APPENDIX 2

Overdose First Aid

Drug and alcohol overdoses can be fatal. Slow pulse, breathing difficulty, hallucinations, pupil dilation, pale skin, sweating, vomiting, and unconsciousness are all indications of an overdose. If you suspect that someone has overdosed, you must act quickly.

If the victim is unresponsive, call 911 right away. If you must leave the person unattended in order to make the call, put them in the recovery position: on their side, with their bottom arm extended straight away from their body and their top arm bent over their chest, with the hand tucked under their head. The top leg should be crossed over the body. This tilts the head so that the victim faces downward, which ensures that any vomit can be expelled and the airways remain clear.

If you suspect that the victim has overdosed on opioids, and you have naloxone available, administer it. Here, it’s better to err on the side of caution. Naloxone can save the life of someone who has overdosed on opioids, and it is not known to cause harm to anyone who has overdosed on something other than opioids.

If the victim stops breathing, or if their breathing is extremely labored, use a finger to clear any obstructions from their throat or mouth. Give CPR or rescue breathing if you’re properly trained.

If the victim is having convulsions, do not administer anything or induce vomiting. Wait until the convulsions have subsided, then place the victim in the recovery position so fluids can drain from their mouth. If vomiting occurs, make sure the patient is positioned at an angle where vomit can be expelled without causing choking.

If the victim is conscious and responsive, ask what they have taken as soon as possible, in case they end up losing consciousness. (The most likely drugs to cause an overdose include fentanyl, prescription opioids, heroin, cocaine, methamphetamines, benzodiazepines, and antidepressants.) Loosen the victim’s clothing to help keep airways open; open a window to let in fresh air. Keep the victim calm. Do not allow them to take anything else. If inhalants are involved, be sure the victim is no longer exposed to any toxic vapors, and avoid lighting a match. Keep the victim away from crowds, bright lights, intense movement, and loud noises—all can worsen the crisis. An overdose victim is likely to be disoriented, so watch carefully to prevent them from injuring themselves. For the victim who is conscious and responsive, you might try giving them a teaspoon of charcoal or two charcoal capsules in a glass of water. Charcoal will bind to the drug or toxins and help carry it out of the body. If the victim took barbiturates, tranquilizers, or opioids, or had too much alcohol, give strong black tea or coffee as a stimulant. Should the victim deteriorate or fail to improve within about five minutes, call 911.

All overdose victims should receive prompt medical attention. If the patient is unresponsive, is extremely lethargic, has labored breathing, has had convulsions, is diabetic, has sustained serious injuries, or may have combined drugs with alcohol, call for an ambulance. Send along a sample of any vomit, drugs, syringes, or containers; these may help medical personnel determine what substances the victim took. Keep the victim cool and calm until help arrives. Encourage the victim to breathe.

Once the crisis is past, vitamin C can help neutralize toxins in the body. An overdose should be a wake-up call to deal with your addiction now.