSE RESPONDERS WILL REQUIRE TRAINING TO LEARN HOW TO: CHECK FOR BREATHING; PROVIDE STIMULATION TO AROUSE A PERSON; PLACE IN RECOVERY POSITION TO PREVENT CHOKING; PROVIDE RESCUE BREATHING; ADMINISTER NALOXONE AND MONITOR FOR RESPONSE; PROVIDE ONGOING SUPPORT AND MONITORING TO THE INDIVIDUAL WHO HAS OVERDOSED; CALL FOR ADDITIONAL SERVICES AND INTERACT WITH EMS; OTHER INTERVENTIONS AS INDICATED; AND COMPLETING NALOXONE ADMINISTRATION RECORDS.

5. TRAINING SHOULD INCLUDE THE FOLLOWING DRUG OVERDOSE PREVENTION TRAINING SHOULD BE TAILORED TO NEEDS OF IDENTIFIED RESPONDERS AND THE POPULATION AND ENVIRONMENT THEY MAY ENCOUNTER. SPECIFIC CULTURAL ASPECTS OF THE COMMUNITY WHERE THE OVERDOSE PREVENTION INTERVENTIONS MAY TAKE PLACE SHOULD BE ADDRESSED IN THE TRAINING. DRUG OVERDOSE PREVENTION TRAINING SHOULD: TAKE INTO ACCOUNT THE OVERDOSE RESPONDER'S PREVIOUS EDUCATION AND MEDICAL KNOWLEDGE. TAKE INTO ACCOUNT THE ENVIRONMENT IN WHICH THE TRAINING MAY TAKE PLACE. ADDRESS SPECIFIC CULTURAL NEEDS OF THE OVERDOSE RESPONDER AND THE CULTURAL ENVIRONMENT IN WHICH THEY MAY ENCOUNTER INDIVIDUALS WHO HAVE OVERDOSED. PROVIDE INDIVIDUALIZED TRAINING AIDS AND TRAINING APPROACHES BASED ON THE OVERDOSE RESPONDER AND THE CULTURAL ENVIRONMENT IN WHICH THEY MAY ENCOUNTER INDIVIDUALS WHO HAVE OVERDOSED. PROVIDE AMPLE OPPORTUNITY FOR QUESTION, ANSWER PERIODS, AND HAVE WRITTEN INFORMATION TO ADDRESS FREQUENTLY ASKED QUESTIONS

6. ???? THE FOLLOWING SLIDES ARE FOR YOUR USE WHEN INSTRUCTING YOUR AGENCY. FOR ACCESS TO THE NARCAN PPT AND POLICY AND PROCEDURES PLEASE CONTACT DOUG FARGHER AT DOUG@MTU1.COM. CERTIFICATION IS NOT MANDATORY, BUT HE CAN ALSO HELP WITH GETTING THE TRAINING CERTIFIED WITH THE STATE TRAINING BOARD. THE RULES DO SAY A CERTIFICATE OF SOME SORT MUST BE ISSUED.DOUG@MTU1.COM

7. A GRIMM TALE OF QUACKER

8. INTRODUCTION PURPOSE:  EARLY INTERVENTION CAN HELP REDUCE FATALITIES  THE FIRST RESPONDER NARCAN PROGRAM IS DESIGNED TO EDUCATE FIRST RESPONDERS IN RECOGNIZING SIGNS AND SYMPTOMS OF OPIATE OVERDOSE

9. OBJECTIVES AT THE CONCLUSION OF THIS TRAINING PARTICIPANTS WILL BE ABLE TO:  RECOGNIZE SIGNS AND SYMPTOMS OF OPIATE OVERDOSE  IDENTIFY RISK FACTORS FOR A PATIENT WITH A NARCOTIC OVERDOSE  INITIATE APPROPRIATE TREATMENTS AND INTERVENTIONS  ASSEMBLE AND ADMINISTER THE NASAL NARCAN DELIVERY DEVICE

10. FACTS, JUST THE FACTS  BETWEEN 2013 – 2014, THE NUMBER OF PATIENTS SUFFER FROM OPIATE OVERDOSES DEATHS IN ILLINOIS WAS 3,284  TIMELY ADMINISTRATION OF NARCAN HAS PROVEN TO REDUCE THE NUMBER OF OPIATE RELATED DEATHS  THE HEROIN ON THE STREETS TODAY IS 10 TIMES MORE POWERFUL THAN THE HEROIN IN THE 60’S AND 70’S

11. JUST A LITTLE MORE…  17% OF HEROIN DEATHS ARE REPORTED TO BE NEW USERS  IN 2010, DRUG OVERDOSE DEATHS OUTNUMBERED MOTOR VEHICLE TRAFFIC DEATHS IN 31 STATES INCLUDING ILLINOIS  HEROIN IS THE MOST COMMONLY CITED DRUG AMONG PRIMARY DRUG TREATMENT ADMISSIONS IN ILLINOIS  MOST YOUTH, UNDER AGE 18 WHO ADMIT TO PUBLIC DRUG TREATMENT ARE CAUCASIAN  PAINKILLERS KILL MORE AMERICANS THAN HEROIN AND COCAINE COMBINED BUT HEROIN DEATHS ARE ON THE RISE

12. WHY HEROIN KILLS – NOTHING YOU DO NOT ALREADY KNOW  HEROIN IS USUALLY MIXED WITH WATER AND INJECTED  IT CAN BE SMOKED, SNORTED OR EATEN  INJECTING THE HEROIN USUALLY GIVES THE PERSON AN IMMEDIATE RUSH, EUPHORIA  EXTREMELY RELAXED FEELING  DECREASED SENSE OF PAIN  BODY TURNS THE HEROIN TO MORPHINE  MORPHINE BINDS WITH MOLECULES IN YOUR BRAIN TO BLOCK OPIOID RECEPTORS AND CREATES THE HIGH

13. WHY THEY DIE THEY FORGET TO BREATHE….

14. HOW OVERDOSE OCCURS Slow BreathingBreathing StopsLack of oxygen may cause brain damageHeart StopsDeath

15. OVERDOSE DEATHS CAN BE PREVENTED BY FIRST RESPONDERS LIVES CAN BE SAVED

16. SO WHY YOU?

17. YOU ARE...  FIRST ON SCENE OF MANY OVERDOSE PATIENTS  FREQUENT INTERACTION WITH HIGH RISK POPULATIONS  POLICE CAN MAKE A HIGH HEALTH IMPACT WITH THE RIGHT TOOLS

18. WHAT HAS BEEN DONE APPROVED IN JANUARY 2010, THE ILLINOIS PUBLIC ACT 096-0361 ENABLES STRATEGIES TO REDUCE DEATHS ATTRIBUTED TO OPIOID OVERDOSE THE ORDER ALLOWS:  AUTHORIZATION TO MAINTAIN SUPPLIES OF NASAL NALOXONE KITS  AUTHORIZATION TO POSSESS NASAL NALOXONE TO RESPONDERS  AUTHORIZATION OF TRAINED FIRST RESPONDERS TO POSSESS AND ADMINISTER NALOXONE TO A PERSON EXPERIENCING A DRUG OVERDOSE

19. ILLINOIS PUBLIC ACT/NALOXONE LAW  ILLINOIS PUBLIC ACT 096-0361 PASSED/EFFECTIVE JAN. 1 2010.  PROVIDES AMENDMENT TO THE ALCOHOLISM AND OTHER DRUG ABUSE AND DEPENDENCY ACT TO ALLOW NALOXONE ADMINISTRATION BY PERSONS NOT CONSIDERED “HEALTH CARE PROFESSIONALS” IN AN EMERGENCY.

20. ILLINOIS PUBLIC ACT/NALOXONE LAW  “A PERSON WHO IS NOT OTHERWISE LICENSED TO ADMINISTER AN OPIOID ANTIDOTE MAY IN AN EMERGENCY ADMINISTER… AND BELIEVES IN GOOD FAITH THAT ANOTHER PERSON IS EXPERIENCING A DRUG OVERDOSE.”  “THE PERSON SHALL NOT, AS A RESULT OF HIS OR HER ACTS OR OMISSIONS, BE LIABLE FOR ANY VIOLATION OF [PROFESSIONAL PRACTICE ACTS] OR ANY OTHER PROFESSIONAL LICENSING STATUTE, OR SUBJECT TO ANY CRIMINAL PROSECUTION ARISING FROM OR RELATED TO THE UNAUTHORIZED PRACTICE OF MEDICINE OR THE POSSESSION OF AN OPIOID ANTIDOTE.”

21. ILLINOIS PUBLIC ACT/NALOXONE LAW IN SUMMARY, THE LAW SUPPORTS:  NALOXONE ADMINISTRATION AS A STANDARD TOOL  USE IN AN EMERGENCY/OVERDOSE SCENARIO  TRAINING FOR ALL PERSONS (NON-HEALTH CARE PROFESSIONALS) TO USE  ELIMINATION OF FEAR OF LIABILITY OR PUNISHMENT IN THE EVENT OF U SE

22. OPIATES AND OPIOIDS ARE  CHEMICALS THAT ACT IN THE BRAIN TO DECREASE FEELING OF PAIN DECREASE REACTION TO PAIN PROVIDE COMFORT  MAY BE USED FOR PAIN FROM INJURY OR AFTER HAVING PROCEDURES (SURGERY) OR AS PART OF LONG TERM CARE FOR CANCER OR OTHER DISEASES THAT ARE PAINFUL AND ARE NOT EXPECTED TO GO AWAY  BOTH OPIATES AND OPIOIDS ARE OFTEN MISUSED RESULTING IN DANGER

23. OPIATES VERSUS OPIOIDS  OPIATES ARE CONCENTRATED FROM THE OPIUM POPPY PLANT AND ARE NOT MADE, BUT PURIFIED FROM THE PLANT FLUIDS, LIKE MAPLE SYRUP  OPIOIDS ARE MANUFACTURED AND DO NOT COME FROM PLANTS  OPIATES AND OPIOIDS ACT THE SAME IN THE BRAIN

24. SOME COMMONLY ABUSED OPIATES ARE: HEROIN OXYCODONE PERCOCET VICODIN METHADONE MORPHINE VICODIN TYLENOL #3 TYLOX CODEINE DEMEROL DARVOCET FENTANYL DILAUDID OPIUM HYDROCODONE PERCOCET PERCODAN

25. OPIATES AND OPIOIDS  AFTER PROLONGED USE OF THESE SUBSTANCES INCREASING AMOUNTS ARE NEEDED FOR THE SAME EFFECTS  COMMON SIDE EFFECTS INCLUDE NAUSEA AND VOMITING DROWSINESS ITCHING DRY MOUTH SMALL PUPILS CONSTIPATION

26. WHO IS AT RISK?  THE DRUG ADDICT  INDIVIDUALS USING MEDICAL VISITS AND CARE FROM MULTIPLE DOCTORS WHO ARE NOT FOLLOWING INSTRUCTIONS ABOUT PRESCRIPTION USE  USERS OF PRESCRIPTIONS THAT SHOULD BELONG TO SOMEONE ELSE  USERS WHO INJECT DRUGS FOR GREATER EFFECT  FORMER USERS WHO ARE RECENTLY RELEASED FROM PRISON OR WHO ARE ENTERING AND EXITING FROM DRUG TREATMENT PROGRAMS

27. BUT WHO ELSE?  ELDERLY PATIENTS USING OPIATES OR OPIOIDS FOR PAIN  PATIENTS USING PAIN RELIEVING PATCHES INCORRECTLY  CHILDREN WHO ACCIDENTALLY TAKE PAIN KILLERS IN THEIR HOMES OR THE HOMES OF OTHERS

28. NALOXONE

29. Generic Name : Naloxone Hydrochloride

30. BRAND NAME : NARCAN®

31. ANOTHER OPTION

32. WHY INTRANASAL NARCAN?  VERY LOW RISK OF EXPOSURE TO BLOOD (NO NEEDLES)  CAN BE ADMINISTERED QUICKLY AND WITH LITTLE TRAINING  ONSET OF ACTION IS QUICK  VERY EFFECTIVE WHEN USED

33. NALOXONE IS.. NALOXONE DOES…  IS A DRUG WHICH REVERSES OPIATE OVERDOSES  TEMPORARILY TAKES AWAY THE HIGH AND GIVES THE PERSON A CHANCE TO BREATHE  WORKS IN 1 – 3 (SOME SAY 3 – 5) MINUTES AND LASTS 30 – 90 MINUTES. PEAKS AT 12 – 20 MINUTES  CANNOT BE ABUSED

34. NARCAN IS ONLY USED FOR OPIATE OVERDOSES NARCAN WILL NOT WORK ON COCAINE, LSD, ECSTASY, SEDATIVES/TRANQUILIZERS AND MARIJUANA.

35. NARCAN FACTS  DOES NOT CAUSE OVERDOSE  CONTRAINDICATED IF A PERSON IS SENSITIVE TO THE DRUG  TOO MUCH NARCAN CAN CAUSE WITHDRAWAL SYMPTOMS NAUSEA/VOMITING DIARRHEA CHILLS MUSCLE DISCOMFORT DISORIENTATION COMBATIVENESS

36. ABOUT NARCAN NARCAN IS SAFE AND EFFECTIVE NARCAN HAS NO EFFECT ON NON-OPIOID OVERDOSES

37.  ENDO PHARMACEUTICALS BROUGHT NARCAN® TO THE MARKET IN THE 1960'S  NARCAN® IS CURRENTLY AVAILABLE GENERICALLY UNDER THE NAME NALOXONE

38. NARCAN®/NALOXONE HAS BEEN USED IN EMERGENCY ROOMS AND EMS FOR MORE THAN FORTY YEARS AS AN ANTIDOTE FOR OPIATE OVERDOSES.

39. PHARMACOLOGY FACTS  OPIOIDS ARE SEDATIVE NARCOTICS  USED PRIMARILY IN PAIN RELIEF  REPRESS THE URGE TO BREATHE  THERE ARE STREET OPIOIDS AND PRESCRIPTION OPIOIDS  OPIOIDS VARY IN HOW LONG THEY LAST DEPENDS ON HOW THEY ARE CONSUMED

40. AN OPIATE OVERDOSE IS..  WHEN OPIATES SETTLE IN THE PART OF THE BRAIN THAT REGULATES BREATHING.  THE IMMEDIATE CONCERN DURING AN OPIATE OVERDOSE IS RESPIRATORY DEPRESSION.

41.  THE EFFECTS OF NALOXONE WEARS OFF BETWEEN 30- 60 MINUTES AFTER ADMINISTRATION  HEROIN LASTS 6-8 HOURS  METHADONE LASTS 24 HOURS  OPIATES OUTLAST NALOXONE  BE PREPARED FOR THE PATIENT TO RELAPSE

42. WHEN AM I SUPPOSED TO GIVE NARCAN © ??????

43. SCENE SAFETY  UNIVERSAL PRECAUTIONS  WHERE ARE THE NEEDLES  HAZARDOUS MATERIALS

44. WHAT AN OPIOID OVERDOSE LOOKS LIKE

45. SIGNS AND SYMPTOMS IN ADDITION TO A KNOWN HISTORY OF OPIATE ABUSE, RESPONDERS SHOULD LOOK FOR:  WEAK/THREADY PULSE  SLOW OR ABSENT RESPIRATIONS  CONSTRICTED PUPILS  WEAKNESS/UNRESPONSIVENESS

46. OFTEN THE PATIENT IS…  NOT RESPONSIVE WHEN SHAKEN  POSSIBLY NOT BREATHING WELL OR AT ALL  POSSIBLY BREATHING LESS THAN 6 BREATHS PER MINUTE  HAVING A BLUISH COLOR OF THE SKIN, NAILS OR LIPS  CONSTRICTED PUPILS

47. JUST HIGH/OVERMEDICATED SMALL PUPILS DROWSY, BUT AROUSABLE RESPONDS TO STERNAL RUB SPEECH IS SLURRED DROWSY, BUT BREATHING 10 OR MORE TIMES PER MINUTE STIMULATE AND OBSERVE OVERDOSE SMALL PUPILS NOT AROUSABLE NO RESPONSE TO STERNAL RUB NOT SPEAKING BREATHING SLOW OR STOPPED < 10 TIMES PER MINUTE MAY HEAR CHOKING SOUNDS OR A GURGLING/SNORING NOISE BLUE/GRAY LIPS OR FINGERTIPS RESCUE BREATHS/NARCAN Just high/overmedicated vs. overdose

50. ADVERSE REACTIONS  RUNNY NOSE  SWEATING  FAST HEART RATE  SHAKES  HIGH OR LOW BLOOD PRESSURE FEAR OF CAUSING WITHDRAWAL SHOULD NOT PREVENT USE WHEN THE PERSON IS UNRESPONSIVE.

51. ADMINISTRATION  FIRST RESPONDER ADMINISTRATION OF NARCAN © WILL BE INTRA-NASALLY.  A PRELOADED SYRINGE WILL BE AFFIXED WITH A MUCOSAL ATOMIZATION DEVICE (MAD)  PRE LOADED SYRINGES CONTAIN 2 MG IN 2 ML.  PER STATEWIDE TREATMENT PROTOCOLS FOR EMTS AND PARAMEDICS THE DOSE FOR NALOXONE IN 0.4- 4.0 MG AND MAY BE REPEATED IF NECESSARY

52. STORAGE OF NARCAN ©

53. INTRANASAL NALOXONE  INTRANASAL NALOXONE NEEDS TO BE DISPENSED WITH THE MUCOSAL ATOMIZATION DEVICE  IF THERE IS NASAL TRAUMA OR BLEEDING, DO NOT ADMINISTER NALOXONE BENEFITS OF INTRANASAL NALOXONE  NOSE IS AN EASY ACCESS POINT  ELIMINATES RISK OF CONTAMINATED NEEDLE STICKS AND NEEDLE DISPENSING  PAINLESS

54. GIVE NALOXONE: INTRANASAL 1.REMOVE BOTH YELLOW CAPS FROM THE ENDS OF THE SYRINGE 2.TWIST THE NASAL ATOMIZER ONTO THE TIP OF THE SYRINGE 3.REMOVE THE PURPLE CAP FROM THE NALOXONE 4.TWIST THE NALOXONE ON THE OTHER SIDE OF THE SYRINGE

55. GIVE NALOXONE: INTRANASAL  PUSH 1ML (1MG) OF NALOXONE INTO EACH NOSTRIL  ADMINISTER THE ENTIRE CONTENTS OF THE 2ML SYRINGE WITH APPROXIMATELY ONE HALF (1ML) ADMINISTERED IN EACH NOSTRIL  ADMINISTERING ONE HALF IN EACH NOSTRIL MAXIMIZES ABSORPTION

57. HOW DOES A PERSON RESPOND TO NALOXONE? Scenarios: 1.Gradually improves breathing and becomes responsive within 3 – 5 minutes 2.Immediately improves breathing, responsive, and is in withdrawal 3.Starts breathing within 3 – 5 minutes but remains unresponsive 4.Does not respond to first dose and naloxone must be repeated in 3 – 5 minutes (keep rescue breathing)

58. REACTIONS TO NALOXONE Post-Naloxone Withdrawal Symptoms in First Responder Rescues: 2010-2013 Total None47 (40%) “Dope Sick”27 (23%) Irritable or Angry33 (28%) Physically Combative6 (5%) Vomiting16 (14%) Other14 (12%)

59.  CONTINUE RESCUE BREATHING WITH 1 BREATH EVERY 5 SECONDS UNTIL EMERGENCY RESPONDERS ARRIVE  AFTER 3-5 MINUTES, IF THE PATIENT IS STILL UNRESPONSIVE WITH SLOW OR NO BREATHING, ADMINISTER ANOTHER DOSE OF NALOXONE After Administering Naloxone (If not breathing)

60. RESPOND TO OPIOID OVERDOSE: NALOXONE ADMINISTRATION KEEP IN MIND…  NALOXONE’S ONLY FUNCTION IS TO BLOCK THE RECEPTORS WHERE OPIOIDS WOULD BE; IF NO OPIOIDS ARE PRESENT, THERE IS NO EFFECT FROM HAVING NALOXONE ADMINISTERED.  NALOXONE WILL NOT MAKE A PERSON FEEL HIGH.  NALOXONE ONLY TREATS THE EFFECTS OF OPIOIDS; IT WILL NOT TREAT THE EFFECTS OF ALCOHOL, COCAINE, OR OTHER SUBSTANCES.  THE ONLY CONTRAINDICATION FOR NALOXONE IS AN ALLERGY TO NALOXONE, WHICH IS RARE.  BECAUSE NALOXONE STOPS THE EFFECTS OF OPIOIDS, AN OPIOID-DEPENDENT PERSON MAY EXPERIENCE WITHDRAWAL SYMPTOMS.

61. RESPOND TO OPIOID OVERDOSE: RECOVERY POSITION

62. QUESTIONS AND ANSWERS  WILL NALOXONE WORK ON AN ALCOHOL OVERDOSE?  NO. NALOXONE ONLY WORKS ON OPIOIDS  WHAT IF IT IS A CRACK/COCAINE OR SPEED/METHAMPHETAMINE OVERDOSE?  NO. NALOXONE ONLY WORKS ON OPIOIDS  WHAT IS THE RISK PERIOD FOR AN OVERDOSE TO REOCCUR AFTER GIVING NALOXONE?  DEPENDS ON HOW LONG ACTING THE OPIOID IS AND HOW MUCH THEY TOOK  IF THE PERSON ISN’T OVERDOSING AND I GIVE THEM NALOXONE WILL IT HURT THEM?  NO. IF IN DOUBT GIVE NALOXONE.

63. JUST A LITTLE MORE NALOXONE IS NOT IN THE DEA SCHEDULE OF DRUG CLASSES, YET REQUIRES A PRESCRIPTION NALOXONE HAS NO POTENTIAL FOR ABUSE

64. NALOXONE HAS NO OTHER PURPOSE BESIDES REVERSING AN OPIATE RELATED OVERDOSE. NALOXONE HAS NO MIND ALTERING EFFECTS

65. NALOXONE IS THE ONLY TREATMENT IN MEDICINE THAT LITERALLY CANNOT HURT ANYONE. THE ONLY POSSIBLE EFFECT IS THE INDIVIDUAL MAY BECOME DOPE SICK (WITHDRAWAL).

66. PROGRAMS THAT WORK WITH DRUG USERS ARE EDUCATING THEM IN THE USE OF NALOXONE. THE CHICAGO RECOVERY ALLIANCE HAS BEEN PROVIDING NALOXONE IN COOK COUNTY, IL SINCE 2001 FROM THE 2011 ANNUAL REPORT CHICAGO RECOVERY ALLIANCE REPORTS 2,972 PEER REVERSALS USING NALOXONE SINCE THE PROGRAMS INCEPTION.

67. BOTTOM LINE NOBODY NEEDS TO DIE FROM AN OPIATE OVERDOSE

68. LET’S PLAY…

69. QUESTIONS??????