1. Presented By: Mary Wheeler Street Outreach Coordinator CAB Health and Recovery Services Inc., Lynn, MA

2. On average 2 people a day die of an opiate overdose in Massachusetts. New England’s opiate use is 35% higher than the rest of the US. In 2008 a reported 644 people died from drug overdose. The Narcan program in MA has reversed over 500 overdoses. The 500 overdose reversals were primarily done by active drug users to other active drug users.

3. Fentanyl and Methadone are synthetic opioids (man-made) Heroin, Percoset, Vicodin and Oxycontin are semi-synthetic opioids Opiates and Opioids are used for primarily pain management Used for people with chronic pain (ex. cancer or HIV/AIDS) Easily and widely abused Regular use leads to tolerance People must take higher doses to feel effects Severe withdrawals Euphoria, warm, relaxed, dry mouth, pinned pupils, nausea/vomiting, suppresion of the nervous system, “rush”, “nod” Opiates can be swallowed in pill form, drank in liquid form, smoked, snorted or injected

4. Benzodiazepines (Xanax, Klonopin, Ativan, valium etc.,) Clonidine Neurontin Cocaine Alcohol Marijuana Meth, Ecstasy, Acid, Mushrooms, Special K, Inhalants Adderall, Ritalin Cough syrup and cough medicine Motion sickness pills

5. Disfigurement from long-time use. Severe health issues such as depression, anxiety, panic disorder, HIV/AIDS, Hepatitis A, B, C. Criminal record.

6. Overdose related health issues. Fatal overdose of friends, family etc,.

7. Too much of a drug Shuts down your bodies main functions Heart Lungs Brain Liver Unconscious for a long period of time but not knowing how long Black-out Falling out on a hand, arm, leg etc., causing loss of circulation

8. Abstinence Don’t Mix Be careful after a period of not using Getting out of jail or drug treatment Never use alone Know what you are taking

9. Not breathing Irregular breathing Turning blue Shaking Sweating Seizure Can’t wake up Can’t talk Can’t hear Not responding to pain

10. Are you ok? Check for breathing Sternum or Sternal Rub If no response call 9-1-1 If they respond try to keep them talking No food or water Put them on their side in the recovery position If they do not respond do rescue breathing If you leave the scene make sure you have put them on their side

17. Medication to reverse an OPIOID overdose Blocks the drug for 20-90 minutes Starts the person breathing Works 100% if heart is beating Does not work on other types of drugs

20. You want Paramedics or Advanced Life Support Calling 9-1-1 will alert medical, fire and police Overdose is not a priority call, respiratory arrest is. “Someone here has stopped breathing.” “Someone here is in respiratory arrest.” Give your address or location They can walk you through the situation if you stay. Or you can say, “I know what to do, see you soon.”

21. Fear Drugs on them Guns/Weapons Warrants Don’t care Don’t want people to know they use. Section 8 Children

22. Stay calm Get people out of the house that do not need to be there Leave a door open so they can get in If you are giving the person rescue breathing let the medical people take over If you have given the person Narcan tell the medics If you know what drugs have been taken tell the medical people

23. Body language Stay calm, don’t make sudden moves Keep your hands where they can be seen What you say CAN be used against you, even if you are not arrested. DO NOT RUN DO NOT touch the officer Don’t resist Don’t argue, be polite Do not say anything if you get arrested Don’t give excuses or make up stories Wait for a lawyer or parent You are entitled to a free lawyer if you can’t afford one

24. Knowingly being present Possession School zone violation Conspiracy to violate drug laws Voluntary manslaughter (if someone dies) Lying to police/giving a fake name Probation/Parole Violation “Known drug user”

25. What does it feel like to see an overdose? Who would you talk to if you see something like this? Who would you talk to if you overdose or a family member overdoses? Do you have any questions, comments or concerns?