This week, my University offered opioid overdose and Narcan training for anyone who was available to attend. While this has not been an issue at our library, it is a concern for every library. The training was presented be HIPS, a local harm reduction non-profit, and it provided a comprehensive look at this issue. 

I am going to share my (lengthy) notes from the training. I have removed the DC specific information but I guarantee there is a local organization near you that would be happy to provide training. Whatever your views on the drug crisis, it's never a bad decision to save a life. (Note - Narcan is the brand name for naloxone.) 
​

• Fentanyl is often mixed into other drugs without the user knowing it; Fentanyl is so prevalent that it's most of the supply - when people think they are getting meth/cocaine, it's mostly fentanyl

• OD on opioids causes respiratory depression - that's the symptom which kills

• Fentanyl is 10-50x stronger which is what makes it more dangerous; this is particularly dangerous for older users who are used to less potent drugs

• Naloxone ONLY reverses opioid overdoses; it does not work on other drugs

• A new drug, tranq, is making fentanyl worse by "giving it legs" - makes it harder to revive with Narcan but Narcan can still work; Tranq is also causing necrosis in those who use it

• Narcan will bring someone back AS LONG AS they are still alive; The timeline depends on how far gone they are - the faster you can use Narcan the better; In some cases, you can bring someone back, but they may have permanent brain damage

• "Fentanyl is no fun." - people are mostly doing the drug to avoid withdrawal

• The stats we have on ODs and how many people are saved by Narcan are undercounted because most revivals are not reported; drug users don't like to call 911

• Massive jump in 2019-2020 from ODs due to pandemic impacts (i.e. people using alone) and increase of fentanyl in the drug supply

• You are more likely to die if you are medically vulnerable - unhoused, food insecure, preexisting conditions, etc.

• There is no age that is too young to do this training - a lot of kids save their family or caretakers lives

• "If it's not coming out of a pharmacy, it's probably fentanyl."

• Needle/intramuscular naloxone is more effective but nasal is much easier to give and people are less squeamish; if giving by needle - in the muscle - arm or thigh is best

• Narcan is roughly $50 OTC

• 5 Steps to Administer Narcan

  • Assess responsiveness

  • Call 911

  • Administer Narcan

  • If necessary, perform rescue breathing

  • Place person in recovery position

• If someone is responding - mumbling, moving - they are NOT overdosing 

• Look for grey, purple, or blue nails, doesn't wake up, difficulty breathing or not breathing, cold/clammy skin

• Assess: Call verbally by name if you can, loudly say "I'm going to Narcan you of call 911 if you don't respond."; assess physically - sternum rub or rub knuckles over upper lip - assessing should take 5-10 seconds total

• Call 911 (or dose with Narcan first then call 911)

• DON'T SAY drugs or overdose when calling 911

  • Cops will show up first if you say drugs or OD

  • Instead say, "I can't wake them up," "Someone is not breathing," just ask for an ambulance

• To administer

  • Peel open package

  • Tilt person's head back

  • Place in nostril and firmly press plunger

  • IF NO response repeat after 2-3 minutes with second dose (second dose is in same package)

• Narcan DOES NOT HARM - even if the person is not ODing or using drugs, it is safe for everyone

• Rescue breathing is rarely needed - 2 breaths every 5 seconds until EMS arrives (chest compressions not necessary)

• Place in rescue position - lay person on their side in a supported position so that they cannot roll over (to prevent choking should vomiting occur)

• MYTHS: Fentanyl cannot be absorbed through the skin or aerosolized (unless there is NO air movement)

• If you do touch fentanyl - stay calm, wash your hands thoroughly with soap and water, avoid touching your face (The myths are designed to scare people)

• Half-life of naloxone is 30-90 minutes, it is possible that a person can OD again from the same original OD since the drug has a much longer half-life; Encourage person not to use again and get medical attention - if person refuses medical attention, stay with them for 3 hours

  • It can help to tell people they won't get high anyway while naloxone is still in their system

• Naloxone has no side effects - but withdrawal symptoms from the opioids can occur which feels like side effects

• Naloxone is safe to take during pregnancy

• Narcan has no known drug interaction

• People don't remember ODing - they may be confused, scared, emotional; Overdoses can be stressful on everyone, and support is available for both users and caregivers

• Bringing someone back is not enabling drug use - you are always doing the right thing by saving a life

• Storage: Don't freeze it; store at room temperature - but is better to have with you so you can use it

• Narcan gets a little weaker but it does not go bad - even weaker, it is still effective, you just may need to use both doses; Studies show that Narcan works 30 years past the expiration date with minimal lose of effectiveness

• Dispose of used Narcan in the trash

• You are protected under the Good Samaritan Law (further protections may exist under local or state law, varies by location)

• Anyone can carry and administer naloxone

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I’m about 50 pages from the end of The Ballad of Never After. I’ve hit the point of the book where all I want to do is speed read to the finish… and then immediately start book three. (Good thing I already grabbed that from the library.)

*Books shared here are affiliate links for Bookshop.org

• Breadfruit sounds amazing. [The Atlantic - gift link]

• Gorgeous concrete. [PetaPixel]

• The science behind the aromas in wine. [Wine Folly]

• Reading newspapers on TikTok. [NPR]

• What data you can (and can't trust) from your wearable fitness tracker. [Lifehacker]

• You have got to be kidding me with this. [Literary Activism]

• The dawn of plastic surgery and the lives it saved. [Noble Blood]

• How do you solve a problem like covering Trump? [The Daily]

• Get thee to the path of totality. [Life Kit]

• Oysters are way more than food. [Gastropod] 

• Tiny Paris apartments. [99% Invisible]

• An explainer about what just happened in real estate that is also an interesting look at how trial law happens. [Planet Money]

• The impact of World Central Kitchen and the attack on its convey in Gaza. [The Daily]

• We were apparently on the Road House bandwagon this week. It was a lot funnier than I expected. Also, Jake Gyllenhaal, who stars, clearly had a blast filming this. The music in many scenes was provided by live bands and was a downright fantastic soundtrack. The story follows Gyllenhaal as a new bouncer at a bar that is having some "issues" with problem patrons. Drama ensues. The bar may be a set but I want to drink there. Minus all the violence, of course. [Amazon Prime]

• Whilst perusing a recipe website we both like, the husband found burst cherry tomato basil chicken rigatoni. It was delicious - even if I couldn't add the cheese because ours went moldy. I highly recommend sticking with rigatoni as the noodle shape. Nothing else would be the same. [Ambitious Kitchen]

• For one of our vegetarian dishes, I tossed together chipotle portobello oven fajitas. This one is so dang easy and produces a wonderful dinner. I topped my tortillas with guacamole. The husband added cheese on top of that. Would also be good with sour cream. [Budget Bytes]

• I'm always on the lookout for new lunch meal prep ideas. I made warm broccoli, chickpea, and rice salad the same week I found it. This one is delicious. In fact, it's so good I considered making it two weeks in a row. It was perfect for lunch or you could top with chicken and call it dinner. I also think this would be a pretty good side dish or item to bring to a potluck. [WaPo -may be paywalled]

This hummingbird is stunning. The feathers are not just ombre in color, they are iridescent! [Collossal]

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Conducting round two of interviews for an open position on our team.