Recognition, Response and Administration of Naloxone (Narcan)

Heroin

Hydrocodone

Codeine

Oxycodone

Demerol

Vicodin

Morphine

OxyContin

Darvocet

Tylenol 3

Fentanyl

Tylox

Dilaudid

Levorphanol

Methadone

Percocet

Opium

Percodan

Methadone ++++

24-32 Hours

Heroin +++++

6-8 Hours

Oxycontin +++++

3-6 Hours

Codeine +

3-4 Hours

Demerol ++

2-4 Hours

Morphine +++

3-6 Hours

Fentanyl +++++

2-4 Hours
+ Potency

Natural opioids: contained in resin of
opium poppy (morphine, codeine)

Semi-synthetic opioids: created from
natural opioids such as
hydromorphone, hydrocodone,
oxycodone, heroin etc.,

Fully Synthetic Opioids: Methadone,
Fentanyl

Rarely instantaneous

Can happen 1-3 hours after use

Body has ingested more than it can handle

Opioids attack receptors that control breathing

Oxygen can’t get to the brain

Heart stops

Unconscious, Coma, Death

Long-term Brain/Nerve/Physical Damage

Tolerance Shift

Mixing Drugs

Physical Health

Variation in
strength/content

Switching from
snorting/smoking to
injection

Using alone

Blue skin tinge- usually lips and
fingertips show first
REALLY HIGH
OVERDOSE
Muscles become
relaxed
Deep snoring or
gurgling (death
rattle)
Very infrequent or
no breathing

Body very limp

Face very pale

Pulse (heartbeat) is slow, erratic, or
Speech is
slowed/slurred
not there at all
Sleepy looking
Pale, clammy skin

Throwing up
Nodding

Passing out

Choking sounds or a
Heavy nod, not
responsive to
stimulation
Will respond to
stimulation like
yelling, sternal rub,
pinching, etc.
Slow heart
beat/pulse
gurgling/snoring noise

Breathing is very slow, irregular, or
has stopped

Awake, but unable to respond
Slow heart
beat/pulse

Are you alright?

Are you ok?

Pain Stimulus

If no response call 9-1-1

Rescue Breathing

Naloxone

Rescue Breathing

Salt Water

Suboxone

Ice On Body

Cold Shower

Cocaine

Milk

Burning Skin

Punching

Slapping

Fear of legal risk (outstanding warrants, DSS involvement, loss of
public housing)

Fear of judgment from family/ community

Personal embarrassment/shame

Other punitive measures (students loose federal financial aid)

Urban legends (homicide charge for being at an OD, being
deported)

Opioid Antagonist

Medication that reverses only OPIOID
Heroin
overdose

Can not get high on it

Can not abuse it

Stays active for 20-90 minutes
depending on metabolism, amount of
drug used

Liver Function

If they use before the Narcan wears off
Narcan
Opioid
receptor
Narcan has a stronger
affinity to the opioid
receptors than the heroin,
so it knocks the heroin off
the receptors for a short
time and lets the person
breathe again.

Harm Reduction?

Know some street slang (does not mean YOU have to use it)

Know the street myths about response

Referrals to outside programs for Narcan

Not just people who inject are at risk for
overdose.
Phone: (781) 592-0243
Thank You!!