Opioids and Naloxone
What are opioids:
Opioids are drugs intended to be used in treating pain. However, some individuals utilize these drugs to get high, and this incorrect usage may result in an overdose.
Common Opioids:
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Fentanyl
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Morphine
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Heroin
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Metadone
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Oxycodone
Signs & Symptoms of Opioid Overdose:
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Slow or lack of breathing
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Difficulty staying awake, walking, or talking
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Pale or blue skin
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Small pinpoint pupils
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Eyes rolled back
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Limp body
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Vomiting
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No response to noise or pain stimuli (ex. trap squeeze or sternal rub)
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Snoring or gurgling sounds
Who is at Risk of Opioid Overdose:
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Those who:
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are taking prescription opioids that were not prescribed to them and could be too strong
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are buying opioids from the street and don’t know how strong they are
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have bought street drugs that are laced with opioids
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have overdosed on opioids before
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are mixing opioids with other downers like alcohol or benzos (e.g. Valium, Xanax)
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have stopped using opioids for a while (which lowers theirs tolerance)
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have just been released from jail and haven’t used opioids in a while
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are using opioids alone
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How to prevent opioid overdose:
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Don’t give anyone your prescription opioids or take opioids prescribed for someone else.
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Don’t mix drugs or take drugs with alcohol.
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Don’t use opioids alone
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If you switch to a stronger opioid, use less and do a test dose.
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If you’re using opioids after cutting down or not using for a while, start low and go slow.
What is Naloxone:
Nalaxone is a drug that can be used to temporarily reverse an opioid overdose. It can help the overdosed individual regain consciousness & breathe normally again. This drug can be administered through either an injection or a nasal spray. It is important to note that this drug is not simply an antidote and the overdosed individual will require professional medical assistance regardless.
What is in a Naloxone Kit?
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Injectable:
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1 hard case
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2 (0.4 mg/1ml) vials of ampoules of naloxone
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2 safety-engineered syringes with 25g, 1” needles attached
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2 devices (known as “breakers,” "snappers,” or “openers”) for opening ampoules safely
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1 pair of non-latex gloves
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1 card that identifies the person who is trained to give the naloxone
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Nasal Spray
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1 hard case
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2 doses of Narcan® Nasal Spray (4 mg/0.1ml)
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1 pair of non-latex gloves
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1 card that identifies the person who is trained to give the naloxone
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1 insert with instructions (English and French)
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1 insert with additional information on the medication (English and French)
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*Remember to check the expiry date!
How to Use a Naloxone Kit
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Injectable:
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Shake their shoulders and shout their name.
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Call 911 if they are unresponsive.
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Give chest compressions
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Give naloxone:
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Inject 1 vial or ampoule (a small glass container) (0.4 mg/1 ml) of naloxone into their upper arm or upper leg.
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Resume chest compressions.
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Continue compressions until the person responds or EMS arrives. If they are not awake after 2-3 minutes, give a second dose of naloxone.
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If they begin to breath, put them in recovery position
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Stay until the ambulance arrives in case paramedics need help or information, or the overdose symptoms return. With more powerful opioids (fentanyl and carfentanil) there is a possibility that a person will go into overdose again even after they have been given naloxone.
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Nasal spray
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Shake their shoulders and shout their name.
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Call 911 if they are unresponsive.
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Give chest compressions:
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Give naloxone:
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make sure the person is lying on their back
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insert tip of nozzle into one nostril
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press the plunger firmly
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Resume chest compressions.
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Continue compressions until the person responds or EMS arrives.
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If they are not awake after 2-3 minutes, give a second dose of naloxone.
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If the person begins breathing on their own, or if you have to leave them on their own, put them in the recovery position.
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Stay until the ambulance arrives in case paramedics need help or information, or the overdose symptoms return. With more powerful opioids (fentanyl and carfentanil) there is a possibility that a person will go into overdose again even after they have been given naloxone.
How to get a naloxone kit:
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Naloxone is available without a prescription at participating pharmacies, and you will need to show your Ontario Health Care. The pharmacist will provide you with training on how to recognize overdose & how to use the naloxone kit
Participating pharmacies at Mac
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Shoppers Drug Mart
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1341 Main St. West, Hamilton L8S 1C6 (across main)
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991 King St. West, Hamilton L8S 1K9 (in Westdale)
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101 Osler Dr. Dundas L9H4H4 (in University plaza)
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620 King St. West Hamilton L8P1C2 (Dundern & King)
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181 Main St. West, Hamilton L8P 4S1 (Main & Hess)
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Metro pharmacy
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119 Osler Dr. Dundas L9H 4B6 (in Univesity plaza)
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Whitney Plaza Pharmacy
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1819 Main St. West, Hamilton L8S 1H6
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King Medical Pharmacy
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Unit 5 505 King St. West, Hamilton L8P 1B9
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McMaster Health Campus Pharmacy
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100 Main St. West, Hamilton L8S 4J9 (Main & Bay)
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For more locations around Ontario, please visit: https://www.ontario.ca/page/where-get-free-naloxone-kit
For More Information, please visit:
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http://www.health.gov.on.ca/en/pro/programs/drugs/naloxone/
https://www.opatoday.com/professional/resources/for-pharmacists/tools-and-forms/naloxone -
Published literature:
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Orkin A, Gassanov MA, Shahin RM. Development and implementation of an opioid overdose prevention and response program in Toronto, Ontario. Canadian Journal of Public Health. 2013 May;104(3):e200-4.
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