What is Naloxone?

Naloxone (pronounced na-LOX-own) is a drug that can temporarily reverse an opioid overdose. Opioids are drugs that are usually used to treat pain, but can also be used recreationally. Some commonly used opioids include:

  • Fentanyl

  • Morphine

  • Heroin

  • Methadone

  • Oxycodone

When someone overdoses on opioids, their breathing either slows or stops completely. If used right away, Naloxone can help them breathe normally and regain consciousness. Naloxone can either be injected or given as a nasal spray. However, this is not meant to replace medical attention/intervention.

Hamilton Public Health Services is collaborating with community partners to provide timely opioid-related information to the public. See recent statistics of overdoses, naloxone kits distributed and utilized, and more on their website:

https://www.hamilton.ca/public-health/reporting/hamilton-opioid-information-system

 

Where to get a free Naloxone kit

Check the list of Ontario pharmacies, community organizations and correctional facilities where you can get kits and training on how to use them: https://www.ontario.ca/page/where-get-free-naloxone-kit

Please note: You do not need a prescription to get Naloxone. However, you will need an Ontario health card to get free kits. Needle syringe programs and hepatitis C programs are the only services that do not require a Ontario health card to provide free kits.

In hospital Naloxone training for patients

If you would like a patient at risk for overdose to receive Naloxone training before their discharge from hospital, please contact Margot, RN, PHN from Hamilton Public Health at 905-546-2424 ext. 7475.

 
 

How to recognize an opioid overdose

Someone may have overdosed if they:

  • can’t stay awake, walk or talk

  • are breathing slowly or not at all

  • have a limp body

  • are not responding to noise or knuckles being rubbed hard on their breastbone

  • are snoring or gurgling sounds

  • have pale or blue skin – especially on their nail beds and lips – and they feel cold

  • have tiny pupils (pinpoint) or their eyes are rolled back

  • are vomiting

 

If you are with someone who has overdosed, call 911 immediately.

How to use a Naloxone kit

If you are with someone who is having an opioid overdose:

(1) Shake their shoulders and shout their name.

(2) Call 911 if they are unresponsive.

(3) Give chest compressions:

  • Put your hands on top of one another in the middle of the person’s chest

  • Keep your arms straight

  • PUSH FAST, PUSH HARD, with no interruptions, except to give Naloxone.

(4) Administer Naloxone:

  • Injectable: Inject 1 vial or ampoule (a small glass container) (0.4 mg/1 ml) of Naloxone into their upper arm or upper leg.
  • Nasal Spray: Make sure the person is lying on their back, insert tip of nozzle into one nostril, then press the plunger firmly.

(5) Resume chest compressions.

(6) Continue compressions until the person responds or EMS arrives. If they are not awake after 2-3 minutes, give a second dose of Naloxone. If the person begins breathing on their own, or if you have to leave them on their own, put them in the recovery position.

 

Please note: This information does not count as training. When you receive a Naloxone kit, you should be trained on how to use it.

The following videos show how to administer the Narcan:

                                        Injectable:                                                                         Nasal Spray:

Who is at risk of an opioid overdose

You are at risk of an opioid overdose if you:

  • are taking prescription opioids that were not prescribed to you and could be too strong for you

  • are buying opioids from the street and you don’t know how strong they are

  • have bought street drugs that are laced with opioids

  • have overdosed on opioids before

  • are mixing your opioids with other downers like alcohol or benzos (e.g. Valium, Xanax)

  • have stopped using opioids for a while, which has lowered your tolerance

  • have just been released from jail and haven’t used opioids in a while

  • are using opioids by yourself

How to prevent an opioid overdose

  • Keep prescription opioids away from children, youth and other adults in your home.

  • Don’t give anyone your prescription opioids or take opioids prescribed for someone else.

  • Don’t mix drugs or take drugs with alcohol.

  • Don’t use opioids alone.

  • If you switch to a stronger opioid, use less and do a test dose.

  • If you’re using opioids after cutting down or not using for a while, start low and go slow.

 

Information retrieved from: https://www.ontario.ca/page/get-naloxone-kits-free

 
 
 
 
 

Opioid Withdrawal and Assessment

The following are videos produced in partnership by the CD Capacity Building Team and Dr. Brendon Trotter of the SJHH Emergency Department.

 

Part 1                                                                                             Part 2

To see additional videos in this series, visit our "Webinars" page, by CLICKING HERE.

Toronto’s Moss Park Overdose Prevention Site (OPS): Exclusive Interview

The CD Capacity Building Team interviewed Brittany Beaton, Social Service Worker and volunteer at the Moss Park Overdose Prevention Site.

 

Brittany has been working in the field of Harm Reduction for over 10 years, in various capacities. She became involved in the OPS because she passionately believes that Harm Reduction saves lives and that people – regardless of what they decide to use or do, or who they are – need a safe and supportive environment to use in.

What is the supervised injection tent and why did it come about?

As is happening everywhere, the opioid crisis has hit Toronto hard. The overdose prevention site was a reaction to a lack of support from the government at all levels to this community of people who use substances. As a community we were reaching out for support and while we were happy the Safe Injection Sites were coming, they weren’t coming fast enough. The hoops that we were forced to jump through were taking too long and people were and are dying. A couple of people from the Toronto Harm Reduction Alliance had a meeting with the mayor and were really disjointed with his lack of response to our discussion, our requests for help and even the language he used while discussing opioids was heartbreaking. After that meeting sitting around dejected and sad, it was decided we are done waiting, we are out of time. The next day we opened the Overdose Prevention Site here in Moss Park. Enough was enough.

 

The Overdose Prevention Site (OPS) is open from 4 pm to 10 pm, daily. Besides the injection tent (now a trailer), we also have a tent for people to smoke in, and a tent for distribution of supplies including safe using kits, naloxone, and other donated food and clothing items.

What is the difference between this service and the city funded Safe Injection Sites?
Technically speaking, what we are doing in Moss Park right now is illegal. We are not sanctioned to be running the tents/trailer in Moss Park. However, we came to an agreement with the city and police that we would always have a medical professional on site, and in return we would be left to run the site without having extra police presence in the area.

 

On the other hand, the Safe Injection Sites are city run and have been broken up into 3 sites: one at Public Health, (which is now open), one at South Riverdale Health Centre, and one at Queen West Community Health Centre (all indoors). These sites have taken over 6 years to get going and they have gone through all levels of government to get approval, including a federal exemption.

What is the difference between this service and the city funded Safe Injection Sites?
Technically speaking, what we are doing in Moss Park right now is illegal. We are not sanctioned to be running the tents/trailer in Moss Park. However, we came to an agreement with the city and police that we would always have a medical professional on site, and in return we would be left to run the site without having extra police presence in the area.

 

On the other hand, the Safe Injection Sites are city run and have been broken up into 3 sites: one at Public Health, (which is now open), one at South Riverdale Health Centre, and one at Queen West Community Health Centre (all indoors). These sites have taken over 6 years to get going and they have gone through all levels of government to get approval, including a federal exemption.

 

Another difference is that the city run Safe Injection Sites have full time paid staff and managers, while the Moss Park Overdose Prevention Site is a collective – there is no hierarchy and we are run by volunteers (made up of peers, community, people who use substances, harm reduction workers, nurses, doctors, etc.) and donations.

How often do people get opioid poisoning when they are there?
Its hard to say. Everyday is different and, of course, some days are busier then others. However, our statistics have shown approximately 1.06 people per day.

Are people being more risky with the type or strength of their substances because they are supervised?
I don’t think people are being more risky. There is always risk involved if someone uses. I think the outcome of our services is that people feel more safe. We have heard from of number of people who use at the tent that they are so happy and grateful we are here. Services users have said that they feel safe using in front of someone who will help then if something goes wrong and that its nice to know that people care.

What is the hardest part of your job?
No doubt about it - the loss. We have lost so many people during this opioid crisis. It is heartbreaking for the community. To build such close relationships with people and then to loose them in an instant is unfair. Secondly, I would say the inability for people with actual power to act is difficult, especially knowing that they could make serious change, which would without a doubt save lives.

 

What are the circumstances when Narcan doesn’t work?
NARCAN always works if it is an opiate overdose and if the person is reached in time. The thing to stress is that it only works for an opiate overdose. If there are other substances in someone’s system (e.g., stimulant, depressant, etc.) it is not going to take the effects of that substance away. At the Moss Park Overdose Prevention Site we have not anyone die due to an overdose, all overdoses that have occurred have been reversed safely.

What is one thing that you wish the public understood about addiction?
That it doesn’t only effect people that are living in poverty. Generally, it seems like people assume that all people who use are poor or uneducated. Addiction effects everyone, and every class of people. I wish that more people would understand that just because someone uses substances it doesn’t mean that are bad people. I have met some of the most incredible, inspiring and lovely people who use substances on a regular basis; just because they use does not mean they deserve to die alone in alleyways, that they don’t deserve apartments and dignity and quality of life. People are people and everyone deserves to live there best life, regardless if they use substances or not.

 
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© 2017 by SJHH Concurrent Disorders Capacity Building Team