Costin Militaru
Romanian Harm Reduction Network
Goals
To increase knowledge and understanding of the
definition, causes and risk factors of OD
To explore and develop strategies for the prevention
of OD
To develop protocols for intervention when OD
occurs to minimize fatalities
To address critical issues related to trauma and loss
associated with OD
To promote provider and community responsibility
for OD prevention
Definition
An OD occurs when an individual takes more of
drugs or combination of drugs than the body can
handle.
In particular, OD occurs when certain vital organs get
overwhelmed, including:
Lungs, heart, liver, kidneys and brain
Symptoms
Awake but unable to talk
Body is very limp
Face is very pale
Pulse is slow, erratic or not there at all
Throwing-up
Passing out
Choking sounds
Breathing is very slow and shallow, erratic or has
stopped
DEATH BY OD CAN BE PREVENTED!
The symptoms of OD CAN BE FATAL without
intervention!
Overdose death CAN BE PREVENTED!
The RESPONSE to an OD is critical!
Who’s at risk?
Anyone who use drugs has the potential to OD
Any period of abstinence
Completion of residential treatment
Release from prison or jail
Other Risk factors
Major disappointment
Reuniting with family with history of conflicts
Holidays
Bio-Psycho-Social Risk Factors
Physical health
Wight
Mental heath
Self-esteem
Social isolation
Unstable housing and living condition
Drinking problems
Dispelling Myths
“Old timers” don’t OD
In fact – in many cases, it IS “old-timers” who OD
Non-injectors can’t OD
Why OD happens
Quality of the drug
Quantity of the drug or drugs
Mode of administration
Policy factors
Prevention
Assessment of risk
Dialog with at-risk users or those with a history of use
Get people thinking about their use
Education: OD prevention tips
OD Prevention Tips
Mixing drugs increases likelihood of OD
If you are going to drink alcohol and use heroin, use
the heroin first
Take the drug in a way that gets you high slower
Do a tester shot
Keep track of how much you are using
More OD prevention Tips
Learn your tolerance
Use the same dealer whenever possible
Use with people you know and trust
If you must use alone, ask people to check in or
consider calling a friend
Locking the door makes it harder for help to reach
you
Consider your surroundings
More
Use less when you are ill or while you are recovering
from illness
Learn to hit yourself
Learn about drug pharmacology
Think though each step of your drug taking
Make an OD plan!
Recognizing Opiate OD
Moderate Serious severe
Uncontrollable nodding Awake – unable to talk Unconscious
Inability to focus Body is very limp Change skin color
Excessive drooling Erratic or very shallow Not breathing
breathing
Pale skin color Excessive vomiting No pulse or it’s shallow
or erratic
Incoherent speech Choking
Lying in vomit
Recognizing Stimulant OD
Moderate Serious Severe
Incoherent speech Inability to focus Seizures
Extreme paranoia Vomiting Unconsciousness
Pale skin Foaming at mouth Choking
Teeth clenching Pressure of chest Not breathing
Aggressiveness Unable to talk No pulse
Minor shakes Unable to walk
Excessive sweating Erratic pulse
Clammy skin Violent action
Very rapid pulse
Basic OD response
Stay calm as possible
Check responsiveness – HOW?
Sternum rub or cuticle pinch
If conscious – keep then tat way!
Do nothing
Pull into street and leave (scream “someone's not
breathing”)
Intervention: Taking Action
1. Stay calm as possible
2. Check Responsiveness
3. Call 911!
Remain as calm as possible
Quiet the space
Be clear and concise – I need an ambulance –
someone has stopped breathing
Give more info to EMS once they arrive
Intervention: Taking Action
4. Check Breathing and Pulse
5. Put them in Recovery position - or
6. Begin Rescue Breathing
Intervention: Taking Action
7. May need to clear airway
8. If no pulse – CPR (if trained)
9. Naloxone
10. Stay with them!
What is NOT helpful
Milk or salt shot
Other drugs
Ice on genitals
Cold bath
Excessive hitting or slapping
Making person vomit
Giving person food or drink
Leaving someone alone!
Postvention
Talking to OD survivors
Program impact of an OD on staff and clients
Counseling family members and clients