Overdose Prevention

[beena]

SWIM went to an overdose prevention workshop yesterday. She would like to pass on her knowledge to the SWIMMERS on this website who use or know someone who uses drugs that may cause an accidental overdose so as we can reduce harm together......

DEFINITION OF AN OVERDOSE
1) Overdose occurs when a person takes too much of one or more depressive substances. This can lead to the lungs and heart stopping working and if help is not given the person could die. Depressant substances include benzodiazepined, opiates (heroin) and alcohol.
2) Using too much of a stimulant substance (ie cocaine or crack) can cause problems with the circulatory system and heart. This can cause heart failure and high blood pressure, which can lead to brain haemorrhage. Heavy use of crack can lead to convulsions, loss of consciousness, respiratory problems and ultimately death

CAUSES OF OVERDOSE
Overdose is an intake of a drug (or group of similar drugs) higher than the tolerance (how much a person is used to) that causes an interruption of the breathing.
Therefore a person is at risk of overdose when
The heroin is better than usual (same quantity, but higher concentration), for instance, when abroad, when bought from different dealer, when usual dealer has new batch
The heroin is more than usual (blind fix)
The injector is experienced and is using more in order to “feel” the fix (remember the average age of people who are overdosing is 40.
The liver functions are impaired, like for people with Hep C positive and/or heavy drinkers (the liver processes all the drugs, if it does not work properly there will be more of the substance in the blood and therefore arriving at the brain.
The person has used a mix of depressant drugs (alcohol, methadone, heroin, benzodiazepines), because they all depress the area of the brain which controls the breathing (the user goes to sleep and ‘forgets’ to breath)
When just out of prison/detox/hospital This is because the tolerance changes very quickly. After a period of abstinence it could be as low as somebody who has never used (therefore if you decide to use , you should use the same amount you used the very first time or less).
After an overdose In hospital you receive an injection of Narcan (antidote for opiates) that, besides saving your life, will also give you immediate withdrawals. Narcan has a short-term effect. If you leave the hospital and not repeat the Narcan injection but instead inject heroin, the small amount of heroin in your system will kick in suddenly when the Narcan wears off, producing you a second overdose.
OTHER CAUSES OF DEATH IN OVERDOSE
When you are in a deep, drug-induced sleep, if you start vomiting and are not in the recovery position, there is the possibility of dying from aspiration of vomitus
When you are in a deep, drug-induced sleep, if you fell asleep near a heat source there is the likelihood of life-threatening burns
If you are mixing stimulant and depressant drugs (ie a speedball), your pulse continuously switch from slow to fast and back to slow. If your heart loses its natural rhythm you could suffer from irregular heart beat and failure
Anaphylaxis reaction If you are allergic to any of the contaminants (‘cut’) in the heroin, you could have a too strong reaction to it. In very bad cases you could faint due to low blood pressure and die due to suffocation caused by swelling of the tongue.
OTHER RISKS
Our body has defences against bacteria coming from the outside. When you inject you are putting non-sterile (with bacteria) substances inside your body. If you use lemon juice or vinegar to cook heroin you risk bacterial and fungal infections.
A dirty hit is a general expression to indicate that your body is fighting some kind of bacteria that has penetrated its defences.
DO NOT LICK THE NEEDLE (it is already sterile, you’re only contaminating it)
BE CAREFUL IT IS NOT SEPTICAEMIA (go to A&E if it lasts more than a few hours)
DO NOT HAVE ANOTHER FIX ON TOP (even if you’re sick, you still have heroin in your system. With another fix you are likely to overdose).
SIGNS OF OVERDOSE
Depressant drugs:
1) Shallow or not breathing. (Look for chest rising and falling. Listen for breath)
2) Blue lips and fingernails
3) Pale skin
4) Slow or faint pulse
5) Gurgling or snoring noises (sometimes means fluid on the lungs)
6) No response to sound or pain
Stimulant drugs:
1) Overheating and excessive sweating
2) Pounding heart
3) Tremors
4) Pale appearance
5) Restlessness/agitation
6) Fitting
7) Stroke
Paralysis (usually to one side of the body)
Speech problems
Collapse
8) Heart Attack
Chest Pains
Blue Lips
Pale Complexion
Above symptoms accompanied by heavy sweating
Collapse
HOW TO RESPOND IN THE EVENT OF AN OVERDOSE
Firstly what NOT to do:
DO NOT PANIC. Do not roll up an overdosed person in a rug and try to dump them somewhere.
DO NOT let someone just sleep it off.
DO NOT put them in a bath or pour cold water over their head. This will not help.
DO NOT walk a person around. This will only make an unconscious person vomit.
DO NOT inject them with salt and water, this puts more pressure on the heart and does nothing except waste time.
DO NOT try to inject with stimulant drugs. Despite what you may have heard, this also does not work.
DO NOT smoke heroin, have a hit or give a hit to someone who has come back from hospital or ambulance after receiving Narcan. The effects of this drug are temporary so you or they could go over again if you have another hit of smoke.
DO NOT dump on your mate! You could be the only link for that person staying alive.
How to respond:
Shout their name. Shake their shoulders. If no response, check breathing for ten seconds. If the person is not breathing normally or not breathing at all, dial 999 and then commence CPR.
If breathing put in the recovery position and then….
CALL AN AMBULANCE!
Your knowledge of CPR could be the key to saving somebodies life (eg, St Johns Ambulance courses). If possible update your CPR knowledge every year. Being able to perform CPR can save a life - it buys the person time before the ambulance arrives with the defibrillator.
If someone is unconscious but still breathing, knowing how to put them in the recovery position could save their life. This is very easy to learn. Around half of all injecting drug users do not know how to put someone in the recovery position. (Preventing overdose, Exchange Campaigns. Department of Health 2001).
Calling an ambulance
Before you call, firstly make sure you have the address and the postcode where you are. Tell the operator that a person has collapsed and are unconscious. The best advice is to inform them of the drugs that have been taken by the person who has overdosed. Not all ambulance crews carry Narcan so the more information given the better equipped the paramedics will be.
The police do not automatically attend overdosed. They will only attend if the address is a known risk and is flagged on the operator’s computer. Also, if the background is quiet and the person on the phone is polite, the chances are the police will not attend. This is just a guide on if the police may or may not attend overdose.
If you’re the only person who knows CPR then obviously stay with the unconscious person. Call an ambulance. If the room is full of people, give them things to do eg: call for an ambulance, ask some people to wait outside to flag the ambulance. Above all, try to keep an atmosphere of calm. Also things to think about: did the person have the same gear as everybody else? Check on others who may be gouching.
When the ambulance and paramedics have left it is best to call it a night and not all have another hit to get over the shock!
AVOIDING OVERDOSE
RISK FACTORS:
Injecting
Age 35 and older
Infection with Hepatitus C
Unknown gear
Don’t use by yourself
Avoid using heroin with other depressants, such as alcohol, benzos and antidepressants
Recognise risky times such as
Just out of prison/hospital/rehab
Different dealer than usual
Quality of gear is not known
Unusual environment
Not knowing the people you are with

Remember, one day you could be relying on someone else to respond to your overdose so make overdose prevention a topic of conversation with your mates.
BE SAFE.

Reputation Comments on this post:

	Thanks. :) Important, useful, and applicable.
	Thanks for sharing
	good advice
	who knows, this info may have prevented my untimely death