Naloxone Opioid Rescue Kits. Aaron Kochar, JD

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1 Naloxone Opioid Rescue Kits Aaron Kochar, JD

2 Common Opioids Codeine Lorcet Demerol Vicodin Oxycontin Hydrocodone Methadone Used as a Medication- Assisted Treatment Liquid methadone (difficult to divert/abuse) As a pain medicine, it can be abused Morphine Opium Heroin

3 Common Opioids Natural Semi-synthetic Fully synthetic Morphine Codeine Heroin Oxycodone Fentanyl Methadone Buprenorphine

4 Total Number of Opioids Prescribed in the United States MILLIONS

5 Indiana Ranks 9 th Highest in the Nation For every 100 Hoosiers, 109 Opioid Prescriptions are Written

6 Paths to Prescription Drug Addiction Former Police Lt. Thomas Foye, 51 years old 26-years in law enforcement Happily married with three children Three surgeries Convicted Felon, two years in jail (Oct. 2014) I would have rather died in the line of duty with my dignity

7 Paths to Prescription Drug Addiction (recorded: April 2015)

8 The Opioid Lethal Dose Forgets to Breathe Central Nervous System depression Opioid overdoses is rarely instantaneous Most deaths occur between one to three hours after taking the opioid Someone found dead with a needle in their arm uncommon, but happens, especially when using opioids + others substances especially Fentanyl

9 How do opioids affect breathing? Opioid Receptors, brain Opioid

10 How does naloxone affect overdose?

11 Why Use Naloxone? No Euphoric effect Safe Even if a person isn t overdosing on an opioid Similar to: CPR, AEDs, EpiPens Proven track record From 1996 through June 2014: 152,283 laypersons trained 26,463 reversals reported Saves Money A life saved can be a life restored

12 Myths: Why Not Use Naloxone? If those with substance use disorder know that Naloxone can save their life, they will abuse more drugs Naloxone will keep people from seeking treatment People can be violent after receiving Naloxone

13 Symptoms of Opioid Overdose Decreased level of consciousness Pinpoint pupils Gurgling or choking noises Body is Limp Breathing slows or stops Heart rate slows or stops Blue lips and nails Caused by insufficient oxygen in the blood Can t be woken or can t speak, even after: shaken or sternal rub

14 High vs. Overdose Really High Muscles relaxed Speech is slowed / slurred Sleepy looking Responsive to stimuli Normal HR / pulse Normal skin tone Overdose Pale, clammy skin Ineffective or no breathing Deep snoring or gurgling Not responsive to stimuli Slow HR / pulse Blue lips and / or fingertips

15 Environmental Signs of Opioid Use Spoons Needles Tourniquet Lighter Balloons or baggies Pill Bottles

16 Each Narcan has a expiration date on the end of box. None of the contents are sharp.

17 Naloxone Facts This is NOT Pulp Fiction You won t be stabbing anyone in the heart Usually works in about 3 minutes (up to 8 minutes) Lasts 30 to 90 minutes Opioids can last longer than Naloxone Won t eliminate the opioid from the system

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19 Administration of Naloxone Patient should be unresponsive first and foremost If no pulse and no breathing Start CPR If pulse and no or slow breathing Use Naloxone Open kit and assemble Place firmly against right nostril and spray half Place against left nostril and spray remainder Provide Rescue Breathing, as needed If it works usually patient will moan, increase breathing or become combative with in 1-5 minutes Advise changes and updates to Medics

20 Recovery position

21 Policies and Procedures for Best Practice Civil Immunity If you follow the protocol in good faith, you will be protected from civil law suits (by state law) Except for an act of gross negligence or willful misconduct is immune from civil liability for acts or omissions when administering the drug. IC (a) Reporting Use or loss Expiration Kit Storage Don t store kit in extreme temperatures

22 Laysaver Carry SEA 406 allows anyone in Indiana to possess Naloxone Entity Distribution Treatment Centers Pharmacies Nonprofits