Karmik Training Session

Standard

Base info – For all Naloxone trainees

  • Language matters
  • Person first
  • Non judgmental language
  • Stigma
  • Actively involve individuals to participate in their own care

Public Health Emergency

  • Peaks in overdose deaths ’95 and ’99
  • 4 pillars strategy of Harm Reduction enacted in early 2000’s along with the foundation of insite.
  • Increasing since 2010-11
  • Doubling every year, since the last 2 years

Substance classification

  • CNS Depressants (D)
    • Opioids* – Fentanyl
      • Further subtypes of opioids
      • Fentanyl Analogues – Synthetics
      • Carfentanil is an Elephant Tranquilizer
    • Alcohol
    • Benzo
    • GHB
  • Stimulant (S)
    • Cocaine
    • Meth
    • Nicotine
    • Caffeine
    • Ecstacy

Risk of overdose

  • Route of administration
    1. Don’t Use – Least Risk
    2. Swallow
    3. Snort/Smoke/Insert
    4. Injected – Highest Risk
  • Lower Tolerance
    • After a break
    • Detox/Jail
    • New
    • Lung/Liver
    • Recent OD
  • Age and Physical health – Old / Compromised immune system
  • Mixing Substances – Don’t!
    • D+D
    • D+S. Use D before S

Risk Minimization

Testing drugs

  • Reagent Kits
  • Testkitplus.ca
  • Can be borrowed from Karmik
  • Fentanyl Dip Sticks – Every supervised consumption site
  • Dose-dose variability of synthetic fentanyl causing differing outcomes

Not Using Alone

  • IV – 30-40 seconds
  • Develop overdose plan
  • Leave door ajar
  • Call someone

Naloxone basics

  • Opioid Antagonist
  • Naloxone amendments
    • Mar 22, 2016 – Remove from prescription drug list
    • Oct 13, 2016 – Enable all people to use Naloxone outside a hospital settings
  • Good Samaritan Drug Overdose act – Bill C224 – Immunity from Drug possession (simple possession, not distribution amounts / production etc) or breach charges for those who seek help in an emergency (If you’re not on parole/pre-trial release)
  • Half-life of naloxone
    • Naloxone 30-90 minutes (least)
    • Morphine/Hydrocodone/Heroin 4h
    • Methadone 24h

Opioid Overdose symptom recognition

  • Unconscious/non-responsive
  • Depressed breating
  • Small pupils

Non opioid overdose symptoms

  • Depressants – look a lot like opioid symptoms
  • Stimulant – Fast pulse, short of breath, chest pain, elevated temp, agitation

 Response

 

“They’re dying behind locked doors with kits in their hands/around them”