Recognition, Response and Administration of Naloxone (Narcan)

Heroin Codeine Demerol Morphine Darvocet Fentanyl Dilaudid Methadone Opium

Hydrocodone

Oxycodone

Vicodin

OxyContin

Tylenol 3

Tylox

Levorphanol

Percocet

Percodan

Methadone ++++

Heroin +++++

Oxycontin +++++

Codeine +

Demerol ++

Morphine +++

Fentanyl +++++

+ Potency

24-32 Hours

6-8 Hours

3-6 Hours

3-4 Hours

2-4 Hours

3-6 Hours

2-4 Hours

Natural opioids: contained in

resin of opium poppy (morphine,

codeine)

Semi-synthetic opioids: created

from natural opioids such as

hydromorphone, hydrocodone,

oxycodone, heroin etc.,

Fully Synthetic Opioids:

Methadone, Fentanyl

Rarely instantaneous

Can happen 1-3 hours after use

Body has ingested more than it can handle

Opioids attack receptors that control breathing

Oxygen can’t get to the brain

Heart stops

Unconscious, Coma, Death

Long-term Brain/Nerve/Physical Damage

Tolerance Shift Mixing Drugs Physical Health Variation in

strength/content Switching from

snorting/smoking to

injection Using alone

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

REALLY HIGH OVERDOSE

Muscles become relaxed

Deep snoring or gurgling (death rattle)

Speech is slowed/slurred

Very infrequent or no breathing

Sleepy looking Pale, clammy skin

Nodding Heavy nod, not responsive to stimulation

Will respond to stimulation like yelling, sternal rub, pinching, etc.

Slow heart beat/pulse

Slow heart beat/pulse

Are you alright?

Are you ok?

Pain Stimulus

If no response call 9-

1-1

Rescue Breathing

Naloxone

Rescue Breathing

Salt Water Suboxone Ice On Body Cold Shower Cocaine Milk Burning Skin Punching Slapping

Fear of legal risk (outstanding warrants, DSS

involvement, loss of public housing)

Fear of judgment from family/ community

Personal embarrassment/shame

Other punitive measures (students loose federal

financial aid)

Urban legends (homicide charge for being at an OD,

being deported)

Opioid Antagonist

Medication that reverses only

OPIOID overdose

Can not get high on it

Can not abuse it

Stays active for 20-90 minutes

depending on metabolism,

amount of drug used

Liver Function

If they use before the Narcan

wears off

Narcan has a stronger affinity to the opioid receptors than the heroin, so it knocks the heroin off the receptors for a short time and lets the person breathe again.

Heroin

Narcan

Opioid receptor

Harm Reduction?

Know some street slang (does not mean YOU

have to use it)

Know the street myths about response

Referrals to outside programs for Narcan

Not just people who inject are at risk for

overdose.

Phone: (781) 592-0243

Thank You!!