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Tapestry Overdose Prevention and Narcan

Tapestry Overdose Prevention and Narcan. Topics. What are Opiates/What is an Opiate Overdose? What is N arcan / Naloxone? What puts at risk? Fentanyl Signs and symptoms How to respond to an Opioid overdose Good Sam Law. Tough Stuff. Opioids? Opiates?.

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Tapestry Overdose Prevention and Narcan

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  1. TapestryOverdose Prevention and Narcan

  2. Topics • What are Opiates/What is an Opiate Overdose? • What is Narcan/ Naloxone? • What puts at risk? • Fentanyl • Signs and symptoms • How to respond to an Opioid overdose • Good Sam Law

  3. Tough Stuff

  4. Opioids? Opiates? • Opiates are drugs derived from opium= natural component • At one time "opioids" referred to synthetic opiates only (drugs created to emulate opium, however different chemically). • Now the term Opioid is used for the entire family of opiates including natural, synthetic and semi-synthetic.

  5. Opioids Semi-synthetic Natural Fully synthetic MorphineCodeine Fentanyl Methadone Buprenorphine Heroin Oxycodone

  6. Heroin

  7. Opiate OverdoseWhat is happening to the body and brain? • **Essentially an opiate overdose is a slow shut down of the respiratory system** • Opioids smother the receptors in the brain which control breathing • If goes untreated the 5 majors organs will shut down

  8. What is Narcan? • Opiate antagonist –medication that’s CAN HELP reverse an opiate overdose • Active for 30 to 90 minutes- shorter with fentanyl • Usually works within 2 min but, may take up to 5 minutes to work

  9. Naloxone Formulations Currently Available Multi-Step Nasal Auto-injector Single-Step Nasal IM Naloxone

  10. Who is at Risk for Overdose: • Anyone who has taken time off from using eg. Detox, residential program or Jail • ANYONE- experienced users or new users • Someone who has OD in the past and survived….why? • Those who smoke opioids, snort and inject

  11. What puts you at risk? • Tolerance: • Long term abstinence • Short term abstinence • Mixing Drugs ( intentionally/ unintentionally): • Benzo’s / alcohol • Trazadone/ Seroquel • Physical health -Hep C/ HIV poor nutrition, lack of sleep • Purity of drugs Variation in strength and content of “street drugs” • Accounts for increase in overdoses- fentanyl • Using Alone

  12. A Few words about Benzos: Klonopin, Xanax, Ativan, Valium • They are long acting (can last days in the system) • Half life for Klonopin 30-40 hrs; Xanax 11 hrs (depending on dosage) • Makes people who are in opiate withdrawal feel better (eases anxiety) • To get jammed (enhance the effects of heroin) • They impair your short term memory. So you may actually forget how many you have taken in the last 24hrs.

  13. Fentanyl This image compares lethal doses of both heroin and fentanyl for someone with no opioid tolerance

  14. About Fentanyl • Created for the intent to relieve pain/ injected prior to surgery’s • Can be prescribed as a patch or lozenge • 30- 50x more potent than heroin • 50-100x more potent than morphine In MA Over 50% of 2015’s confirmed opioid-related overdose deaths with a toxicology screen had a positive screen for fentanyl.

  15. About Fentanyl

  16. About Fentanyl Black Tar (West Coast) Mexican drug cartels increase the production as it is much cheaper to make then heroin. Cartels are getting your Fentanyl from China. Fentanyl can be made anywhere from chemicals. That knocks out several steps in the supply chain, no crops of opium to grow, harvest and transport.

  17. Harm Reduction: Preventing an Overdose • Go slow, don’t push too fast • Don’t use alone • Tester shots • Safe injecting practices • Know your dealer • Assess and Link to Care and Treatments Keep it simple and individualized!!No need to over complicate and confuse folks.

  18. Really high or overdose? Really high Overdose Not responsive • No response to sternal rub • Not speaking • Breathing slow or stopped • Less than 8 times per minute • May hear choking sounds or a gurgling/snoring noise • Blue or purple lips/fingertips • Gray, cold, clammy skin • Nodding, but responsive • Responds to sternal rub • Speech is slurred • Sleepy, intoxicated, but breathing • 8 or more times per minute >> Stimulate and observe >> Call for help + rescue breathe + give naloxone

  19. Signs and Symptoms… • Breathing is very slow, irregular, or has stopped • Choking sounds or a gurgling/snoring noise • unable to respond • Blue skin tinge- usually lips and fingertips show first • Face very pale • Pulse (heartbeat) is slow, erratic, or not there at all • Passing out

  20. How to respond to an OD • Assess the signs • Stimulation • Narcan • Call 911 • If they do not wake immediately after administering 1 dose of Narcan= rescue breathing 1 breath every 5 seconds • After the 2-3 minutes of rescue breathing if the person has not responded you may now administer the second dose of Narcan

  21. If you must leave the person: Recovery Position

  22. Calling 911 • It is importantto call 911 because: • Narcanonly works on opioids • not benzos, cocaine, alcohol or other drugs • Person overdosing may have other medical issues. • Person can overdose again once narcan wears off

  23. Naloxone components Prefilled ampoule of naloxone- comes in the box Mucosal Atomization Device (MAD)- nasal attachment, comes in bag separately Plastic delivery device- looks like barrel of a syringe, comes in the box

  24. SINGLE-STEP NARCAN NASAL SPRAY

  25. Single Step Nasal Spray Administration

  26. Important Points for Single Step Narcan • Do not prime the spray • you will end up wasting it • Insert the tip until your fingers are against the nose • One dose is one nostril • If 2nd dose is needed- use other nostril • Nasal trauma will reduce the effectiveness

  27. Street Methods Now Have Better Alternatives Applaud people’s ability to figure out how to keep people alive. Street knowledge about how to treat an overdose often works. Mostly, the reason why street methods have worked is due to stimulation • Nunca… • Leave the person alone • Put them in a bath • Induce vomiting • Put ice down their pants • Slap, kick, punch, or cause harm • Inject them with anything (saltwater, cocaine, milk) These methods of stimulation take more time and can add more risk. There is a better alternative form of stimulation: the Sternal Rub

  28. Good Samaritan Law Massachusetts - Passed in August 2012: • Protects people who overdose or seek help for someone overdosing from being charged or prosecuted for drug possession • Protection does not extend to trafficking, distribution charges, or warrants, public housing/ section 8, children in home

  29. RefillsIf lost, expired or used during an overdose: • Tapestry Health Needle Exchange 15A Main St. Holyoke, Ma 01040 (413) 315 3732 x1 • Tapestry Health-La Voz 130 Maple St. (lower Level) Springfield, Ma 01103 (413) 363 9472

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