TAKE HOME NALOXONE - The Right to Survive Overdoses
Can you explain what Naloxone is?
Naloxone is a medication that has been used for many decades.
It is used as an emergency antidote
to reverse the symptoms of an opioid overdose.
Heroin goes to a centre called the pons,
where the respiratory centre of the brain is.
Heroin works at that centre and depresses it,
and then in overdose, finally turns it off
so that the brain is no longer instructing the lungs to breath.
Overdose is a leading cause of death
for people who use drugs.
[In] countries where that is recorded well, we see that overdose is a leading cause of death among youth.
In New York City, there are actually far more deaths from opioid overdose every year
than there are murders and suicides.
The most important thing to do for overdose is Naloxone.
The medication has got to be the backbone of any intervention,
once the overdose happens.
There are two types of kits that are generally used in the United States.
One comes in either a one millilitre vial like this,
or a ten millilitre vial which looks similar but bigger.
And that one is administered with an intramuscular syringe.
The other kind is for a nasal formulation which can be squirted up the nose.
This is the Naloxone.
This is an intramuscular syringe,
and you only need one millilitre.
And that is ready for injection into the arms, the thighs, the buttocks, anywhere there is muscle and fat tissue.
The second one is a liquid that is in a glass canister,
and it comes in two parts.
One is the syringe and the Naloxone,
and one is what is called a nasal applicator.
So you take that out,
you open this big yellow part.
You screw it on, you take this top off.
you take that top off,
you put it in,
and it is ready to go
into the nose.
I have actually revived five people myself.
The first one was woman a who,
and her boyfriend, had come to our outreach a number of times.
She was running through one time and she heard us talking about overdose
and Naloxone and she mentioned [it] to her boyfriend.
One day, they came to one of our sites
and got some syringes and other equipment - they went to inject.
She went out.
He was horrified.
She was unconscious and she was turning blue.
He did not want to bring her to the hospital, for fear of the police
and being charged with murder, which happens in Chicago.
He drove back to our site remembering what she had said about overdose.
He was crying, ìPlease help!î
We went to the car [and] she looked dead, as dead as anyone can look.
The first thing you do is you check to see if the person does not respond to painful stimulation,
such as knuckles on the lips or the chest.
She did not, so I drew up a cc [cubic centimetre] of Naloxone and injected it into her shoulder.
[I] lead the chair back in the passenger seat and I breathed for her maybe three or four times and she woke up.
It sounded like this [sharp intake of breath]
ñ just like a baby being born or someone splashing you with cold water.
I spent the next half hour with her and her boyfriend,
teaching them about overdose and how to help each other should it happen again.
And it did, it happened a few times with them and they revived each other.
They are still alive, happy, and healthy today.
[A] relatively new practice that has proven to be quite effective
is the distribution of Naloxone directly to people who use drugs.
Previously, it was available, and it has been available for a long time, for hospital based uses.
But what we see is that most of the time when a drug overdose occurs,
people are not necessarily near the place where the Naloxone is available.
Often times, there is reluctance to call for medical help
because people are afraid of police interference.
What we can do by giving out Naloxone to the communities,
the families, the friends of people who use drugs is to make sure the Naloxone is where it needs to be
when overdoses occur.
A very brief kind of training ñ ten minutes on a street corner,
and that can be enough to give someone the skills to be able to save someoneís life in that situation.
There are several medical precedents
for putting medical interventions into peopleís hands in case of accidental poisonings:
like giving people an Epipen if they are allergic to bee bites,
or most people when they are diabetic, are prescribed Glucagon
which is a medication that can help them if they have an insulin reaction.
So, there are these presedents and both Glucagon and epinephrine
have far more potential for harm than Naloxone does.
It has no potential for abuse.
It has one action only: it blocks the opiate receptor.
In someone who is not dependent on opiates, you will feel nothing.
It is like sugar water.
You could pump...
a cup of it into a newborn baby
and the baby would feel nothing.
This is an incredibly cost-effective intervention.
Naloxone costs a dollar a vial.
So it is not an expensive thing, it just needs to become part of the way we provide services
The international research, as well as the research conducted in the United States,
I think [makes] a very convincing case for the continued support of the Naloxone programs.
In most programs, for every ten people that you train and give Naloxone to,
one person will use that Naloxone to reverse an overdose.
So when you talk about training ten thousand people,
you are talking about saving potentially hundreds of lives.
In Khorog, in Tajikistan, the local NGO began to distribute Naloxone
both among communities of people who use drugs and to emergency services.
And you can see, really, within the first year of their work that they have reduced overdose death almost to zero.
Whereas previously, I think they were having around two hundred deaths a year.
They have started a number of
pilot overdose prevention programs in Russia,
which work very successfully
and which have shown their efficiency
duringthe last, I think, two years.
Naloxone became probably one of the most popular harm reduction products in the cities.
Drug users come first for the Naloxone and then to get other services, such as
syringes or drug testing or whatever.
We have, across the board, had very positive feedback especially from parents of children who are using drugs,
where they feel empowered for the first time to have something where they can save their childrenís lives.
Heroin addicts know that they are useless,
that they are worthless,
that most people think that they would be better off dead.
They know that.
They get told that by all sorts of people all the time.
And they begin to believe it.
When we give someone a blottle of Naloxone, we are telling them with actions
ñ so much better than words ñ
ìHere. It matters whether you live or die.î