S A M H S A Opioid Overdose TOOLKIT: Safety Advice for Patiets & Family Members
TABLE OF CONTENTS SAFETY ADVICE FOR PATIENTS & FAMILY MEMBERS WHAT ARE OPIOIDS 3 PREVENTING OVERDOSE 3 IF YOU SUSPECT AN OVERDOSE 3 WHAT IS NALOXONE? 4 REPORT ANY SIDE EFFECTS 4 STORE NALOXONE IN A SAFE PLACE 4 SUMMARY: HOW TO AVOID OPIOID OVERDOSE 4 ACKNOWLEDGMENTS, ETC. 5 Ackowledgmets Disclaimer Public Domai Notice Electroic Access ad Copies of Publicatio Recommeded Citatio Origiatig Office Also see the other compoets of this Toolkit:. Facts for Commuity Members. Five Essetial Steps for First Respoders. Iformatio for Prescribers. Recoverig from Opioid Overdose: Resources for Overdose Survivors & Family Members
SAFETY ADVICE FOR PATIENTS & FAMILY MEMBERS WHAT ARE OPIOIDS? Opioids iclude drugs such as heroi ad prescriptio medicatios used to treat pai such as morphie, codeie, methadoe, oxycodoe (Oxycoti, Percoda, Percocet), hydrocodoe (Vicodi, Lortab, Norco), fetayl (Duragesic, Fetora), hydromorphoe (Dilaudid, Exalgo), ad bupreorphie (Suboxoe). Opioids work by bidig to specific receptors i the brai, spial cord ad gastroitestial tract. I doig so, they miimize the body s perceptio of pai. Stimulatig the opioid receptors or reward ceters i the brai also ca trigger other systems of the body, such as those resposible for regulatig mood, breathig, ad blood pressure. A variety of effects ca occur after a perso takes opioids, ragig from pleasure to ausea, vomitig, severe allergic reactios (aaphylaxis) to overdose, i which breathig ad heartbeat slow or eve stop. Opioid overdose ca occur whe a patiet misuderstads the directios for use, accidetally takes a extra dose, or deliberately misuses a prescriptio opioid or a illicit drug such as heroi. Also at risk is the perso who takes opioid medicatios prescribed for someoe else, as is the idividual who combies opioids prescribed or illicit with alcohol, certai other medicatios, ad eve some over-the-couter products that depress breathig, heart rate, ad other fuctios of the cetral ervous system [1]. PREVENTING OVERDOSE If you are cocered about your ow use of opioids, do t wait talk with the health care professioal/s who prescribed the medicatios for you. If you are cocered about a family member or fried, urge him or her to do so as well. Effective treatmet of opioid use disorders ca reduce the risk of overdose ad help a perso who is misusig or addicted to opioid medicatios attai a healthier life. A evidece-based practice for treatig opioid addictio is the use of FDA-approved medicatios, alog with couselig ad other supportive services. These services are available at SAMHSA-certified ad DEA-registered opioid treatmet programs (OTPs) [2,3]. I additio, physicias who are traied to provide treatmet for opioid addictio i officebased ad other settigs with medicatios such as bupreorphie/ aloxoe ad altrexoe may be available i your commuity [4]. IF YOU SUSPECT AN OVERDOSE A opioid overdose requires immediate medical attetio. A essetial first step is to get help from someoe with medical expertise as soo as possible. Call 911 immediately if you or someoe you kow exhibits ay of the symptoms listed below. All you have to say: Someoe is uresposive ad ot breathig. Give a clear address ad/or descriptio of your locatio. Sigs of OVERDOSE, which is a lifethreateig emergecy, iclude: Face is extremely pale ad/or clammy to the touch Body is limp Figerails or lips have a blue or purple cast The patiet is vomitig or makig gurglig oises He or she caot be awakeed from sleep or is uable to speak Breathig is very slow or stopped Heartbeat is very slow or stopped. Sigs of OVERMEDICATION, which may progress to overdose, iclude: Uusual sleepiess or drowsiess Metal cofusio, slurred speech, itoxicated behavior Slow or shallow breathig Pipoit pupils Slow heartbeat, low blood pressure Difficulty wakig the perso from sleep
SAFETY ADVICE FOR PATIENTS & FAMILY MEMBERS WHAT IS NALOXONE? Naloxoe (Narca) is a atidote to opioid overdose. It is a opioid atagoist that is used to reverse the effects of opioids. Naloxoe works by blockig opiate receptor sites. It is ot effective i treatig overdoses of bezodiazepies (such as Valium, Xaax, or Kloopi), barbiturates (Secoal or Fiorial), cloidie, Elavil, GHB, or ketamie. It also is ot effective i treatig overdoses of stimulats such as cocaie ad amphetamies (icludig methamphetamie ad Ecstasy). However, if opioids are take i combiatio with other sedatives or stimulats, aloxoe may be helpful. IMPORTANT SAFETY INFORMATION. Naloxoe may cause dizziess, drowsiess, or faitig. These effects may be worse if you take it with alcohol or certai medicies. Use aloxoe with cautio. Do ot drive or perform other possibly usafe tasks util you kow how you react to it. If you experiece a retur of symptoms (such as drowsiess or difficulty breathig), get help immediately. REPORT ANY SIDE EFFECTS Get emergecy medical help if you have ay sigs of a allergic reactio after takig aloxoe, such as hives, difficulty breathig, or swellig of your face, lips, togue, or throat. Call your doctor or 911 at oce if you have a serious side effect such as: Chest pai, or fast or irregular heartbeats; Dry cough, wheezig, or feelig short of breath; Sweatig, severe ausea, or vomitig; Severe headache, agitatio, axiety, cofusio, or rigig i your ears; Seizures (covulsios); Feelig like you might pass out; or Slow heart rate, weak pulse, faitig, or slowed breathig. If you are beig treated for depedece o opioid drugs (either a illicit drug like heroi or a medicatio prescribed for pai), you may experiece the followig symptoms of opioid withdrawal after takig aloxoe: Feelig ervous, restless, or irritable; Body aches; Dizziess or weakess; Diarrhea, stomach pai, or mild ausea; Fever, chills, or goosebumps; or Seezig or ruy ose i the absece of a cold. This is ot a complete list of side effects, ad others may occur. Talk to your doctor about side effects ad how to deal with them. STORE NALOXONE IN A SAFE PLACE Naloxoe is usually hadled ad stored by a health care provider. If you are usig aloxoe at home, store it i a locked cabiet or other space that is out of the reach of childre or pets. SUMMARY: HOW TO AVOID OPIOID OVERDOSE 1. Take medicie oly if it has bee prescribed to you by your doctor. 2. Do ot take more medicie or take it more ofte tha istructed. 3. Call a doctor if your pai gets worse. 4. Never mix pai medicies with alcohol, sleepig pills, or ay illicit substace. 5. Store your medicie i a safe place where childre or pets caot reach it. 6. Lear the sigs of overdose ad how to use aloxoe to keep it from becomig fatal. 7. Teach your family ad frieds how to respod to a overdose. 8. Dispose of uused medicatio properly. ReAd MoRe AT www.drugs.com/cdi/ aloxoe.html.
REFERENCES 1. BMJ Evidece Cetre. Treatmet of opioid overdose with aloxoe. British Medical Joural. Updated October 23, 2012. [Accessed March 24, 2013, at www.bmj.com] 2. Natioal Treatmet Referral Helplie 1-800-662-HELP (4357) or 1-800-487-4889 (TDD for hearig impaired) 3. Natioal Substace Abuse Treatmet Facility Locator: www.fidtreatmet.samhsa.gov/treatmetlocator to search by state, city, couty, ad zip code 4. Bupreorphie Physicia & Treatmet Program Locator: www.bupreorphie.samhsa.gov/ bws_locator Ackowledgmets This publicatio was prepared for the Substace Abuse ad Metal Health Services Admiistratio (SAMHSA) by the Associatio of State ad Territorial Health Officials, i cooperatio with Public Health Research Solutios, uder cotract umber 10-233-00100 with SAMHSA, U.S. Departmet of Health ad Huma Services (HHS). LCDR Brado Johso, M.B.A., served as the Govermet Project Officer. Disclaimer The views, opiios, ad cotet of this publicatio are those of the authors ad do ot ecessarily reflect the views, opiios, or policies of SAMHSA or HHS. Public Domai Notice All materials appearig i this volume except those take directly from copyrighted sources are i the public domai ad may be reproduced or copied without permissio from SAMHSA or the authors. Citatio of the source is appreciated. However, this publicatio may ot be reproduced or distributed for a fee without the specific, writte authorizatio of the Office of Commuicatios, SAMHSA, HHS. Electroic Access ad Copies of Publicatio This publicatio may be ordered from SAMHSA s Publicatios Orderig Web page at www.store. samhsa.gov. Or, please call SAMHSA at 1-877-SAMHSA-7 (1-877-726-4727) (Eglish ad Español). Recommeded Citatio Substace Abuse ad Metal Health Services Admiistratio. SAMHSA Opioid Overdose Prevetio Toolkit: Safety Advice for Patiets. HHS Publicatio No. (SMA) 14-4742. Rockville, MD: Substace Abuse ad Metal Health Services Admiistratio, 2014. Origiatig Office Divisio of Pharmacologic Therapies, Ceter for Substace Abuse Treatmet, Substace Abuse ad Metal Health Services Admiistratio, 1 Choke Cherry Road, Rockville, MD 20857. HHS Publicatio No. (SMA) 14-4742. First Prited 2013. Revised 2014
HHS Publicatio No. (SMA) 14-4742 First Prited 2013. Revised 2014