1. Recognition, Response and Administration of Naloxone (Narcan)
Opioid Overdose 101

2. What are opioids? Hydrocodone Heroin Oxycodone Codeine Vicodin Demerol
OxyContin
Tylenol 3
Tylox
Levorphanol
Percocet
Percodan
Heroin
Codeine
Demerol
Morphine
Darvocet
Fentanyl
Dilaudid
Methadone
Opium

3. Opioids Methadone ++++ 24-32 Hours Heroin +++++ 6-8 Hours
Oxycontin +++++
Codeine +
Demerol ++
Morphine +++
Fentanyl +++++
+ Potency
24-32 Hours
6-8 Hours
3-6 Hours
3-4 Hours
2-4 Hours

4. Opioids
Natural opioids: contained in resin of opium poppy (morphine, codeine)
Semi-synthetic opioids: created from natural opioids such as hydromorphone, hydrocodone, oxycodone, heroin etc.,
Fully Synthetic Opioids: Methadone, Fentanyl

5. What is an OPIOID Overdose?
Rarely instantaneous
Can happen 1-3 hours after use
Body has ingested more than it can handle
Opioids attack receptors that control breathing
Oxygen can’t get to the brain
Heart stops
Unconscious, Coma, Death
Long-term Brain/Nerve/Physical Damage

6. Risk Factors Tolerance Shift Mixing Drugs Physical Health
Variation in strength/content
Switching from snorting/smoking to injection
Using alone

7. What are the Signs/Symptoms of an OD?
REALLY HIGH
OVERDOSE
Muscles become relaxed
Deep snoring or gurgling (death rattle)
Speech is slowed/slurred
Very infrequent or no breathing
Sleepy looking
Pale, clammy skin
Nodding
Heavy nod, not responsive to stimulation
Will respond to stimulation like yelling, sternal rub, pinching, etc.
Slow heart beat/pulse
Blue skin tinge- usually lips and fingertips show first
Body very limp
Face very pale
Pulse (heartbeat) is slow, erratic, or not there at all
Throwing up
Passing out
Choking sounds or a gurgling/snoring noise
Breathing is very slow, irregular, or has stopped
Awake, but unable to respond

8. Response Are you alright? Are you ok? Pain Stimulus
If no response call 9-1-1
Rescue Breathing
Naloxone

9. Response Myths Salt Water Suboxone Ice On Body Cold Shower Cocaine
Milk
Burning Skin
Punching
Slapping

10. What are barriers to calling 911 from the perspective of a substance user?
Fear of legal risk (outstanding warrants, DSS involvement, loss of public housing)
Fear of judgment from family/ community
Personal embarrassment/shame
Other punitive measures (students loose federal financial aid)
Urban legends (homicide charge for being at an OD, being deported)

11. Naloxone Hydrochloride (Narcan)
Opioid Antagonist
Medication that reverses only OPIOID overdose
Can not get high on it
Can not abuse it
Stays active for minutes depending on metabolism, amount of drug used
Liver Function
If they use before the Narcan wears off
Heroin
Narcan
Narcan has a stronger affinity to the opioid receptors than the heroin, so it knocks the heroin off the receptors for a short time and lets the person breathe again.
Opioid receptor

12. Talking with Patients/Clients
Harm Reduction?
Know some street slang (does not mean YOU have to use it)
Know the street myths about response
Referrals to outside programs for Narcan
Not just people who inject are at risk for overdose.

13. Mary Wheeler Street Outreach Coordinator Christian Alba Health Educator CAB Health and Recovery Services Inc., Healthy Streets Outreach Program 280 Union Street Lynn, MA 01901
Phone: (781)
Thank You!!