MBEMSC /PIER Committee

Nasal Naloxone/IntroductionPurpose: Early intervention can help reduce fatalitiesThe First Responder Narcan Program is

designed to educate first responders in recognizing signs and symptoms of opiate overdose

OBJECTIVESAt the conclusion of this training participants

will be able to:Recognize signs and symptoms of opiate

overdoseInitiate appropriate treatments and

interventionsAssemble the nasal narcan delivery deviceSuccessfully administer appropriate dosing

of Nasal Narcan

Background

Annually XXXX # of patients suffer from opiate overdoses in Massachusetts

XXX # result in death

Timely administration of Narcan has proven to reduce the # of opiate related deaths

Since officers started carrying Narcan in October 2010, 163 doses have been administered, resulting in 157 overdose reversals. In the 18 months before October 2010, there were 46 overdose related deaths. In the 18 months after the implementation of the Narcan program there were 22 overdose related deaths.

Read more: PAUL KEENAN: The Quincy Narcan model is saving – and changing – lives - Quincy, MA - The Patriot Ledger http://www.patriotledger.com/topstories/x1590647422/PAUL-KEENAN-The-Quincy-Narcan-model-is-saving-and-changing-lives#ixzz2VUSpPut3 Under Creative Commons License: Attribution Non-Commercial Follow us: @patriotledger on Twitter | patriotledger on Facebook

Naloxone

Generic Name :

Naloxone Hydrochloride

Brand Name : Narcan®

• Endo Pharmaceuticals brought Narcan® to the market in the 1960's

• Narcan® is currently available generically under the name Naloxone

Naloxone is..An opiate antagonist which reverses opiate overdosesSome commonly abused opiates are:

HeroinOxycontinPercocetVicodinMethadoneMorphine

Pharmacology• Opiates produce their effects as an

agonist on the mu receptors in the central nervous system

• Mu¹ receptors are responsible for a large portion of analgesic (pain management) effects

• Mu² receptors are responsible for respiratory distress

Naloxone kicks opiates out of the brain by blocking certain receptor sites.

Naloxone occupies the receptor sites and prevents opiates from binding to the brain.

Naloxone in conjunction with rescue breathing has life saving potential.

An opiate overdose is..

When opiates settle in the part of the brain that regulates breathing.

The immediate concern during an opiate overdose respiratory depression.

• The effects of Naloxone wears off between 30-60 minutes after administration

• Heroin lasts 6-8 hours

• Methadone lasts 24 hours

• Opiates outlast Naloxone

• BE PREPARED FOR THE PATIENT TO RELAPSE

When am I supposed to give Narcan©??????

Signs and symptoms of Opiate Overdose

Signs and SymptomsIn addition to a known history of opiate

abuse, responders should look for:

Weak/Thready pulseSlow or Absent RespirationsConstricted PupilsWeakness/Unresponsiveness

Administration

First Responder administration of Narcan© will be Intra-Nasally.

A preloaded syringe will be affixed with a mucosal atomization device (MAD)

Administration

Pre loaded syringes contain 2mg in 2ml.

Per statewide treatment protocols for EMTs and Paramedics the dose for Naloxone in 0.4- 2.0 mg and may be repeated if necessary

Storage of Narcan©

Common Misconceptions

• Administering Naloxone does not require extreme force

Schedule• Naloxone is not in the DEA schedule of

drug classes, yet requires a prescription

• Naloxone has no potential for abuse

Naloxone has no other purpose besides reversing an opiate related overdose.

Naloxone has no mind altering effects

Naloxone is the only treatment in medicine that literally cannot hurt anyone.

The only possible effect is the individual may become dope sick (withdrawal).

Naloxone is specific, safe, and effective

EpidemiologyPeople coming out of jail or treatment

have highest risk of overdose.

Most deaths are among opiate users who are in their late twenties to early thirties and have been actively using for the past

five to ten years.

Only 17 % of opiate related deaths are among new users.

Programs that work with drug users are educating them in the use of Naloxone.

The Chicago Recovery Alliance has been providing Naloxone in Cook County, IL since 2001

From the 2011 Annual report Chicago

Recovery Alliance reports 2,972 peer

reversals using Naloxone since the programs

inception.

If interested in knowing more about overdose..

Mass DPH-Bureau of Substance Abuse Services

www.mass.gov/dph/bsas

Bottom Line

Nobody needs to die from an opiate overdose

Questions??????