1. Naloxone in North Carolina
Robert Childs, MPH
Harm Reduction and Drug Policy Consultant

2. 911 Good Sam/Naloxone Legislation in North Carolina
2013
911 Good Samaritan Law, Community Naloxone Access
2015
Good Samaritan Protections for People on Parole, Probation, Pretrial Release & Pharmacy Standing Orders
Funding for naloxone
2017
Stop Act: Provision allowing for expanded naloxone access and changed mechanism to expand syringe exchange funding
Naloxone Funding

3. Naloxone
Non-addictive prescription medication reverses opiate overdose
Distribution is associated with up to a 50% drop in OD fatalities
Administer via intramuscular injection or nasal spray
Cannot be abused nor cause overdose
Restores breathing and consciousness
Onset: One to three minutes Duration: 30 to 90 minutes

4. Recognizing an Opioid Overdose
Signs
Unresponsiveness to loud noises or sharp pain
Blue skin/lips/fingernails
Shallow breathing
Strange, gurgling, or snoring-like noises

5. Responding to an Opioid Overdose
Attempt to make verbal contact
Perform a sternum rub to determine the level of responsiveness.
Prepare the naloxone
Confirm correct medication, expiration date, and dosage
Administer the Naloxone
Follow your protocol for requesting EMS

6. Responding to an Opioid Overdose
Recovery Position
Once the victim is breathing again, place them in recovery position due to risk of vomiting.
Monitor the patient for medication effects, which may include opiate withdrawal symptoms and/or agitation.
This should include the patient’s assessment of his/her response to the treatment and reassessment of vital signs.
Notify person an overdose reversal medication was used on them and that they may feel pain/withdrawal symptoms and that it is NORMAL!!
On their side, mouth facing down, with the leg propped up over to the side and arm underneath their head

7. Recap Blue color Sluggish breathing Not responding
Sternum Rub/Mustache Rub
Call 911!
Administer narcan
Recovery position
If trained to do chest compressions, you can do chest compressions

8. Myths Intentional Overdosing Narcan Parties
People reversed are combative

17. Emergency Department Opioid Overdose Visits & EMS Naloxone Administrations, 2011-2017†
Emergency Department (ED) visits for opioid overdoses are increasing. Heroin overdose ED visits significantly increased since 2011 (shown in blue above). The use of naloxone by Emergency Medical Services (EMS) has also increased dramatically during this time.
Technical Notes:
Note that naloxone administration alone does not necessarily equate to an opioid overdose as EMS may administer naloxone when an individual is suffering from a different condition with similar signs and symptoms to an opioid overdose. Additionally, the coding transition of ICD-9-CM to ICD-10-CM occurred in October 2015, making it difficult to assess trends before and after the transition. However, this metric still serves as an indication of the number of opioid overdoses seen by EMS. Some ED visits are coded as substance abuse rather than overdose, therefore, the counts represented above are likely an undercount of overdoses.
Important Note: Due to an on-going transition to a new EMS data system, beginning in 2017 Q4 there is an under-counting of EMS naloxone administrations. This is a statewide transition currently being worked on, and data will be backfilled as agencies complete the transition