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Overdose Advice & Overdose Steps

Contents

Prevention

Overdose Intervention

What Not to Do

Related Internet Sites

 

Prevention

This information is given as a guide only and does not replace proper first aid instruction.  No responsibility taken for the accuracy of this information or consequences of its use.  See Disclaimer Notice for more detail.

  1. Get trained in first aid.  It may not only save your client's life, but also someone you love.  It sets a good example.
    bullet give the above advice to clients who are using substances as well as their family and friends
    bullet provide yourself and clients with the St John's Simple First Aid booklet - phone 1300 360 455 (free call in Australia).
    bullet advise clients to join an ambulance fund (or advise friends & relatives to give as a gift or find a sponsor to subsidise the cost of overdose call outs)
  2. Discuss risk of overdose with clients.  Those at particular risk include:
    bullet previous overdose
    bullet mixing drugs - eg heroin & tranquillisers/prescription drugs &/or alcohol
    bullet withdrawing from drugs (reduced tolerance)
    bullet drug users coming out of prison (reduced tolerance)
    bullet coming on to naltrexone or methadone programs
    bullet depressed, evidence of high risk-taking, suicidal
  3. Discourage using substances alone (using alone can include using with others who are also heavily sedated and/or who don't care)
  4. If using alone develop strategies for seeking assistance during first signs of OD
  5. Encourage clients to contact ambulance immediately for friends if they suspect overdose (police will not be called in WA unless death or violence - (click here for police guidelines re illicit drugs & overdoses in other Australian states - PDF format). This should be their first action but not their last (ie see interventions)
  6. Don't let clients go home alone if you suspect heavy drug use.  Stay with them, call a close friend/partner, use sobering-up facilities or call an ambulance.
  7. Support peer education networks
  8. Contact the Opiate Overdose Prevention Strategy (OOPS) project team in Perth for more information (08) 9370 0333
  9. Provide overdose post cards, 'Z-card' fridge magnets and other overdose information
  10. If Narcan (a reversal drug for opoid overdose) is used, advise to stay with others as they may lapse back into unconsciousness when the Narcan wears off
  11. Work towards reduced substance where possible and appropriate - discuss reduced tolerance in the context of relapse prevention
  12. Liaise with other health & welfare service providers, particularly police, ambulance officers, A&E hospital workers and Prison/Parole workers.

 

Overdose Intervention

This information is given as a guide only and does not replace proper first aid instruction.  No responsibility taken for the accuracy of this information or consequences of its use.  See Disclaimer Notice for more detail.

  1. Don't let them 'sleep it off'. They may roll on their back, vomit and stop breathing.

    Warning signs include:

    bullet

    Failing to Respond

    bullet

    Snoring and/or Gurgling

    bullet

    Blue Lips and/or Fingernails

  2. Place them in the recovery position as below.
    Recovery.gif (5099 bytes)

  3. Get someone to call an ambulance (000).
    Ambulance officers are not obliged to contact the police (in WA)
    - unless physically threatened or death occurs.

  4. Use the DR-ABC method:
    bullet Danger
    bullet Check for your and their safety (eg traffic)
    bullet Response
    bullet Gently shake & call name.  If a response, keep talking. 
    They may lapse into unconsciousness.
    If no response, turn on side (recovery position).
    bullet Airway
    bullet Check & clear airway while on side by removing any obstructions
    - possibly use a two-finger scoop from top to bottom.
    bullet Gently tilt head back and open mouth.
    bullet Breathing
    bullet Check for breathing by listening and watching for the rise and fall of the chest.
    Use your cheek to feel any breath.
    bullet If not breathing, commence mouth-to-mouth resuscitation.
    bullet Give 5 full breaths in 10 seconds with the head tilted back, chin forward,
    nose pinched and mouth sealed over the person.
    bullet Circulation
    bullet If breathing doesn't start, check the pulse in their neck (Carotid Pulse).
    bullet If pulse, continue mouth-to-mouth @ 15 breaths per minute.
    bullet If no pulse, commence Cardio-Pulmonary-Resuscitation (CPR)
    bullet Gently (but firmly) press the lower third of the breast bone about once a second,
    using a rocking motion, with your body weight over the person and straight arms,
    one hand over the other using the ball of your hand.
    bullet If one operator, 15 compressions to 2 breaths
    bullet If two operators, 5 compressions to 1 breath

     

What Not to Do

Do not wait for things to get better or for the drug to wear off - call an ambulance; better safe than sorry - this is about life and death.

Do not inject salt water - it simply doesn't work and wastes valuable time

Do not try to give anything by mouth to someone who has overdosed (eg, tea, coffee, alcohol). Apart from not working, you may make them vomit.

If someone is unconscious, it is not recommended that you make them vomit.  There is a significant risk or them inhaling their vomit and suffocating.

Do not inject amphetamines or other stimulants to try to reverse the effects of heroin.   It doesn't work and can complicate further emergency procedures.

Do not put an unconscious person in a bath - they may drown.  However, if someone has overdosed on stimulants (particularly Ecstasy), and their body feels very hot, consider using water soaked cloth to cool them as the ambulance arrives.

Do not use again after being revived, particularly if Naloxone/Nacan has been used.   Narcan may wear off while your first dose is still active.  A further depressant drug (heroin, Valium, alcohol, etc) will likely lead to another overdose.

Do not get aggressive with ambulance officers for saving your life.  You may attract the police if they feel threatened, you make it difficult for others who overdose and  it's not polite.

 

Related Internet Sites

[ Conference - Preventing Heroin Overdose: Pragmatic Approaches Jan 2000 Seattle - USA ]
[ Quick Overdose Tips USA ]

[ WA Opiate Overdose Strategy & Resources (WADASO Web) - Australia]

[ Opiate Overdose Prevention Strategy (OOPS) - Australia]
Signs someone has dropped |  What to do if someone drops | When you call an ambulance

[ Turning Point Overdose Prevention, Research & DROP Program Australia]

[ How Can We Reduce Heroin "Overdose" Deaths? ] Dr Wayne D. Hall.

[ Heroin Overdose: The Case for Take-Home Naloxone John Strang, Shane Darke, Wayne Hall, et al. ]

[ Drug-Specific First Aid Information - UK ]

[ Overdose Information - USA]

[ Guidelines From Different Australian States For Police Attendance At Overdoses (PDF) ]

Search the Rx List below for pharmaceutical drug information including overdose info.

 

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