1. Opioid Rescue Kits for Porter County Sheriff’s Department

2. The Opioid Problem  Lethal Drug dose is the leading cause of accidental death in America  41,502 drug overdose deaths in 2012  39% caused by opioids  Lethal Drug doses have quadrupled in Indiana since 1991 12/7/2014www.overdose-lifeline.org 2

3. The Opioid Problem  Opioids include legal prescriptions and illegal drugs  Prescription Diversion  Heroin  Porter County is a HIDTA since 2011 12/7/2014www.overdose-lifeline.org 3

4. The Opioid Problem  Paths to Prescription Drug Addiction  39 year-old with back pain  17 year-old riffling through their friend’s grandma’s medicine cabinet  Star DE getting some “safe” meds from a buddy to make the next game 12/7/2014 www.overdose-lifeline.org 4

5. The Opioid Problem  Paths to Heroin Addiction  Prescription Drug Addiction  Limiting supply of prescription opioids didn’t solve the problem of addiction  Girls/women: introduced to Heroin by a boy/man  Lower cost, higher purity www.overdose-lifeline.org 5

6. The Opioid Lethal Dose  Forgets to Breathe  Central Nervous System depression  Opioid overdoses is rarely instantaneous  Most deaths occur between one to three hours after taking the opioid  Someone “found dead with a needle in their arm” uncommon, but happens, especially when using opioids + others substances 12/7/2014 www.overdose-lifeline.org 6

7. How do opioids affect breathing? Opioid Receptors, brain Opioid 12/7/2014 www.overdose-lifeline.org 7

8. How does naloxone affect overdose? Neutralizes opioid’s effect on receptors 12/7/2014 www.overdose-lifeline.org 8

9. Why Use Naloxone?  No Euphoric effect  Safe  Even if a person isn’t overdosing on an opioid  Similar to: CPR, AEDs, EpiPens  Proven track record  From 1996-2010:  53,032 people trained  10,171 people saved  Saves Money A life saved can be a life restored 12/7/2014 www.overdose-lifeline.org 9

10. Myths: Why Not Use Naloxone?  If those with substance use disorder know that Naloxone can save their life, they will abuse more drugs  Naloxone will keep people from seeking treatment  People can be violent after receiving Naloxone 12/7/2014 www.overdose-lifeline.org 10

11. Positive Tests for Opiates Porter Country Adult Population 2003-2013 12/7/2014 www.overdose-lifeline.org 11

12. Opiate Patients Treated 12/7/2014 www.overdose-lifeline.org 12

13. PRH E.R. Opioid Admissions 12/7/2014 www.overdose-lifeline.org 13

14. Opioids by Age 12/7/2014 www.overdose-lifeline.org 14

15. Total Number of Opioids Prescribed --1991-2013 12/7/2014 www.overdose-lifeline.org 15

16. HIDTA Chronic Addicts 12/7/2014 www.overdose-lifeline.org 16

17. Heroin-Related Deaths in Porter County 2003-2013 12/7/2014 www.overdose-lifeline.org 17

18. Potential Naloxone Opportunities 12/7/2014 www.overdose-lifeline.org 18

19. Common Opioids  Codeine  Demerol  Vicodin  Oxycontin  Hydrocodone  Lorcet  Methadone  Used as a Medication- Assisted Treatment  Porter-Starke uses liquid methadone  Can be abused  Morphine  Opium  Heroin 12/7/2014 www.overdose-lifeline.org 19

20. Common Opioids Natural Morphine Codeine Semi-synthetic Fully synthetic Heroin Oxycodone Fentanyl Methadone Buprenorphine 12/7/2014 www.overdose-lifeline.org 20

21. Symptoms of Opioid Overdose  Decreased level of consciousness  Pinpoint pupils  Gurgling or choking noises  Body is Limp  Breathing slows or stops  Heart rate slows or stops  Blue lips and nails  Caused by insufficient oxygen in the blood  Can’t be woken or can’t speak, even after:  shaken or  sternal rub 12/7/2014 www.overdose-lifeline.org 21

22. Environmental Signs of Opioid Use  Spoons  Needles  Tourniquet  Lighter  Balloons or baggies  Pill Bottles 12/7/2014 www.overdose-lifeline.org 22

23. Each Narcan has a expiration date on the end of box None of the contents are sharp 12/7/2014 www.overdose-lifeline.org 23

24. Naloxone Facts  This is NOT Pulp Fiction  You won’t be stabbing anyone in the heart  Usually works in about 3 minutes  Lasts 30 to 90 minutes  Opioids can last longer than Naloxone  Won’t eliminate the opioid from the system 12/7/2014 www.overdose-lifeline.org 24

25. 12/7/2014 www.overdose-lifeline.org 25

26. Administration of Naloxone Patient should be unresponsive first and foremost If no pulse and no breathing  Start CPR If pulse and no or slow breathing  Use Naloxone Open kit and assemble Place firmly against right nostril and spray half Place against left nostril and spray remainder Provide Rescue Breathing, as needed If it works usually patient will moan, increase breathing or become combative with in 1- 5 minutes Advise changes and updates to Medics 12/7/2014 www.overdose-lifeline.org 26

27. Recovery position 12/7/2014 www.overdose-lifeline.org 27

28. Porter County Sheriff’s Department Policy-- Highlights  Civil Immunity  If you follow the protocol in good faith, you will be protected from civil law suits (by state law)  Reporting  Use or loss  Expiration  Kit Storage  Don’t store kit in extreme temperatures 12/7/2014 www.overdose-lifeline.org 28