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Community Response to Opioid Overdose
- 1. Community Response to Opioid Overdose Ryan Trudeau CCEMT-P, C-NPT
- 2. Ryan Trudeau CCEMT-P, C-NPT Paramedic/Firefighter Frederic Township Fire Department Secretary- Board of Directors Michigan Rural EMS Network 13 Years Experience Adult, Pediatric & Neonatal Critical Care Transport 911 EMS/Fire Response Life Saving Award (2017) Frederic Township Fire Department
- 3. Disclosures Some training materials and products were provided by Harm Reduction of Michigan No financial disclosures
- 4. Understand the Impact the opioid epidemic has on the health and well-being of the community Understand Who is At Risk for opioid-related overdose and death Be Aware of Current Resources available to those struggling with addiction Recognize & Respond to opioid overdose
- 5. What are Opioids? Heroin Prescription Pain Medication Codeine Hydrocodone (Vicodin, Norco) Morphine (MS Contin) Oxycodone (Oxycontin, Percoset) Hydromorphone (Dilaudid) Fentanyl (Duragesic)
- 6. The Impact of Opioid Addiction Predator & Prey: Opioids Savage Effect On Our Community East Middle School Digital Media Students (Traverse City, MI) and former student, Shane Bagwell
- 8. At Risk for Addiction and Misuse ANYONE who takes opioids Known risk factors: Male History of substance abuse Psychiatric disorder Young age Social/Family problems
- 9. How Opioids Decrease Pain • Opioid binds to Mu opioid receptor • Calcium channels close • cAMP levels decrease • Potassium channels open • Neuron less likely to fire https://www.the-scientist.com/cover-story/pain-and-progress-38043
- 10. How Opioids Get You High • Opiate binds to Mu opioid receptor • Decreases GABA release • Low GABA causes Dopamine surge • Dopamine binds to receptor causing euphoria https://www.the-scientist.com/cover-story/pain-and-progress-38043
- 11. Other Effects of Opioids Respiratory Centers of the Brain Feedback mechanisms from lungs and airways Feedback mechanisms from carotid artery Koo CY. Respiratory Effects of Opioids in Perioperative Medicine. The Open Anesthesiology Journal. 2011;5(1):23-34. doi:10.2174/1874321801105010023.
- 12. Tolerance • Brain chemistry changes • Dopamine receptors get switched off when the brain is “too happy” for too long • Effect is needing drug to stay “normal”, needing even more to feel euphoric
- 13. OVERDOSE OPIOID
- 14. Local Resources for Addiction • County Health Departments • MSP Angel Program • Northern Michigan Regional Entity • Harm Reduction of Michigan • Needle exchange programs • NA (Narcotics Anonymous) Groups
- 15. Recognizing Opioid Overdose Known or suspected drug use (opioids) Unresponsiveness Pinpoint Pupils Slow/Shallow/Absent Breathing
- 16. Responding to Overdose Aftercare Administer Naloxone Call for Help – 911 Stimulation Assess the signs
- 17. CPR Saves Lives • Consider learning CPR, AED, and Rescue Breathing • Useful anywhere and any time, not just for overdoses • Contact local Fire/EMS, American Red Cross, Hospital for training resources
- 18. Types of Naloxone Kits Intramuscular Intranasal Intranasal Auto-injector
- 19. How to Administer Naloxone Demonstration and Practice Intramuscular Naloxone Kit
Editor's Notes
- Intramuscular Naloxone Kits Training Syringes Training Vials Training Muscle Pad No Financial Disclosures I don’t promote one service or product over another, those listed in this program are intended as examples only and other options may be just as good or better.
- Impact: Financial impacts, legal impacts too Who at Risk Local Resources, Online Resources Recognize & Respond to opioid overdose
- Terminology: Opioids are any number of legal prescription or illegal pain medications which act on opioid receptors in the body (discussed later) List on slide Heroin sometimes has fentanyl mixed in. Recently, CARFENTANYL has been reported mixed in heroin across the US; “elephant tranquilizer” more potent, less mass to mix in, improper mixing into drugs; contributes to more overdoses and “bad batch” mass-overdose because users don’t always know and dose themselves wrong. Why mix in Fentanyl and Carfentanyl? “Better, bigger high” means you’ll come back and tell your friends. It’s business.
- Video to show impact of opioid addiction (18 minutes) (autoplays on next slide)
- Predator & Prey: Opioids Savage Effect On Our Community East Middle School Digital Media Students (Traverse City, MI) and former student, Shane Bagwell This video captures what opiate addiction is doing to the community.
- To beat (or treat) something you must understand it! Image represents how opioids decrease pain. cAMP is an energy source (like ATP) for cells. Less likely to fire = doesn’t send pain signal to brain = No Pain
- Image represent dopamine dump and euphoria associated with using opioids. GABA normally flows to help inhibit dopamine release. Flood of Dopamine
- K. T. S. Pattinson; Opioids and the control of respiration, BJA: British Journal of Anaesthesia, Volume 100, Issue 6, 1 June 2008, Pages 747–758, https://doi.org/10.1093/bja/aen094 2) Koo CY. Respiratory Effects of Opioids in Perioperative Medicine. The Open Anesthesiology Journal. 2011;5(1):23-34. doi:10.2174/1874321801105010023.
- Needle exchange- because people are going to use anyway, we should keep them from further harm while offering treatment options. Dirty Needles lead to increased risk of HIV, Hepatitis, bacterial blood infections, etc. There are also many online resources, just search.
- Really High: Constricted Pupils, “nod out”, slurred speech, will respond to outside stimulus (loud noise, gentle shake) Overdose: unresponsive to outside stimulus, breathing slow or not breathing, choking sounds or gurgling noises, snoring noises, vomiting, body limp, pale, blue/purple/gray/ashen skin, slow or absent pulse
- 1- Breathing? Responsive? Shake & Shout? Speaking? Skin Color? 2- Try to wake them up. Say “I’m calling 911” or “I’m going to give you Narcan” If unresponsive try sternal rub. 3- If not responding, or not responding well, call 911. This is an emergency! ** Remember- Naloxone only works for opioid overdose, if another emergency it will have no effect. Get help coming early! -- Tell 911 what you see “not breathing, turning blue, unresponsive” etc. Tell if you already gave naloxone and if it worked or not. 4- Give naloxone AND rescue breathing/chest compressions if necessary 5- Risk of RE-overdose depending on amount and type of drug taken. They may have withdrawal symptoms, may have pain.