OD Advice

[ProdigalSon]

Hey ya'll, just had a thought. Could you all maybe put up a PROFESSIONAL'S step by step instruction or guide on what to do in case of an OD. Id put it up somewhere else, put dont want some idiot to say a dead wrong thing. Reason is a friend of mine OD'd on H last night, he was in the middle of nowhere and it took the ambulance 45min to get there. He died en route to the hospital. And NOONE tried anything to save hime. I know CPR and trauma stabilization techniques and whatnot from my military training, as long as knowledge of what is happeneing physically when an overdose happens, so ttheres a start, might have been able to help him, might not who knows. And maybe even have it made to a sticky?

Thank You guys,

Mike

[candy]

It is always good to know CPR when you are dealing with people who use opiates and one thing to remember is that mixing two or more drugs that cause respiratory depression can lead to an overdose faster than that of just heroin alone. This is not to say that heroin will not cause an overdose, but many OD's were due to the mixing of heroin and another drug or alcohol.

The very first thing you want to do is put the person in the recovery position. Lie them on their right side with the left leg pulled over the right leg to stabilize them in this position. Then call 911! If there is someone else there with you, they can assist you in keeping your friend or loved one alive by helping with either staying on the phone with emergency assistance or doing CPR if the person is not breathing and has no pulse.

Remember if they have a pulse but need assistance with breathing, do not do compressions and just help with giving them oxygen by mouth to mouth. Only start compressions if you have no pulse.

With an overdose, respiratory depression happens first before the heart stops, even if someone is still breathing, but unresponsive, they are overdosing. It does not always happen like you might see on T.V.

Do no try home remedies! No salt water injections or cocaine injections. Try and keep them awake by yelling their name or rubbing the sternum very hard. BY making a fist and rubbing their sternum, this make often wake or arouse the person and continue to do this is they respond.

There are still many who are afraid they will get busted if they call 911. Your friend is more important. If there are a few of you, stay calm, get rid of the rigs and drugs, but do not leave this person alone.

For those of you that just cannot stay.....Call 911! Give them all the info they need to help and find your friend. Make sure the entry to the home is unlocked and they know where they are. You want to make it as easy as you can for the EMT's to find your friend. Don't forget to put them in the recovery position by lying them on their right side, left leg crossed over right. This will keep them from aspirating any vomit and takes some pressure of the lungs in this position.

Unless you live a block from the ER, don't try and drive them their unless your willing to bring them through the door and make sure someone sees them immediately.

As an ER nurse, I have seen a few unlucky dudes obviously rolled from a moving vehicle, but unfortunately missed the ER entrance and were found in the bushes by the gardening crew and one found by a nurse who happened to see a shoe sticking out.
This is just completely unacceptable and you wouldn't want someone rolling your body from a car doing 40 flying by the ER....A body in motion, stays in motion sometimes and may miss the intended target!

If you live in an area where their is Needle Exchange...Ask about Narcan and if they give it out? Some cities are now doing this. Narcan can save someones life and make a huge impact on their outcome.

Take up CPR if you usually use with others. It's a one day class and many are cheap or offered free and can save a live. Get your freinds to go along. No one needs to know why your there.

If your in a group and someone is going for their first time injecting, be a mentor of sorts and make sure they don't do to much and are practicing safe techniques. If your a long time user, you will most likely know if it is too much for someone opiate naive. Yes, everyone is different, but you have more experience and you can help to keep a bad situation from happening.

Me, I made it a policy that anyone I used with had to be an experienced user. If someone was new to it, I would recommend they didn't do it. Maybe it sounds hypocritical, but an OD can ruin your high real quick and I just didn't want to see someone hurt.

Be smart, be safe, take action and get all the info. Keep a copy of instructions on how to do CPR on your fridge if you can or someone where it can be easily seen or obtained and everyone knows where it is. It is great in a scary situation and can really help you focus on doing it right!

Yeah, getting high should be fun.....But being prepared and knowing what to do in case of an OD is a good idea!

[candy]

The above info is good and I hope it helps anyone interested in reading it.
It really should be a must if your going to use with others!

[Woowoo]

Hey pill. I am no health professional and all my knowledge in this area comes from "street-smart" junky wisdom so maybe I have been tutored with dangerous advice. I was going to start a new thread on this subject, since you are asking for the professional's opinion. Instead, I decided to build on your thread and just take it in a different direction, if that's OK with everybody. I still think your idea is the best but I don't see any harm in going over non-professional advice.

What do you do, when your friend overdoses right in front of you?

Here's how I've been taught. I can't stress enough that I do not know if this advice is good, half-good, or totally reckless. I'm throwing it out here because it's the best advice I know, and if it's wrong I'd like to find out about it. I've been on both sides of this procedure and it's worked in my experience, but that doesn't mean shit. Anyhow, just to have a starting point, here goes:

#1. Don't panic. Don't worry about your own stupid ass, don't worry about hiding drugs, etc. Worry about somebody who is going to die in front of you if you don't do something quick.

#2. A lot of people in this situation feel they have to treat the OD victim very carefully, "baby them", treat them with kid-gloves. This is wrong. Their system needs to be shocked if they are going to come out of it.

#3. Start off pretending it's somebody who is in a deep sleep, and you're trying to wake them up. Grab them by the shoulders and shake them. Scream in their face. Slap them in the face (but not enough to actually cause damage). WAKE THEM UP!! I know it sounds silly but I've seen this work.

#4. If that fails, it's time for the "cold water" treatment. Put them in a shower and blast the coldest water possible on them. Continuing to scream and shake them.

#5. Keep in mind, that what is happening to them is that they are suffocating. Their lungs are forgetting to do that lung thing. Therefore, any point during the process, you may want to do some artificial resuscitation, which is really easy to do. It's not necessary to do this right away, but the longer they are out, the more important this becomes. Here's how you do artificial resuscitation in case you don't know: While they are on their back[i] hold their nose so that the air will not escape. Take a deep breath, and cover the victim's mouth with your mouth, and breathe into their mouth [i]slowly until their chest rises. Repeat this two or three times.

#6. If none of this is working, you have no choice but to dial 911. Paramedics are not cops, they probably don't even like cops, so put your legal concerns aside. This is not a likely bust-scenario (although I'm sure it can happen) so just chill and do the right thing.

Can anybody confirm or deny any of this advice? Is it madness or is it half-right or what? This is important shit that we all should know.

[Woowoo]

By the way pillophile, I am so sorry about your friend. I lost a friend to heroin myself, a real true friend--he was like a brother to me. All these years later it still hurts to think about it. I really want to believe he's in a better place now. Take care.

[nick]

Junkies ARE O.D. proffesionals and RING A GODDAM AMBULANCE.

[bronyraur]

Hey ya'll, just had a thought. Could you all maybe put up a PROFESSIONAL'S step by step instruction or guide on what to do in case of an OD. Id put it up somewhere else, put dont want some idiot to say a dead wrong thing. Reason is a friend of mine OD'd on H last night, he was in the middle of nowhere and it took the ambulance 45min to get there. He died en route to the hospital. And NOONE tried anything to save hime. I know CPR and trauma stabilization techniques and whatnot from my military training, as long as knowledge of what is happeneing physically when an overdose happens, so ttheres a start, might have been able to help him, might not who knows. And maybe even have it made to a sticky?

Thank You guys,

Mike

Sorry to hear about your friend, Mike. You have my condolences.

[nick]

http://harmreduction.org/index.html


I hope it works-if not,go to the harm reduction coalition website.

And I apologise-my first post was flipant.

Sorry for your loss Mike.

[Papa Verine]

I'm real sorry to hear about your freind Mike. Here in Chicago you can get a NARCAN shot from the needle exchange places. My ex-girlfreind carried one with her all the time. I OD'ed once and she gave me just enough to snap me out of it but not the whole shot because she didn't want to spoil my high.

If anyone is not familiar with this stuff it's a pure antagonist and injected it will reverse the effects of heroin or other opiates. If someone was there with a shot of this shit your freind would have been saved.

We should all have a needle full of some kind of antagonist for these situations. It's THE answer to your question!

[nick]

I'm real sorry to hear about your freind Mike. Here in Chicago you can get a NARCAN shot from the needle exchange places. My ex-girlfreind carried one with her all the time. I OD'ed once and she gave me just enough to snap me out of it but not the whole shot because she didn't want to spoil my high.

If anyone is not familiar with this stuff it's a pure antagonist and injected it will reverse the effects of heroin or other opiates. If someone was there with a shot of this shit your freind would have been saved.

We should all have a needle full of some kind of antagonist for these situations. It's THE answer to your question!

That's the kicker-you can get diamorphine on script here,but narcan is illegal.

[Woowoo]

That Harm Reduction site has this PDF file about overdose
http://harmreduction.org/pubs/PUBSpdfs/od2000.pdf
Here's a juicy part of it
If someone looks like they are overdosing, act quickly and follow
these steps:
First, find out if the person is conscious. See if the person can open
their eyes or speak to you: shake them and call their name. If that
doesn’t work try to bring them around by causing pain: rubbing their
breastbone with your knuckles really hard, or twisting a pencil up
against the space between their fingers. Don’t worry about either of
these methods hurting too much! It is more important that the
person wakes up.
and this

Do NOT inject the person who has overdosed on heroin with cocaine
or speed, or vice versa. It wastes valuable time and can make them
worse: it’s one more drug that their body has to deal with.

I've heard said before that you should bang some cocaine into somebody's vein if they OD. I always thought it sounded insane, good to see that myth busted.

Do NOT put the person in a cold water bath—they may drown. If they
are still breathing, you can put them under a cool shower to wake
them up, but stay there with them and keep the water away from
their nose and mouth.

So this actually confirms that some of what I posted above makes good medical sense including the cold shower thing. I don't see anything here about artificial resuscitation in this document though so maybe that part is BS?

(CORRECTION: It does endorse artificial resuscitation except they use the term "rescue breathing." It's not a way to wake them up, but it can buy more time.)

[Narkotikon]

Call out their name to make sure they're out, then call 911.

Commence with CPR after first checking their airway.

Try to talk with them, if they're just really really groggy that is. If they're completely out, put them into a bath tup with cold water.

Check their pupils to determin the type of drugs (stims tend to dilate; opies constrict generally, unless it's a major overdose in which case they can also dilate).

If you're lucky to have a shot of Narcan (which I don't see why ER techs wouldn't have in their abulance), try that. Or you could also try a shot of epinephrine or norepinephrine. You can sometimes get those pens from people with heart conditions. Not that I'm suggesting it.

Other than that, there's not much you can do. Not really sure what else to say.

[RoadHead]

mike--sorry to hear that you lost a buddy to OD. it's always hard to lose a friend no matter what the cause.


woo--on #5 in regards to the breathing, just want to add that if anyone DOES try the artificial respiration, just make sure to clear the airway first. any puke, food, dentures, ANYTHING---clear it out with a quick swipe of your fingers, then tilt their head back and start the respirations.

you will know if you have their head tilted back far enough because you will see the chest rise.

all of the other things that people have said all help also. main thing is try not to panic. you can't help them if you panic but you also don't need to worry about some bruises or cuts/scrapes, etc. they are already dead if you don't act fast so do whatever it takes to wake them up or get them breathing.

a little knowledge now may very well save the life of a loved one so if anyone has NOT taken a CPR class, they really should take one.

[Chemical_Boy]

mike--sorry to hear that you lost a buddy to OD. it's always hard to lose a friend no matter what the cause.


woo--on #5 in regards to the breathing, just want to add that if anyone DOES try the artificial respiration, just make sure to clear the airway first. any puke, food, dentures, ANYTHING---clear it out with a quick swipe of your fingers, then tilt their head back and start the respirations.

you will know if you have their head tilted back far enough because you will see the chest rise.

all of the other things that people have said all help also. main thing is try not to panic. you can't help them if you panic but you also don't need to worry about some bruises or cuts/scrapes, etc. they are already dead if you don't act fast so do whatever it takes to wake them up or get them breathing.

a little knowledge now may very well save the life of a loved one so if anyone has NOT taken a CPR class, they really should take one.

CPR saved my lousy ass when I ODd.

[ProdigalSon]

Guys, thank you very much for the things you said. I meant alot. Thing is with him, it wasnt a matter of if, it was a matter of when. I was kinda hopin maybe a sticky right at the top of the page, with a closed thread, from a Dr, like Euphoria2002 or Candy, just in case. I was 45 min away, actually listenin too U-100s radio station and wouldnt pick my phone up cause I didnt want to go to this party I was previously invited to because of all the H, and OCs and crack and coke and meth blah blah blah. Out in HICKVILLE USA, 20 miles to the nearest gas staton I think, anyways get this shit. I took the ambulance 45 min to arrive. The motherfuckers where callin me to ask what to do. They were so fucking high they forgot about the net. Still awaiting autopsy results but theres beatdowns comin to some of the motherfuckers that ran cause they were scared of the cops, trust me, theyll be harsh. And to the others, fuck em to. Dont play the game if you dont know the rules of the sport. Fuck em all. I need to get away from em anyway. I mean, they didnt do ANYTHING. NOTHING. The one guy on the phone was so incoherent he couldnt listen to the operators advice.

I think all of us opiophiles should have flat the fuck out, tried and true, step by step manual straight from a ER Dr. or something of the like posted on the site and make it aware to everyone. Maybe make us all pass a test to stay members after a couple months of havin it up:rolleyes:

[tonyk]

Well, I could probably help out as I work as a paramedic in a med. sized city. There are plenty of OD's frequently. I have worked there for14 yrs & have handled many OD calls. There are definite protocols we follow & we can do just as much on the scene for the patient as they can in the ER.

[Narkotikon]

Cleveland? Just guessing.

[tonyk]

:cool: Nah, Nark, not the "mistake on the lake" city.

[Dolomiti]

If you have naloxone/narcan, use it immediately! If it's an opioid overdose, then the naloxone should reverse it. Do not let the person go without breathing. Rescue breathing if you must. If the heart stops then CPR. If they aren't breathing, they're not getting oxygen, and if they're not getting oxygen, they will die or at least suffer permanent brain damage within a few minutes.

Call for help... cops might show up first... if that is a problem then bring them outside if you must, or hide the stuff. Dont take the risk of not calling for help before it's too late. You probably don't need to tell them that it's a drug OD over the phone... but I dont know, but I've heard that it wont hurt to just say that this friend came over your place and passed out, you don't know why, and when the ambulance shows up mention that they might have taken a painkiller, or heroin, or something like that. If naloxone is available in your area, I strongly recommend owning some... can save a life.

[Chipper]

I OD'ed recently. My mates didn't waste time and called the ambulance. They revived me with both oxygen and narcan.

I have heard that you can get narcan from ?. As junkies, we really should have that stuff in our first-aid kit

[Narkotikon]

I know it probably wouldn't be as quick, but it is fairly easy to get Revia (naltrexone), which is also an antagonist like Narcan. They give it a lot after you're detoxed for help with cravings. I've been offered it five times by doctors, but I've always turned it down. I'm depressed enough naturally without opies, that I'd think taking that would make things worse by fucking up the natural endorphins that I do have. But yeah, you could probably keep that on hand easier than you could Narcan.

[ProdigalSon]

Well, I could probably help out as I work as a paramedic in a med. sized city. There are plenty of OD's frequently. I have worked there for14 yrs & have handled many OD calls. There are definite protocols we follow & we can do just as much on the scene for the patient as they can in the ER.


Goddamn it!!!!:D please share what to do..

[red26]

POONWALLA OVERDOSED I CANT FIND THE START THREAD THINGAMAFUKER TELL ME HOW.:( :( :(

[Chipper]

I'd think taking that would make things worse by fucking up the natural endorphins that I do have

I don't that anatagonists have any effect on your natural endorphins but you may correct me if i am wrong

[Dolomiti]

I just copied this section from the Better Vein Care manual from Chicago Recovery Alliance (PDF file):

Overdose Management - The most critical thing to do if someone
overdoses on heroin is to keep them breathing! Knowing and using rescue
breathing/cardio-pulmonary resuscitation (CPR) will save lives as might
naloxone, the drug shown here. Although naloxone has no effects on its own it
dramatically reverses the effects of opiates. If given intravenously naloxone
reverses an overdose almost instantly, injecting it into a muscle take only a little
longer to work. While 1mg IV is the suggested initial dose more can be given if
there is no response up to 10mg, at which point the overdose is probably not
opiate induced. If you only give a naloxone shot under the skin, and not into the
muscle it takes longer to have an effect and unless you are breathing for the
person they could die. Breathing for them until they do it on their own is always
a good idea.
In addition to possibly performing miracles in case of overdose, naloxone also
stimulates withdrawal in those who are opiate addicted. Also, naloxone's effects
only last 60 to 90 minutes and so, depending on the length of action of the opiate
used, the overdose can return after the naloxone wears off. Clearly, learning
about naloxone's benefits and limitations is very important to using it helpfully.
Discussing 911, CPR, naloxone and other overdose management techniques with
the people you inject with is critical to being prepared for effective action in case
of an overdose.

AAnd a fairly unrelated note, which may help lessen chances of OD:
A getting a hit he injects a small
amount of drug, stops to taste/feel it (first highlighted picture), injects some
more, stops to taste/feel it (second highlighted picture), and then injects the rest.
This extra measure of safety can prevent overdoses and other harmful
experiences while injecting. Use of this procedure is especially useful when you
are not sure of your tolerance and/or are using a newer source or different type
of drug.

[robojunkie]

POONWALLA OVERDOSED I CANT FIND THE START THREAD THINGAMAFUKER TELL ME HOW.:( :( :(

Red, just hit the "home" link where the "new posts" and other links are then hit "forums" in the same place once you go home. Then open one of the forums and the option to start a new thread will be right at the top of any forum/sub-forum you open. Is he OK? Updates?

[tonyk]

Everyone, I am trying to be respectful on these forums as I am still rather new. Nothing worse than some hot-shot that blah-blah-blahs about every topic. I've been sitting back, reading & learning. I feel you should earn any position. So now along comes a topic I am familiar with & I know I can help with. So here goes: Any patient that is "altered" goes by the decreased level of consciousness protocol. First is airway, unless the pt fell hard (not slumped to the floor) the pt should be positioned on their back or side with their chin up so they aren't kinking their airway. If there are bystanders I start asking questions of them to try to determine what may have caused the pt's current state. I don't share with the cops. Actually I make them get back & give me space. Usually there is a strong feeling that it is a possible OD. Next check for breathing. Opiates typically slow ( & sometimes stop) the resp. rate. I apply high-flow oxygen & prepare to provide artificial resps. Without any equipment this would be mouth to mouth. Prepare yourself for poss. pukeing:( .:( I would check the pt's other vital signs, start an IV & check their blood sugar level. If their BS is within normal range administration of Narcan, IV Push, in 2mg. increments would be the next & only option. I have seen it wake up an OD immediately & they sometimes need restraints as they may be violent.

So, as a friend with no equipment, the best you can do is: Don't panick, open airway, check for breathing & start mouth to mouth if they aren't breathing on their own( or if they are only breathing very shallowly & slow at less than 10-12 times a minute.) CALL 911!! Chec.k for pulse & start chest compressions if there is none. Like someone said, everyone should have aclass on CPR. Think how helpless you would feel if your friend was dying & you couldn't do anything!

Narcan is a prescribed med so I don't know how anyone could get it. It is in our med kit at work. Sure would be great to have on hand for any junky outings. Could very well save someones life. But if you could atleast do CPR until the paramedics arrive that is the best option.

Hope this has been of some help. Be glad to answer any questions & if I don't know the answer I will look it up. Tonyk

[ProdigalSon]

POONWALLA OVERDOSED I CANT FIND THE START THREAD THINGAMAFUKER TELL ME HOW.:( :( :(


Holy mother of fuck...that made my heart sink

[nick]

Everyone, I am trying to be respectful on these forums as I am still rather new. Nothing worse than some hot-shot that blah-blah-blahs about every topic. I've been sitting back, reading & learning. I feel you should earn any position. So now along comes a topic I am familiar with & I know I can help with. So here goes: Any patient that is "altered" goes by the decreased level of consciousness protocol. First is airway, unless the pt fell hard (not slumped to the floor) the pt should be positioned on their back or side with their chin up so they aren't kinking their airway. If there are bystanders I start asking questions of them to try to determine what may have caused the pt's current state. I don't share with the cops. Actually I make them get back & give me space. Usually there is a strong feeling that it is a possible OD. Next check for breathing. Opiates typically slow ( & sometimes stop) the resp. rate. I apply high-flow oxygen & prepare to provide artificial resps. Without any equipment this would be mouth to mouth. Prepare yourself for poss. pukeing:( .:( I would check the pt's other vital signs, start an IV & check their blood sugar level. If their BS is within normal range administration of Narcan, IV Push, in 2mg. increments would be the next & only option. I have seen it wake up an OD immediately & they sometimes need restraints as they may be violent.

So, as a friend with no equipment, the best you can do is: Don't panick, open airway, check for breathing & start mouth to mouth if they aren't breathing on their own( or if they are only breathing very shallowly & slow at less than 10-12 times a minute.) CALL 911!! Chec.k for pulse & start chest compressions if there is none. Like someone said, everyone should have aclass on CPR. Think how helpless you would feel if your friend was dying & you couldn't do anything!

Narcan is a prescribed med so I don't know how anyone could get it. It is in our med kit at work. Sure would be great to have on hand for any junky outings. Could very well save someones life. But if you could atleast do CPR until the paramedics arrive that is the best option.

Hope this has been of some help. Be glad to answer any questions & if I don't know the answer I will look it up. Tonyk

They give out the narcan after you do a half day course.


Which is cool,you rarely see it at all in the UK.

[Lil_Miss_Brownstone]

I have been resuscitated three times with narcan, all in my first couple yrs of using H, before I had any kind of habit. so i never experienced the wd from it. I was also revived by a friend using CPR. The cartilage in my chest was crushed, which hurt for a couple weeks, but otherwise I was fine and able to enjoy my high afterwards.

I do not know where you would get narcan in the detroit area, but suboxone contains naloxone, right? would crushing up suboxone and IM-ing an OD'd person help at all???? Most of my friends (i don't use with anyone who isn't a long-term user) have crap veins I don't know if I could hit in a panic.

[Synack]

I have been resuscitated three times with narcan, all in my first couple yrs of using H, before I had any kind of habit. so i never experienced the wd from it. I was also revived by a friend using CPR. The cartilage in my chest was crushed, which hurt for a couple weeks, but otherwise I was fine and able to enjoy my high afterwards.

I do not know where you would get narcan in the detroit area, but suboxone contains naloxone, right? would crushing up suboxone and IM-ing an OD'd person help at all???? Most of my friends (i don't use with anyone who isn't a long-term user) have crap veins I don't know if I could hit in a panic.

A shot in the heart? maybe? ...

[underide]

A shot in the heart is pure myth. You will kill someone doing that for fucks sake!!
Narcan is meant to be effective iv. But not the way they dramatize it in Hollywood, not into the heart

[ChesterMcEnroe]

I would say to never worry about getting busted while someone id OD'ing. When I OD'ed on Coke in October of '06 (havn't touched it since) my dad called 911 right away and all that came was an ambulance and two fire truck type vehicles. No cops. However, the lead paramedic guy told me to tell them where my shit was so my dad could throw it away. Which is exactly what happened, they didn't lie and no cops ever came.

[Duckfeet]

It's important to read the *dates* on these old threads, especially if there is controversial advice...sometimes just letting threads die, rather than *once* more, all of us arguing over whether or not we are qualified to be shooting up our friends w/nalaxone...

got OD, call 911....don't know CPR? Take a class...

[monkeyphunk]

That's the kicker-you can get diamorphine on script here,but narcan is illegal.
its funny that narcan is illegal there being that narcan given to non opipate addicted people does absolutly nothing thats right its the same as water to a non opiod tolerant person

[candy]

Imagine if they allowed for scripts of Narcan. Do you realize how many unnecessary deaths would not have
occurred.

But, giving scripts of Narcan would only promote the drug problem according to those fighting this war on drugs!
My God, saving the lives of junkies.....How absurd?(said so sarcastically)

I think in some areas up North in California they have Narcan for IV drug users at Needle Exchange.