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Opiate Overdose Prevention and Intervention in Chicago Use of a proven antidote to save lives where they are being lost on the streets Dedicated to John Szyler the originator of Any Positive Change

Opiate Overdose Prevention and Intervention in Chicago1).pdf · Of 133 reported saves: • 2nd 1cc was required to reverse OD 4x -- 1 thought SQ shot by mistake, 2 impatient • One

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Page 1: Opiate Overdose Prevention and Intervention in Chicago1).pdf · Of 133 reported saves: • 2nd 1cc was required to reverse OD 4x -- 1 thought SQ shot by mistake, 2 impatient • One

Opiate Overdose

Prevention and Intervention

in Chicago

Use of a proven antidote to save

lives where they are being lost

on the streets

Dedicated to John Szyler the originator of Any Positive Change

Page 2: Opiate Overdose Prevention and Intervention in Chicago1).pdf · Of 133 reported saves: • 2nd 1cc was required to reverse OD 4x -- 1 thought SQ shot by mistake, 2 impatient • One

RESULTS TO DATE Of 133 reported saves:

• 2nd 1cc was required to reverse OD 4x -- 1

thought SQ shot by mistake, 2 impatient

• One OD required an additional shot to

reverse possible impending return of OD

• Discomfort was reported 3x - 2 w/ IV use, 1

w/ 2cc dose - one seizure, two vomiting

• Most cases person was cyanotic before use of NX

• OD saves were negative experiences for all

Page 3: Opiate Overdose Prevention and Intervention in Chicago1).pdf · Of 133 reported saves: • 2nd 1cc was required to reverse OD 4x -- 1 thought SQ shot by mistake, 2 impatient • One

Enough Motivation!!?!?

Source: DAWN

Page 4: Opiate Overdose Prevention and Intervention in Chicago1).pdf · Of 133 reported saves: • 2nd 1cc was required to reverse OD 4x -- 1 thought SQ shot by mistake, 2 impatient • One
Page 5: Opiate Overdose Prevention and Intervention in Chicago1).pdf · Of 133 reported saves: • 2nd 1cc was required to reverse OD 4x -- 1 thought SQ shot by mistake, 2 impatient • One

Gold Standard of Motivational Analysis

If you were to inject

an opiate of

uncertain

quality/purity

would you want naloxone next to you along with a

person who knows how to use it?

Page 6: Opiate Overdose Prevention and Intervention in Chicago1).pdf · Of 133 reported saves: • 2nd 1cc was required to reverse OD 4x -- 1 thought SQ shot by mistake, 2 impatient • One
Page 7: Opiate Overdose Prevention and Intervention in Chicago1).pdf · Of 133 reported saves: • 2nd 1cc was required to reverse OD 4x -- 1 thought SQ shot by mistake, 2 impatient • One
Page 8: Opiate Overdose Prevention and Intervention in Chicago1).pdf · Of 133 reported saves: • 2nd 1cc was required to reverse OD 4x -- 1 thought SQ shot by mistake, 2 impatient • One
Page 9: Opiate Overdose Prevention and Intervention in Chicago1).pdf · Of 133 reported saves: • 2nd 1cc was required to reverse OD 4x -- 1 thought SQ shot by mistake, 2 impatient • One

Naloxone Impact

Page 10: Opiate Overdose Prevention and Intervention in Chicago1).pdf · Of 133 reported saves: • 2nd 1cc was required to reverse OD 4x -- 1 thought SQ shot by mistake, 2 impatient • One

Low Threshold Treatment Options - All are Welcome

Page 11: Opiate Overdose Prevention and Intervention in Chicago1).pdf · Of 133 reported saves: • 2nd 1cc was required to reverse OD 4x -- 1 thought SQ shot by mistake, 2 impatient • One
Page 12: Opiate Overdose Prevention and Intervention in Chicago1).pdf · Of 133 reported saves: • 2nd 1cc was required to reverse OD 4x -- 1 thought SQ shot by mistake, 2 impatient • One
Page 13: Opiate Overdose Prevention and Intervention in Chicago1).pdf · Of 133 reported saves: • 2nd 1cc was required to reverse OD 4x -- 1 thought SQ shot by mistake, 2 impatient • One
Page 14: Opiate Overdose Prevention and Intervention in Chicago1).pdf · Of 133 reported saves: • 2nd 1cc was required to reverse OD 4x -- 1 thought SQ shot by mistake, 2 impatient • One
Page 15: Opiate Overdose Prevention and Intervention in Chicago1).pdf · Of 133 reported saves: • 2nd 1cc was required to reverse OD 4x -- 1 thought SQ shot by mistake, 2 impatient • One
Page 16: Opiate Overdose Prevention and Intervention in Chicago1).pdf · Of 133 reported saves: • 2nd 1cc was required to reverse OD 4x -- 1 thought SQ shot by mistake, 2 impatient • One
Page 17: Opiate Overdose Prevention and Intervention in Chicago1).pdf · Of 133 reported saves: • 2nd 1cc was required to reverse OD 4x -- 1 thought SQ shot by mistake, 2 impatient • One

Medical Precedents to

Take-Home Naloxone

IM Epinephrine

for severe allergic individuals

IM Glucagon

for diabetic individuals for reversing insulin shock

Page 18: Opiate Overdose Prevention and Intervention in Chicago1).pdf · Of 133 reported saves: • 2nd 1cc was required to reverse OD 4x -- 1 thought SQ shot by mistake, 2 impatient • One
Page 19: Opiate Overdose Prevention and Intervention in Chicago1).pdf · Of 133 reported saves: • 2nd 1cc was required to reverse OD 4x -- 1 thought SQ shot by mistake, 2 impatient • One

T R A I N I N G

Page 20: Opiate Overdose Prevention and Intervention in Chicago1).pdf · Of 133 reported saves: • 2nd 1cc was required to reverse OD 4x -- 1 thought SQ shot by mistake, 2 impatient • One

PRACTICE

Page 21: Opiate Overdose Prevention and Intervention in Chicago1).pdf · Of 133 reported saves: • 2nd 1cc was required to reverse OD 4x -- 1 thought SQ shot by mistake, 2 impatient • One
Page 22: Opiate Overdose Prevention and Intervention in Chicago1).pdf · Of 133 reported saves: • 2nd 1cc was required to reverse OD 4x -- 1 thought SQ shot by mistake, 2 impatient • One
Page 23: Opiate Overdose Prevention and Intervention in Chicago1).pdf · Of 133 reported saves: • 2nd 1cc was required to reverse OD 4x -- 1 thought SQ shot by mistake, 2 impatient • One
Page 24: Opiate Overdose Prevention and Intervention in Chicago1).pdf · Of 133 reported saves: • 2nd 1cc was required to reverse OD 4x -- 1 thought SQ shot by mistake, 2 impatient • One

WORKIN’ IT ON-SITE

Page 25: Opiate Overdose Prevention and Intervention in Chicago1).pdf · Of 133 reported saves: • 2nd 1cc was required to reverse OD 4x -- 1 thought SQ shot by mistake, 2 impatient • One

GRADUATION!!

Page 26: Opiate Overdose Prevention and Intervention in Chicago1).pdf · Of 133 reported saves: • 2nd 1cc was required to reverse OD 4x -- 1 thought SQ shot by mistake, 2 impatient • One

GRADUATION!!

Page 27: Opiate Overdose Prevention and Intervention in Chicago1).pdf · Of 133 reported saves: • 2nd 1cc was required to reverse OD 4x -- 1 thought SQ shot by mistake, 2 impatient • One

RESULTS TO DATE • program well accepted/appreciated by

participants - built on 22 years of pre-existing

relationships

• more frequent reports of OD preventative

injecting techniques

• no reports of adverse use – most use aversive

• Over 32,000 reached since 1996

• 5,123 peer reversals thru Feb 2014

Page 28: Opiate Overdose Prevention and Intervention in Chicago1).pdf · Of 133 reported saves: • 2nd 1cc was required to reverse OD 4x -- 1 thought SQ shot by mistake, 2 impatient • One

Shame

Stigma Silence

Condemnation

Ignorance Isolation

Page 29: Opiate Overdose Prevention and Intervention in Chicago1).pdf · Of 133 reported saves: • 2nd 1cc was required to reverse OD 4x -- 1 thought SQ shot by mistake, 2 impatient • One

Endpoints?

Cheap, widespread OTC Access

Legal and social support for staying alive despite drug use

Acceptance of healthy intoxication in humans