Overdose awareness and intervention

COMMON CIRCUMSTANCES IN OVERDOSE DEATHS

In own or friend’s homeWitnesses presentSometimes several hours between overdose and deathRecent overdose experience, but survivedOther drugs presentRecent abstinence or reduction in useOlder, experienced injector

MAIN DRUGS INVOLVED

Illicit opiatesMethadoneBenzodiazepinesALCOHOL

all ‘DOWNERS’…………

CAUSES AND RISK FACTORS

Tolerance levelPoly drug use. In particular, mixing different CNS depressant-type drugs (illicit & prescribed)/alcoholLonger history of drug use and HISTORY OF NON FATAL OVERDOSEDepression or very low mood?Significant life eventsPoor physical and/or mental healthUsing drugs aloneInjecting drugs (?)Homeless drug usersNot being in treatment/unsupported/’disconnected’Any others??

HIGHER RISK TIMES FOR OVERDOSE?

Times when tolerance may be lowered:During/leaving prison or custody?During/leaving rehab or hospitalBeginning/ending substitution therapy?Others?

Difficult life events:Bereavement, loss of contact with children, separation, major stress events, arrest etcHolidays/festive periods, weekendsCash windfall times ie: times with extra cash

WHAT STOPS PEOPLE DOING THE RIGHT THING?

Failure to identify overdose?Lack of knowledge of correct procedures?Panic?Fear of implicationFear of involving authorities in case of negative consequences?Police involvement?

TAKE HOME NALOXONE (2ML NALOXONE 1MG/1ML SOLUTION FOR INJECTION –

PRENOXAD INJECTION)

What it is?What it does?Is it dangerous or harmful?Storage?Who can get it?Can it be abused?What’s the law on it?Do I have to give it?

Setting up a Prenoxad injection really is a piece of....

.... handy information That you might want to familiarise yourselves with,

NALOXONE COUNTERACTS THE EFFECTS OF OPIOIDS

ONLYHeroinCodeine and DihydrocodeineMethadoneBuprenorphine (Subutex & Suboxone) partiallyTramadol, MST, Oramorph etcNOTAlcoholBenzodiazepines(Valium, Temezepan etc) although these drugs contribute to an overdose effect.

Naloxone is short acting and does NOT get rid of opiate drugs from the body.Once naloxone wears off, (after about 20-30 minutes) opiates will still be in the body and the person may become unconscious/unresponsive again It is very important to phone 999 and request an ambulance as soon as possibleNaloxone will keep someone alive until medical help arrives

unconscious and NOT

breathingAttempt to rouse casualty with voiceApproach with cautionRemove any danger if possibleAttempt to rouse with noise & touch – shout for helpPerform chin lift and assess breathingCALL 9991 cycle chest compressions and rescue breathsAdminister 0.4 mls of naloxone into outer thighContinue with 3 more cycles of rescue breaths and CPR, then administer 0.4mls naloxone again and…. STAY WITH CASUALTY

won’t wake up but is

breathingAttempt to rouse casualty with voiceApproach with cautionRemove any danger if possibleAttempt to rouse using noise and touch – shout for helpPerform chin lift and assess breathingRecovery positionThen 999, first dose naloxone injected into thigh – STAY WITH CASUALITY

Reporting the use of Naloxone

Give the ambulance crew the used pack

ORReturn the used kit (with needle still attached to syringe) to your local drug service or needle exchangeReport the usage of Naloxone to the service that supplied you

Insist on a re-supply!!

FINALLY TO THE RESISTANT WHO ARE NOW THANKFULLY IN THE MINORITY

YOU ARE ACCOUNTABLE