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Do you know what to do in case of an overdose?

May 12 2011
Preventing and responding is easier than you might think

In London, Canada, many people injecting narcotics have died of overdoses in the past year. Although heroin, cocaine and other amphetamines are around, the most frequently injected drugs are prescription pills such as Oxycontin or Percocet. We have also had some deaths related to Fentanyl, which is a slow-release narcotic patch. As the use of prescription narcotics increases, it is important that people keep themselves safe. Two things that we are doing right now to focus on safety in London - on this side of the pond! - are education around peer support in the case of overdose, and connecting with our local police services to ensure everyone’s safety if 911 (our version of 999) is being called for an overdose.

The first thing to know is how to prevent an overdose? Here are some things you can do to keep yourself or your friends safe:

1. Know what you’re using and how much. Everyone has a different tolerance for drugs, and you need to know what is safe for you

2. Don’t mix injecting and booze. Narcotics and alcohol have a side-effect of decreasing your breathing, which makes overdose death more likely

3. Always use with a friend or friends, preferably with one of you not using. Someone needs to be able to call 999

4. Think about having a phone available before you use.

The second thing to know is are they having an overdose? Basically, an overdose is occurring if they fall asleep and you can’t wake them up. Signs of an overdose include:

1. They may act confused or stupid

2. They go to sleep and won’t wake up

3. Slow breathing, or they actually stop breathing

4. Their lips and fingernails might start to turn blue

5. Cold skin

6. They may throw up.

The third thing to know is what to do in case of an overdose?

1. If your friend is getting confused and starting to go out, keep them awake. They won’t like this, but it will help them keep breathing.

2. If they do go out and you can’t wake them, call 999 immediately! Paramedics have a medication called Naloxone that reverses overdose.

3. If they are not breathing, you need to breathe for them. Make sure there is nothing in their mouth, tilt their head back, lift their chin, plug their nose and breathe into them every 5 seconds. You know it’s working if you see their chest rise. You need to keep doing this until they breathe on their own or paramedics arrive.

Calling 999 can be a challenge, because you may be concerned about police responding to the phone call as well as paramedics. In London, Canada, people have been arrested on the basis of outstanding warrants and what is in the room when they called because of an overdose. Having more people with you means that you can clean up while one person is breathing for your unconscious friend. In Vancouver, Canada, there is an agreement that police do not respond to 999 calls for an overdose. We hope to be able to do the same.

The last thing to think about in terms of preventing deaths from overdose, is Naloxone, which paramedics carry. It only works for a bit, so the person still has to go to the hospital, but it will allow them to wake up and breathe. In some cities in the United States, they are working hard to make sure Naloxone is available to more people than just paramedics. You can only get it through a prescription, and you need to know how to inject it, but it is being given out as part of some needle exchange programs. This is an idea that has been shown to work, and could be useful in both the UK and Canada as well.

So, if you are going to use, make sure you use safely and know what to do in the case of an overdose.