1. NCW Opioid Response Conference
PATHWAYS TO PREVENTION
Thank you to Washington State University Extension for developing the Rural Pathways to Prosperity conference delivery model and for providing training and support for this conference.

2. North Central Washington
Opioid Response Conference
Pathways to Prevention
Welcome!!!
We will join over 300 people at 10 sites across North Central Washington who will connect virtually for conversations with inspiring speakers on opioid Prevention
Following their remarks, we’ll focus on and discuss local opioid prevention efforts.
By the end of this conference, you will have:
Learned about the opioid epidemic and local prevention efforts
Engaged and connected with diverse public and private partners and identified areas of mutual interest
Catalyzed collaboration and be empowered to take action locally

3. Today’s agenda 9:10 - Keynote Webinar Presentations 10:00 - Break
North Central Washington
Opioid Response Conference
Pathways to Prevention
Today’s agenda
9:10 - Keynote Webinar Presentations
The Opioid Epidemic and Response in North Central WA
Mobilizing Rural Communities Around Opioid Prevention
10:00 - Break
10:10 - Facilitated Discussion and Local Action Planning
11:45 - Call to Action and Evaluation
12:00 - Optional: Narcan Training

4. North Central Washington
Opioid Response Conference
Pathways to Prevention
Your Role Today
You are all here because you care about the community and want to personally and/or professionally contribute to opioid prevention efforts locally.
By the end of this conference, our goal is develop a COMMUNITY ACTION PLAN for local Opioid Prevention.
We will ask each of you to complete a CALL TO ACTION for you to personally commit to what you will do to help move the Community Action Plans forward in order to be COLLECTIVELY SUCCESSFUL.
Your commitment may be large or it may be small. We all have DIFFERENT SKILLS AND RESOURCES, but everyone is able to contribute in some way.

5. North Central Washington
Opioid Response Conference
Pathways to Prevention
Asset Mapping 10:20 – 10:45
Who is currently doing this work in our community and what are they doing?
What resources are available to address this issue?
Does your school district offer education to students about the opioid epidemic and prevention?
If yes, what are some current examples?
If not, what resources can be offered within the schools?

6. North Central Washington
Opioid Response Conference
Pathways to Prevention
Gap Analysis 10:45 – 11:15
What can we do as individuals to aid in the prevention of this spreading epidemic? What can we do as a community?
What role can schools play in combatting the opioid epidemic?
What actions can we take to begin or expand use of the assets discussed?
Who is missing in the room?

7. Selection of Community Project 11:15 – 11:30
North Central Washington
Opioid Response Conference
Pathways to Prevention
Selection of Community Project 11:15 – 11:30
Goal: Using the assets and gaps identified, select 1-3 projects or actions that are feasible for the community to implement.
What should we as a community decide to do to promote opioid prevention?

8. Community Action Plan 11:30 – 11:45
North Central Washington
Opioid Response Conference
Pathways to Prevention
Community Action Plan 11:30 – 11:45
Identify:
Project Champion
Project Team
Immediate Next Steps
Resources Available and Resources Needed
NCACH Rapid Cycle Opioid Application

9. Call to Action & Evaluation 11:45 – 12:00
North Central Washington
Opioid Response Conference
Pathways to Prevention
Call to Action & Evaluation 11:45 – 12:00
CALL TO ACTION: This is the opportunity for you to personally commit to what you will do to help move the Community Action Plans forward and help us be collectively successful! EVALUATION: Your honest feedback will help us know what you liked or didn’t like about this conference and help to shape future Opioid Conferences in our region!

10. Thank you all for your time effort!
There are over 30 Site Managers, Group Facilitators, and Technology Coordinators that volunteered their time in order to help bring this conference to your local community.
Thank you all for your time effort!
Thank you!!!
Thank you to Washington State University Extension for developing the Rural Pathways to Prosperity conference delivery model and for providing training and support for this conference.

11. NARCAN TRAINING

12. Drug Deaths in the US, 2017
Drugs Involved in U.S. Overdose Deaths - Among the more than 72,000 drug overdose deaths estimated in 2017, the sharpest increase occurred among deaths related to fentanyl and fentanyl analogs (synthetic opioids) with nearly 30,000 overdose deaths. Source: CDC WONDER
Total U.S. Drug Deaths - More than 72,000 Americans died from drug overdoses in 2017, including illicit drugs and prescription opioids—a 2-fold increase in a decade. ~49,000 involved opioids. Source: CDC WONDER

13. Opioid-related Overdose Deaths, WA 2000-2017

14. Opioid-related Overdose Deaths by County of Residence, 2012-2016

15. WA State Overdose Prevention and Response Training

16. What are Opioids? Heroin Prescription Pain medicines like:
Hydrocodone (Vicodin)
Hydromorphone (Dilaudid)
Meperidine (Demerol)
Morphine (MS Contin)
Oxycodone (OxyContin, Percocet)
Codeine
Fentanyl
Methadone

17. What Causes Overdose?
If someone take more opioids than their body can handle, they can pass out, stop breathing, and die.
Overdose can take minutes or even hours to occur.
Anyone who uses opioids can overdose.
The body is so relaxed, it forgets to breathe.

18. Overdose Risks
Restarting opioids after a break.  (e.g., like after being in treatment, a hospital, or jail). Tolerance drops within a few days.
Using opioids at the same time with alcohol or sedating drugs like sleep aids and benzodiazepines (“benzos” like Valium and Xanax). Mixed together, they can slow breathing even more.
Taking prescription pain medicine more often or in higher doses than prescribed.
Any heroin use due to its wide range of purity.
Using heroin or pills bought on the street or online.
Taking someone else’s pain medication.
Using long-acting opioids (like methadone) or powerful opioids (like fentanyl).
Any current or chronic illness (such as heart of lung disease) that weakens the heart or makes it harder to breathe.
If someone has overdosed before, they are more likely to overdose again.
Leave behind program.

19. 1. Check: Could this be an Opioid Overdose?
Look and listen for:
Slow or no breathing
Gurgling, gasping, or snoring
Clammy, cool skin
Blue lips or nails
Pill bottles, needles, or alcohol
If they don’t wake up, you need to act fast!
Pulse?
Try to wake them up:
Shake them and call their name.
Rub you knuckles hard over their chest bone.

20. 2. Call 911 Good Samaritan Law
If you get medical help for an overdose or alcohol poisoning, you and the victim cannot be charged for drug use, possession, or underage drinking.
This does not include outstanding warrants.
Say where you are and that the person isn’t breathing.
You don’t need to say anything about drugs or medications.

21. 3. Give Naloxone and Start Rescue Breathing
Give the naloxone. Follow the instructions on the package or in the overdose rescue kit.
Start rescue breathing.
If they don’t respond in 3-5 minutes, give a second dose of naloxone. Keep rescue breathing.
Narcan blocks the opioid receptor.
Puts someone into withdrawal.
There is no effect if they are not on opioids. If you give someone Narcan that is not experiencing an overdose, it will not hurt them.

22. Do rescue breathing even if you don’t have naloxone.
Tilt head back. Lift chin. Pinch nose.
Give 2 quick breaths. Chest should rise.
Then give 1 slow breath every 5 seconds.
Keep going until they start breathing or until help arrives.
People have been revived from rescue breathing alone.
Do rescue breathing even if you don’t have naloxone.
Oxygen is critical!

23. 4. Stay with Them RECOVERY POSITION
If they start to wake up and breathe, stay with them.
Watch them until medical help arrives. Naloxone wears off in 30 – 90 minutes. When it does, the person can stop breathing again.
If you must leave, put them into the recovery position and in a place they can be found.
RECOVERY
POSITION

24. Taking Action in an Opioid Overdose
Check: Could this be an opioid overdose?
Call 911.
Give naloxone and start rescue breathing.
Stay with them.

25. Naloxone Products

26. How naloxone works
Naloxone attaches to the same brain receptors as opioids, but more strongly. Naloxone kicks off the opioids and “takes over” the receptors, causing opioid withdrawal. 
This restores breathing and consciousness in about 2-5 minutes.
When the naloxone wears off in about minutes, any opioids still in the brain can return to the receptors. The person may stop breathing again.
Naloxone will not reverse the effects of other drugs like cocaine, methamphetamine, alcohol, or benzodiazepines (e.g. Xanax®, Klonopin® and Valium®). But naloxone can still block the effect of opioids (and reverse the overdose) even if the person has also taken one or more of these other drugs.
Naloxone is very safe and easy to use. Bad reactions to naloxone are rare and it is safe to give to anyone, including children and pregnant women. When naloxone is used on a pregnant woman, there is a risk from miscarriage due to opioid withdrawal. Pregnant women who have overdosed should get medical help right away.
When someone wakes up after naloxone, they may feel some symptoms of opioid withdrawal like pain, sweating, nausea, or vomiting. The person may also feel confused, anxious or slightly agitated. Rarely are people combative or violent.

27. Build a Naloxone Kit Naloxone (recommended Narcan Nasal Spray)
Instructions to use Naloxone
Face Shield for CPR Rescue Breathing
Medical Gloves
Can get Naloxone from major chain pharmacies – cost is about $125.

28. Learn more at:
stopoverdose.org