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
- Opioids* – Fentanyl
- Stimulant (S)
- Cocaine
- Meth
- Nicotine
- Caffeine
- Ecstacy
Risk of overdose
- Route of administration
- Don’t Use – Least Risk
- Swallow
- Snort/Smoke/Insert
- 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”