1. Slide 6.1 Topic 6. Assisting an IDU in trouble a) Intoxicated and at risk b) Unconscious / Overdosed c) Guidelines for Police i. Not routinely attending overdoses ii. Using discretion when attending overdoses

2. A closer look at heroin Slide 6.2 Intoxicated "on the nod“ Unconscious overdosed

3. Why is it dangerous to be unconscious? Slide 6.3 Air passages may be blocked which prevents them from breathing - this can happen when the tongue falls against the back of the throat Cannot protect yourself from danger Unable to cough or swallow to remove spit, vomit, etc - vomit and spit can block the air passage or leak into the lungs source: Kirketon Road Centre (undated). Drug Overdose. South Eastern Sydney Area Health Service: Sydney.

4. Slide 6.4 Assessment Task What policies, procedures, guidelines, and systems does your organisation have in place to ensure the safety of people who are intoxicated? intoxicated and at risk? in custody no matter what their condition?

5. Slide 6.5 What is meant by the term "overdose"? Overdose from different drugs produces different symptoms

6. Characteristics of an overdose of heroin Slide 6.6 Too much heroin causes your blood pressure to drop to such low levels that oxygen does not get to vital organs the body “shuts down” breathing slows and stops he heart stops death

7. Slide 6.7 Do not worry about trying to identify which drug is involved No matter what the drug is, the person needs help

8. Slide 6.8 Police have an important role in protecting all people including those who are · intoxicated and at risk · unconscious · are suffering an overdose

9. Slide 6.9 The material in this Training Program does not replace proper First Aid training. The information in the Training Program is only a general overview Place them in the recovery position Call an ambulance or get someone to call an ambulance (or other appropriate medical assistance)

10. Slide 6.10 Check for Danger (e.g. traffic) Check for a Response Gently shake & call name If a response, keep talking - they may lapse into unconsciousness If no response, turn them on their on side (in the recovery position) Check the Airway Check & clear airway while on side by removing any obstructions - possibly use a two-finger scoop from top to bottom Gently tilt head back and open mouth

11. Slide 6.11 Check for Breathing Check for breathing by listening and watching for the rise and fall of the chest. Use your cheek to feel any breath If not breathing, commence mouth-to-mouth resuscitation Check for Circulation If breathing doesn't start, check the pulse in their neck (Carotid Pulse) If pulse, continue mouth-to-mouth If no pulse, commence Cardio-Pulmonary-Resuscitation (CPR)

12. Slide 6.12 Getting medical assistance. Do you know who to contact and how to do it?

13. Slide 6.13 You should consider providing information about an incident to health and welfare services

14. Slide 6.14 Some IDUs and their family and friends may not call for medical help (ambulance, nurse, doctor) because they are afraid that the Police will be called

15. Police can help IDUs to avoid an overdose by Slide 6.15 Providing them (and others) with information on The risks of injecting drugs, being unconscious, and overdose. What to do if someone has an overdose Not attending overdoses every time or just as a matter of routine When attending overdoses, being more concerned with the health and safety of those present rather than with the possession of illegal substances Collaborating with health and welfare agencies to provide the best care possible for people who have overdosed

16. Guidelines for Police - overdoses Slide 6.16 Not attending every time When attending being more concerned with the health and safety of those present rather than with the possession of illegal substances 1. Development of guidelines 2. Advertising them 3. Making them work

17. Slide 6.17 What things need to be done to help Police successfully develop and implement guidelines for Police to i) Not routinely attend overdoses? ii) Use discretion when attending overdoses?