Thank You For Attending Our NALOXONE TRAINING Goals

Thank You For Attending Our NALOXONE TRAINING

Goals Of Training Indiana Recovery Alliance Identify and Prevent Opiate Overdoses What is Naloxone How To Administer Naloxone Practice Administering Naloxone Review So What Is The IRA ?

WHAT IS THE IRA?

Indiana Recovery Alliance What Is The IRA? Grassroots Non-profit All volunteer Participant-Driven Non-coercive “Any Positive Change” Education & Advocacy with elected officials What Are Our Values? Direct Action Participatory Decision Making Voluntary Association Respect And Dignity for Participants Enough About The IRA…

OVERDOSES (OD) What is the leading cause of accidental death in adults in America ? Physiology Of An OD How To ID An OD Risk Factors For OD How To Prevent An OD Physiology

Physiology Of An Overdose After you ingest opiates, opiate receptors in brain are filled Depressed breathing results The more of the drug taken, the more breathing becomes depressed to the point 0 f not breathing at all (overdose) More than 5 minutes of not breathing could lead to permanent brain damage Rescue breathing will keep a person alive An Important Point:

RESCUE BREATHING DURING AN OPIATE OD CAN SAVE A LIFE Signs Of Overdose?

What Are Some Signs Of An Opiate Overdose? Call ‘em out…

How To Identify An OD Awake but unable to talk Body is very limp Face is Pale, clammy Lips, fingernails skin blue for lighter skinned people Lips, fingernails turn gray for darker skinned people Breathing is very slow, shallow, erratic or has stopped Unresponsive to outside stimulus Yell “The cops are here!” Yell “Narcan” Do a Sternal Rub Act Right Away!! Choking or gurgling sounds Vomiting, foaming Loss of consciousness Rescue Breathing! Risks Increasing OD?

What Risk Factors Increase The Possibility Of An Overdose? Call ‘em out…

Increased Risk of Overdose Low Tolerance (been clean for as little as three days) Mixing with other drugs (Either uppers or downers) Hot loading Type of drug / potency Using alone (Stigma) Age and physical health Previous, non-fatal OD Confusion Old age Mode of administration (snort, oral, skin pop, muscle, vein) Shame Kills / Stigma Prevent Overdoses?

What Can A Person Do To Reduce The Chances of An Opiate Overdose? Call ‘em out…

Prevent Opiate Overdoses Have naloxone on hand Don’t mix drugs Educate on OD prevention Know Your Source Don’t use alone (Sober Sitter) Partner Agreement Checklist “Taste” the shot Use less if tolerance is low Don’t use opiates What Is A Partner Agreement Checklist?

Partner Agreement Checklist ü knows OD prevention practices ü Knows if and when you want them to call 911 / go to ER ü Knows if, when and how you want them to use naloxone ü Has agreed to stay with you for support ü Knows your commitment to not use again while you wait for naloxone to wear off Tell Them That:

ASSISTED BREATHING DURING AN OPIATE OD CAN SAVE YOUR LIFE Head Tilt / Chin Lift / Pinch Nose / Breath every 5 Seconds What is Naloxone?

WHAT IS NALOXONE? Opiate Overdose Reversal Drug - that’s it - just that - nothing else Naloxone and Narcan are the same drug Why Can The IRA Distribute Naloxone?

The IRA And Naloxone Three Things IRA Must Do to Distribute Naloxone Instruct how to use naloxone 2. Offer treatment referral 3. Instruct to call 911 1. Aaron’s Law/Standing Order 1. No special certification needed for Indiana resident to carry and administer naloxone How Naloxone Works

How Does Naloxone Work? Antagonist Stronger affinity for opiate receptors than opiates Kicks opiates out for up to 90 minutes Allows resumption of breathing No euphoria Many ways to administer IV fastest intramuscular next fastest subcutaneous slowest, but longest lasting Works on ALL opiates What ‘s That Look Like?

Different Forms Of Naloxone What are common opiates?

What Are Some Common Opiates? What Drugs Are NOT Opiates? Call ‘em out… Does Naloxone Work On All Opiates?

Naloxone ONLY works on Opiates NOT 0 piates Heroin Demerol Cocaine Opana Morphine DMX Vicodin Suboxone Spice Tylenol 3 Oxycontin Percocet Methadone Fentanyl Hydrocodon e Alcohol Antihistamine Benzodiazepine Methamphetamine Should I use Naloxone If I’m Not Sure What They’ve Taken?

Use Naloxone Even If You Aren’t Sure If Opiates Are Involved Naloxone is harmless Only reverses opiate overdose Does not interact with other illicit drugs Take opiates out of equation Is Naloxone Safe?

Naloxone Is Very Safe used when delivering babies if too much sedative administered not known to interact with any other drugs invented in 1961, FDA approved in 1971 no potential for abuse we could safely inject or ingest it right now What Do If I Find An Opiate Overdose?

Keep the Naloxone Safe Keep it in the brown bag Keep it above Freezing Keep it under 80 degrees Notice the expiration

What To Do In Case Of An OD S. C. A. R. E. M. E. Stimulate Muscular injection Call 911 Evaluate and Support Airway Cleared Rescue Breathing Evaluate if Naloxone would help

SC A R E ME Stimulation Call for help Can they be awakened? If the person is not responsive Yell “Cops!” Yell “Narcan!” Sternal Rub Call 911 Tell them your friend is not breathing

S C AR E M E Airway: (A&B of Life) Roll on back Tilt head Clear airway Pinch Nose Rescue Breathing First: 2 quick breaths Then: 1 big breath every 5 -7 seconds Make sure: Watch the chest to make sure it rises & falls You are NOT doing CPR just rescue breaths Don’t forget…

ASSISTED BREATHING DURING AN OPIATE OD CAN SAVE A LIFE

SCARE ME Evaluate for Naloxone Muscular Injection Are they better? Can you get naloxone quick enough for them so they don’t go too long without assisted breathing? Only 1 cc / 1 ml Could safely do 2, or 3, or 10 cc/ml BUT they will be more sick and possibly combative Thigh, upper arm or ass / hip Needle will go through clothing, leather, etc THIS IS NOT PULP FICTION

SCARE ME Evaluate And Support Is the person breathing on their own? Is another dose needed? They will start feeling better in about 15 minutes 30 - 90 minutes naloxone will wear off, OD could come back on long acting opioids (methadone, oxy, very rare to return) Support them and stop them from using again, Naloxone works for 30 -40 minutes, so on long lasting opiates (methadone, oxy) overdose may return RECOVERY POSITION (lying on the side) is used to prevent aspiration What’s the Recovery Position?

SCARE ME

SCARE ME Coming out of an OD with Naloxone ER uses IV Naloxone with a concentration of 2 mg, severe withdrawals We use IM Naloxone with 0. 4 – 0. 9 mg - Much more gentle - Only a few people have reported vomiting - Wears off in 30 -40 minutes *Note the difference between dosage and concentration

SCARE ME(after 5 minutes) Are they coming around? YES: Support them, help them, don’t let them use NO: Re-administer naloxone, after 3 doses, call 911 One hour later, are they getting sleepy again? YES: May need another dose of naloxone NO: Watch closely for at least another hour

These Techniques DO NOT Work If Someone Is Not Breathing Milk Salt water Beat 'em Silly Ice water Video time!

Watch it Youtube Video LIVE! Using Nalxone to Reverse Opiate Overdose Chicago Harm Reduction Coalition https: //www. youtube. com/watch? v=U 1 fr. PJo. Wtkw Practice time!

Practice Time! 1. Uncap naloxone vial 2. Tighten syringe with a twist 3. One cc of air in syringe 4. Put needle into liquid 5. Draw up 1 cc naloxone 6. Hit ‘em in the arm, ass or thigh 7. Recap the syringe safely 8. Dispose of syringe While you are doing all of this…

DON’T FORGET TO BREATH FOR THEM!

Practice Time! • Auto Injector Trainer • Dispose of Auto Injector

Review of what to do: S. C. A. R. E. M. E. Stimulate Muscular injection Call 911 Evaluate and Support Airway Cleared Rescue Breathing Evaluate if Naloxone would help

Dead Addicts Don’t Recover “It used to be, you talked about overdose in the past tense: ‘I HAD a friend who OD’d. ’ Now, overdose is in the present tense: ‘I HAVE a friend who OD’d last week, but it’s OK. He’s all right. ”

Where And How To Get Naloxone

How to get Naloxone Where to find it IRA Lucky’s Market CVS Walgreens Williams Brothers Overdose Lifeline How to Pay for it IRA (free!!) Insurance Commercial HIP Self-Pay

Where To Get Help Get Clean Stay Healthy IRA Centerstone Amethyst House Recovery Engagement Center Restorative Solutions Positive Link Volunteers in Medicine Futures Family Planning Planned Parenthood Primary Physician

Contact – Volunteer, Donate, Get Help, Get Educated Indiana Recovery Alliance PO Box 394 Bloomington, IN 47402 812 -964 -9497 indianarecoveryalliance. org facebook. com/indianarecoveryalliance

Be careful out there, and let us know if we can be helpful.