1. QC Harm Reduction Opioid Overdose Reversal Training
Kim Brown RN
President and Founder, QC Harm Reduction

2. What Are Opioids? Oxycontin Vicodin Diladid Heroin Fentanyl Percocet
Morphine

3. Risk Factors for Overdose
Using drugs alone.
Mixing drugs ie: Opioids, Cocaine, Benzodiazepines or Alcohol.
New drug user.
Decreased tolerance ie: Leaving jail or rehab. Any period of abstinence.
Switching route of administration ie: Smoking, snorting to injecting.

4. What Happens When You Overdose?
Breathing slows.
Unresponsive.
Breathing stops.
Death.

5. Signs And Symptoms Of Overdose
Snoring/Gurgling.
Blue color around lips or nail beds.
Deep sleep/Unresponsive.
Slow/Shallow Breathing.
Does not respond to Stimulation (Sternal Rub)
No Breathing.

6. Don’t Do This!!! Put them in a cold shower!
Inject them with salt water!
Give them stimulants such as Cocaine or Meth!
Administer overly harsh stimulation to their body!
These are old interventions that drug users tried before naloxone became readily available. They can cause undo harm.

7. What Is Naloxone? Naloxone is an opiate antagonist.
It kicks opioids out of brain receptor sites.
It only reverses opioid overdoses.
It is not a controlled substance. You can’t get high.
It has no known negative outcomes- IDPH
Works immediately to reverse an opioid overdose in 1-3 minutes.
Brings an overdose victim back from sure death.
Naloxone availability does not encourage drug use.
Using naloxone does not mean the person is fine. It is very short acting and an individual can go into another overdose. They must be monitored.

8. Naloxone Laws
As of 2016, Iowa Pharmacists are allowed to dispense naloxone (opioid antagonist) to a “person in a position to assist with an overdose,” without a prescription.
Illinois has a state standing order.
Available by prescription to family and friends of a drug user.
EMS and some law enforcement agencies carry naloxone.
Under a standing order, QC Harm Reduction provides training and free naloxone and syringes to individuals and organizations in our community.

9. Naloxone Administration Methods
Evzio Auto Injector:
Trainer (Like an AED)
Two doses of naloxone.

10. Administration Methods Cont.
Intranasal Administration of Naloxone

11. Administration Methods Cont.
Injectable Naloxone

12. Overdose Rescue with Naloxone
If you suspect an overdose try to arouse the person. Say their name, or “hey can you hear me, are you alright?” Rub their sternum hard with your knuckles. If they do not respond to your voice or pain, call for help (911) and give naloxone.
Pop the orange lid off of one vial. Stick an intramuscular syringe into the vial and draw up all of the naloxone.
Inject all of the naloxone into a muscle; arm, thigh or buttock. Not a vein. You can go right through the clothes if need be.
Give a rescue breath, if the person is not breathing. Tilt the head back, plug their nose and give a deep breath every 5 seconds.

13. Overdose Rescue Cont.
If they don’t wake up in 1-3 minutes, give them a second dose with a new syringe.
Continue rescue breathing for them until they can breathe on their own
Once they are breathing on their own, turn them on their side.
Some additional information to know:
This person, or your friend, may still be in danger and at risk for death. They may have ingested more than one drug, ie: (Xanax, Valium, etc.) or alcohol, and heroin that may have been cut with Fentanyl.

14. Overdose Rescue Cont.
Remember, Naloxone is a short acting medication. Some opiates, such as methadone or fentanyl are longer acting. Stay with them as they could easily go into another overdose.
Your friend may not feel well when they wake up. Naloxone brings on immediate withdrawal. They may want to use again. DON’T LET THEM! They are at great risk of overdosing again.
When you call for help (911) Make sure you are clear: Report what you see. “They are not breathing, or they are unresponsive.”
When the medics arrive give them a complete report of what you did to help.

15. Overdose Rescue Cont.
Remember, the law protects you with a Good Samaritan clause when rendering aid to an overdose victim.
Naloxone does not have any negative outcomes when given to a person, whether they have ingested opioid drugs or not.
You have just saved a life! How awesome is that?!

16. Conclusion Overdose Deaths are preventable.
Naloxone is safe, has no negative outcomes, is not a controlled substance, and can’t be sold on the streets.
In our country, a human being dies every nine minutes from a preventable overdose.
In January of 2016, there were 52,898 recorded overdose deaths in our country. As of January, 2017, there have been 64,070 deaths nationwide.
There was a 7% increase in overdose death in Iowa and a 33% increase in Illinois. We can do better.
After all, every life is worth saving.