Naloxone Administration Training
Welcome! Welcome to the online training for naloxone administration
The Presenter Dr. Joe Parks, Medical Director, Distinguished Professor, Missouri Institute for Mental Health, practicing Psychiatrist
Learning Objectives After completion of this orientation, you will be able to: Explain the history of the opioid epidemic. Describe the clinical foundation of the curriculum. Recognize signs and symptoms of an opioid overdose. Describe how to respond to an opioid overdose by administering Naloxone and calling 911. Provide information for appropriate mental health and addiction services specific to overdose crises.
A Brief History Opioids are one of the most significant substance use concerns in the United States. In 1990s, national focus in US on treating pain. Opioids used to treat chronic non-cancer pain. Prescribed based on subjective reporting. Lack of focus on risk of misuse.
A Brief History In 2018: Every day, more than 172 Americans die from a drug overdose (averaging 7 people per hour)* 116 are specifically due to opioids**. If this epidemic remains unchecked, it has the potential to claim 1 million lives by 2020. *Center for Disease Control, National Center for Health Statistics https://www.cdc.gov/nchs/data/databriefs/db294.pdf American Society of Addiction Medicine https://www.asam.org/docs/default-source/advocacy/opioidaddiction-disease-facts-figures.pdf SAMHSA https://recoverymonth.gov ** Health and Human Services April 2018 https://www.hhs.gov/opioids/
The Clinical Foundation Risk Factors for Overdose Use of multiple substances Variation in strength and content of substances used (purity or potency) Tolerance level especially recent changes Switching from sniffing/eating to injection. Physical Health (liver functioning, weight loss, etc.) Psychological health Using alone Transient living new dealers/new product Thinking you know everything
Identifying an Overdose What are the Signs/Symptoms of an Overdose? Blue skin tinge- usually lips and fingertips show first Body very limp Face very pale Pulse (heartbeat) is slow, erratic, or not there at all Throwing up Passing out Choking sounds or a gurgling/snoring noise Breathing is very slow, irregular, or has stopped Awake, but unable to respond
Overdose versus High
The Clinical Foundation Naloxone Facts Naloxone is a short-acting emergency response medication Does not have psychoactive effects does not make a person high Its effects can last from 30-90 minutes After 90 minutes, effects of opioid may return depending on the opioid and if there is enough drug still in the bloodstream Advise against using more opioid since adding more opioid would be extremely dangerous Possibility of withdrawal symptoms and doesn t eliminate risk for re-overdose
Naloxone Formulations Nasal with separate atomizer Multi-step Narcan Nasal Spray Single- Step Auto-injector Intramuscular Injection Amphastar Pharmaceuticals Kaleo Inc. Various Companies Adapt Pharma
How People Respond to Naloxone Most awaken slowly after 2 doses in 3-5 minutes, some require more, especially if there is fentanyl on board Most often people feel very confused, embarrassed-tell them that they have had an overdose; they were given naloxone and the ambulance is coming Sometimes people mild to moderate withdrawal symptoms Rarely people will feel severe withdrawal symptoms Reassure them that withdrawal symptoms will diminish as the naloxone wears off
Opioid Withdrawal Symptoms Muscle and joint pain Runny nose and eyes Nausea, vomiting, abdominal cramps, diarrhea Goosebumps, chills, sweating Anxiety, depression, intense craving Loss of appetite Confusion, irritability
Auto-injector naloxone
Nasal spray naloxone
Naloxone for Overdose Temporarily reverses opioid effects Requires medical attention even with positive response Safe to administer check your state s Good Samaritan laws to confirm what is covered Can be used with anyone who may be at risk (prescribed opioids and/or substance use disorders) If Narcan is administered, you MUST CALL 911 MENTAL HEALTH FIRST AID USA
How to Help 1. Check for signs of an overdose 2. Administer naloxone Injectable naloxone (syringe and vial) Auto-injector (Evizio ) Assembly required nasal spray Ready-to-use nasal spray Place the individual in the recovery position 3. Call 911 MENTAL HEALTH FIRST AID USA
Assess for Risk of Suicide or Harm Safety and Follow-Up Be aware of your surroundings be safe Be careful not to touch any drugs or needles Be aware that although the individual may wake up immediately, they should still receive medical attention Be aware that the individual may not wish to involve rescue or law enforcement Strongly encourage professional help or peer assistance MENTAL HEALTH FIRST AID USA
Listen Non-Judgmentally Prevention Messages for Families I am concerned about you when one s tolerance is very low, one is at high risk for an overdose. Do you have an overdose plan? Do you and your friends know about Narcan? Your safety is the most important thing. How can I help? If you feel the need to use a substance again, please do not do it alone. I am not an expert on this, but I could connect you with someone I trust who is they might be able to help. MENTAL HEALTH FIRST AID USA
Q&A
Thank you!