MBEMSC /PIER Committee Nasal Naloxone MBEMSC /PIER Committee

Nasal Naloxone/Introduction Purpose: Early intervention can help reduce fatalities The First Responder Narcan Program is designed to educate first responders in recognizing signs and symptoms of opiate overdose

OBJECTIVES At the conclusion of this training participants will be able to: Recognize signs and symptoms of opiate overdose Initiate appropriate treatments and interventions Assemble the nasal narcan delivery device Successfully administer appropriate dosing of Nasal Narcan

Background Annually XXXX # of patients suffer from opiate overdoses in Massachusetts XXX # result in death Timely administration of Narcan has proven to reduce the # of opiate related deaths

Since officers started carrying Narcan in October 2010, 163 doses have been administered, resulting in 157 overdose reversals. In the 18 months before October 2010, there were 46 overdose related deaths. In the 18 months after the implementation of the Narcan program there were 22 overdose related deaths. Read more: PAUL KEENAN: The Quincy Narcan model is saving – and changing – lives - Quincy, MA - The Patriot Ledger http://www.patriotledger.com/topstories/x1590647422/PAUL-KEENAN-The-Quincy-Narcan-model-is-saving-and-changing-lives#ixzz2VUSpPut3 Under Creative Commons License: Attribution Non-Commercial Follow us: @patriotledger on Twitter | patriotledger on Facebook

Naloxone

Naloxone Hydrochloride Generic Name : Naloxone Hydrochloride

Brand Name : Narcan®

Endo Pharmaceuticals brought Narcan® to the market in the 1960's Narcan® is currently available generically under the name Naloxone

Naloxone is.. An opiate antagonist which reverses opiate overdoses Some commonly abused opiates are: Heroin Oxycontin Percocet Vicodin Methadone Morphine

Narcan®/Naloxone has been used in emergency rooms and EMS for more than forty years as an antidote for opiate overdoses.

Pharmacology Opiates produce their effects as an agonist on the mu receptors in the central nervous system Mu¹ receptors are responsible for a large portion of analgesic (pain management) effects Mu² receptors are responsible for respiratory distress

Naloxone kicks opiates out of the brain by blocking certain receptor sites. Naloxone occupies the receptor sites and prevents opiates from binding to the brain. Naloxone in conjunction with rescue breathing has life saving potential.

An opiate overdose is.. When opiates settle in the part of the brain that regulates breathing. The immediate concern during an opiate overdose respiratory depression.

BE PREPARED FOR THE PATIENT TO RELAPSE The effects of Naloxone wears off between 30- 60 minutes after administration Heroin lasts 6-8 hours Methadone lasts 24 hours Opiates outlast Naloxone BE PREPARED FOR THE PATIENT TO RELAPSE

When am I supposed to give Narcan©??????

Signs and symptoms of Opiate Overdose

Signs and Symptoms Weak/Thready pulse Slow or Absent Respirations In addition to a known history of opiate abuse, responders should look for: Weak/Thready pulse Slow or Absent Respirations Constricted Pupils Weakness/Unresponsiveness

Administration First Responder administration of Narcan© will be Intra-Nasally. A preloaded syringe will be affixed with a mucosal atomization device (MAD)

Administration Pre loaded syringes contain 2mg in 2ml. Per statewide treatment protocols for EMTs and Paramedics the dose for Naloxone in 0.4- 2.0 mg and may be repeated if necessary

Storage of Narcan©

Common Misconceptions Administering Naloxone does not require extreme force

Schedule Naloxone is not in the DEA schedule of drug classes, yet requires a prescription Naloxone has no potential for abuse

Naloxone has no other purpose besides reversing an opiate related overdose. Naloxone has no mind altering effects

Naloxone is the only treatment in medicine that literally cannot hurt anyone. The only possible effect is the individual may become dope sick (withdrawal). Naloxone is specific, safe, and effective

Epidemiology People coming out of jail or treatment have highest risk of overdose. Most deaths are among opiate users who are in their late twenties to early thirties and have been actively using for the past five to ten years. Only 17 % of opiate related deaths are among new users.

Programs that work with drug users are educating them in the use of Naloxone. The Chicago Recovery Alliance has been providing Naloxone in Cook County, IL since 2001 From the 2011 Annual report Chicago Recovery Alliance reports 2,972 peer reversals using Naloxone since the programs inception.

If interested in knowing more about overdose.. Mass DPH-Bureau of Substance Abuse Services www.mass.gov/dph/bsas

Nobody needs to die from an opiate overdose Bottom Line Nobody needs to die from an opiate overdose

Questions??????