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Naloxone… Give One More Chance

Naloxone… Give One More Chance. Kentucky Harm Reduction Coalition Naloxone Training. Harm Reduction Coalition Naloxone Training. PRESENTED BY Louisville, Kentucky.

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Naloxone… Give One More Chance

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  1. Naloxone… Give One More Chance

  2. Kentucky Harm Reduction CoalitionNaloxone Training Harm Reduction CoalitionNaloxone Training • PRESENTED BY • Louisville, Kentucky

  3. Reduce addiction overdoses and deaths, the stigma associated with addiction, and to offer harm reduction solutions which includes improving public health in Kentucky and Southern Indiana. MISSION

  4. Learning Objectives • Identify names of various opiates; • Recognize the signs & symptoms of an opiate overdose; • Learn how to respond to an opiate overdose; • Explain how to use intranasal Narcan to treat an opiate overdose; • Describe the steps in aftercare of an opiate overdose.

  5. What do opiates & opioids do? • Opioids & opiates are depressants and they Slow down your central nervous system, including: Your breathing.

  6. 2 • Breathing stops • 3 • Lack of oxygen may cause brain damage • 4 • Heart stops • 5 • Death How overdose occurs. • 1 • Slow breathing • Opioids repress the urge to breathe • Carbon dioxide levels increase • Oxygen levels decrease • There is time to respond, but no time to waste • 4 minutes until brain death occurs • Oxygen #1 need

  7. Opioid Naloxone Opioid receptor DOES NOT REMOVE OPIOID FROM BLOOD STREAM How does Naloxone work? Naloxone 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. • Naloxone has a stronger affinity to the opioid receptors. • Knocks the opioid off the receptors. • Naloxone temporarily sits on receptors. • Last 30-90 minutes. 28

  8. How to recognize an opiate overdose

  9. Notice the pupil on your right, it is very pinpoint. Opiates will cause both pupils to be very tiny and pinpoint. Blue gray lips Overdose symptoms Blue finger tips

  10. Do the Math! It May Save Your Life! • Fentanyl is 100 x more potent than morphine. • Fentanyl is 40-50 x more potent than heroin. • Carfentanil is 100 x more potent that fentanyl. • Carfentanil is 10,000 x more potent than heroin. 1 gram = 1000 milligrams (mg) 2 mg of fentanyl can cause 1 death 2 mg of carfentanil can cause 100 deaths 1 gram of fentanyl can cause 500 deaths 1 gram of carfentanil can cause 50,000 deaths

  11. What is Naloxone or “Narcan?” • Naloxone an opioid antagonist. Can reverse an opioid overdose. • Blocks opioids from attaching to receptors in the brain. • Patented in 1961 by Sankyo. • Used in hospitals. 14

  12. NOT Opioids: • Cocaine • Methamphetamines • Valium • Xanax • Flakka • Spice • Kratom • Alcohol Naloxone only works on opiatesDoes not work on any other drug

  13. Naloxone Facts • Is not addictive, no psychoactive effects. • Naloxone given to someone not experiencing an opiate overdose is usually harmless. • May produce immediate withdrawal symptoms. • Withdrawals are usually not life threatening, but secondary deaths have been reported from dehydration. 2

  14. How is Naloxone given?There are 3 FDA-approved formulations of Naloxone • Injectable (IV or IM) • EVZIO Auto-injectable • Prepackaged Nasal Spray 24

  15. ADAPT Intranasal NarcanTWO DOSES PER BOX

  16. ADAPT Intranasal NarcanHOW TO OPEN PACKAGE & SPRAY INTO NOSE

  17. Storage & Expiration • Storage information is on box (Room temperature 59-77, protect from light, excursions permitted up to 104, DO NOT FREEZE) • Expiration date is on box • Shelf life: 2 years

  18. STEPS FOR RESPONDING TO AND REVERSING AN OPIATE OVERDOSE 54

  19. Assessment & Stimulation • Stimulation: • Shake person’s shoulder and yell their name: [NAME] “Are you alright?” “Wake up.” • If no answer do a sternum rub: Make a fist, rub your knuckles firmly up and down the breast bone. • Assess signs: • Is the person breathing? • Is the person responsive? • Do they answer when you shake or call their name? • Can the person speak? • How is their skin color (lips/fingertips?) • Stimulation • f the person is unconscious or in a heavy nod, try to wake them up:  Call his or her name and/or say something that they might not want to hear, like “I’m going to call 911” or“I’m going to give you naloxone.” • If this does not work, try to stimulate him or her with mild pain by rubbing your knuckles into the sternum (the place in the middle of your chest where your ribs meet), rubbing your knuckles on their upper lip. The sternum is preferable over the upper lip, because the person may have dental problems, or prosthetic teeth that may cause pain or unnecessary discomfort when rubbed vigorously. However, if the person is in a position where you cannot get to their sternum easily, or if they are wearing multiple layers of heavy clothing, rub the upper lip area.

  20. STEP 1: Call 911 • Clearly give address or nearest intersection. • Stick to what you see: “not breathing” “turning blue” “unconscious” “not responsive”. • Police will be dispatched to the scene for a suspected overdose. • Scene has to be cleared as “safe” before EMS can enter.

  21. STEP 2: Clear Airway, Rescue Breathing • It is important that the person’s airway is clear, so air can get into their lungs. • Place person on their back, and tilt their chin up. • Check to see if there is anything in their mouth blocking their airway: gum, pills, patches, food; remove them.

  22. Pinch nose Cover mouth with barrier provided in kit Give breaths Rescue Breathing (continue) RESUCE BREATHING IS ONE OF THE MOST IMPORTANT STEPS IN PREVENTING AN OVERDOSE DEATH • Give 1 breath every 5 seconds. • Do this for 30 seconds.

  23. DO NOT PRIME OR TEST MEDICATION BEFORE SPRAYING IN NOSE MEDICATION IS DOUBLE STRENGTH AND CONCENTRATED STEP 3: Give Naloxone • Peel package. • Place in hand. • Press medicine in nose.

  24. Resume Rescue Breathing • Resume rescue breathing if person does not awaken from first dose of Naloxone. • Rescue breathing: 1 breath every 5 seconds for 2 minutes.

  25. Give 2nd Dose of Naloxone • After 2 minutes of rescue breathing, give 2nd dose of Naloxone if person is still unresponsive maintain rescue breathing.

  26. Resume Rescue Breathing • Continue rescue breathing if person does not awaken and all Naloxone has been used! • Use more Naloxone if available!

  27. NALOXONE WILL WEAR OFF IN 30-90 MINUTES. STAY WITH PERSON. DO NOT LEAVE THEM ALONE. STEP 4: Recovery Position, Aftercare • Stay until help arrives. • Do not leave person alone. • Let person know they have overdosed and are going to hospital. • Narcan wears off & person can overdose without using again.

  28. The Wake Up • People wake up differently from an overdose. • Some people can wake up combative, most wake up confused, disoriented, and calm. • Temporary effects may include: body aches, fast heart rate, nausea, vomiting, abdominal cramps, sweating, trembling, nervousness. Usually from withdrawals. • KyHRC has no reports of adverse effects of the reversals reported. • DO NOT ALLOW OVERDOSED PERSONS TO TAKE ADDITIONAL DRUGS • LAW ENFORCEMENT ALLOWED TO MANDATE HOSPITAL TREATMENT AGAINST PERSON’S OBJECTIONS

  29. REMEMBER YOU ONLY HAVE 4 MINUTES UNTIL SOMEONE IS BRAIN DEAD! OXYGEN IS OF UPMOST IMPORTANTANCE!! OVERVIEW:Responding To An Opiate Overdose • Call 911. • Rescue breaths for 30 seconds (1 breath every 5 seconds). • Give Naloxone • Rescue breaths for 2 minutes. • Give 2nd dose Naloxone if needed. • Place in recovery position. • Stay with person until help arrives 46

  30. Naloxone Law Overview KRS 217.186 • Board and governing body of public and private schools or schools district may permit schools to keep Naloxone on premises. • Kentucky Department for Public Health develops clinical protocols to address supplies of Naloxone kept by schools. • Advise on the clinical administration of Naloxone. • Collaborates with local health departments, providers, and local schools and school districts.

  31. Naloxone Law OverviewKRS 217.186 • Provides immunity to health care provider prescribing or administering Naloxone in good faith. • Third party carriers (must immediately summon help from local public safety answering point). • Includes a person or agency: peace officers, jailors, firefighters, paramedics or emergency medical technicians, and school employees (may receive a prescription, possess, and administer). • Immunity from criminal or civil liability. • Physician approved protocol.

  32. Good Samaritan Law OverviewKRS 218A • Provides immunity for drug possession and use offenses when seeking medical assistance for overdoses. • Protects police, firefighters, EMS, other first responders and others from needle sticks and other infectious devices. • Does not extend to outstanding warrants, probation or parole violations, or other non-drug related crimes.

  33. Good Samaritan Law OverviewKRS 218A • Does not offer protection for drug offenses involving: • Sales for consideration or other benefit or gain • People guilty of trafficking in possession of amounts of narcotics listed in KRS 218A.1412 • Criminal possession of a controlled substance • Criminal sale of a controlled substance • Operating as a major trafficker • Arrest or charge for drug or alcohol possession for individuals with an open warrant for their arrest or are currently on probation/parole. • Does not extend to outstanding warrants, probation or parole violations, or other non-drug related crimes

  34. RESOURCES 1-833-8KY-HELP 1-833-859-4357

  35. RESOURCES www.KyHRC.org

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