In an emergency
What to do in an emergency!
Do you want to save a life? This section is for people who use opiate drugs, their friends, family members, addiction workers, homeless staff and others concerned with their welfare. People who use opiates like morphine, codeine, fentanyl and methadone can be at risk of overdose. Many people who come across an overdosed person have little confidence or knowledge of what to do when faced with such a scenario.
New opioids have arrived in the UK in the last two years, called "nitazenes". They have recently been found mixed with heroin, with some being sold as illicit oxycodone pills or even Xanax powders.
Nitazenes can be at least as strong as fentanyl and can be hundreds of times more potent than heroin. They are known to have led to accidental overdoses and deaths of people in several areas across the UK in the last few weeks.
The vast majority of people taking drugs do not expect to die from an overdose. If you use drugs, this information will help you and your friends to stay alive.
Considering new information around contaminated drugs, the way you use drugs might need to change to avoid overdose:
- Mixing different drugs is common, but it is more likely to cause an overdose. Try to use one at a time. If you are going to mix drugs, use less of each.
- Try not to use drugs alone, and don’t let your mates use them alone either. Watch out for signs of overdose in your friends. The signs include difficulty breathing, blue colouring to the lips or fingertips, unresponsiveness, and limp limbs.
- Always carry naloxone. It’s available from all treatment providers. If someone overdoses, give naloxone to them and call an ambulance.
- Naloxone only works on opioids. However, if you suspect someone has overdosed give them naloxone even if you’re not sure they have taken an opioid. It will not harm your friend.
- If you use opioids every day your local drug treatment service can support you and prescribe alternatives such as methadone and buprenorphine. Even if abstinence isn’t your goal these alternatives can help keep you safe. You will know what you are taking and your risk of overdose may be reduced.
- If you are already in treatment for opioid dependence and you don’t want to use on top, speak to your worker and make sure you’re getting the right dose.
Signs of an overdose
Signs of Overdose Video
If someone has overdosed, put them in the recovery position and keep watching them. You need to know if they are asleep or unconscious. You can find out by shouting or pinching their ear.
They are unconscious if you can’t wake them or they are showing other signs of unconsciousness such as:
snoring deeply, turning blue; or not breathing
Don’t panic
Put them in the recovery position
Dial 999 and ask for an ambulance
Stay with them until the ambulance arrives
Call an Ambulance
If someone is unconscious they need an ambulance. If you are worried about the police coming, don’t mention drugs when you dial 999. Tell them you’ve found someone unconscious and explain what has happened when the ambulance arrives.
Make sure there is no shouting or panic in the background when you dial 999 to reduce the chances of the police coming.
Remember: if you don’t call an ambulance and someone dies, the police will always come so that they can inform relatives and investigate the death. If the person who died had been given an injection by someone else, there could be a charge of manslaughter.
Calling an ambulance saves liv es
Keep them alive
Chest Compression Video
If the person stops breathing, give them 10 breaths of mouth-to-mouth resuscitation. Then, if you haven’t already done it, call an ambulance.
Giving mouth-to-mouth
1. The person should be lying flat on their back.
2. Remove chewing gum or anything else you can see in their mouth, then lift their chin.
3. Pinch their nostrils together, using your first finger and thumb.
4. Take a deep breath and make a good seal around their lips with your mouth.
5. Blow steadily until you see their chest rise.
6. Take your mouth away and let their chest sink right back down.
7. Repeat steps 3 to 6.
If you are giving mouth-to-mouth but find that the person isn’t moving at all (look to see if their eyes are moving) or is getting bluer or colder
Don’t waste time looking for a pulse
Start chest compression straightaway.
Chest compression (also known as heart massage)
Even if their heart is still beating, if they are not moving and are getting bluer or colder, their heartbeat can’t be that strong. You won’t do any harm by starting chest compressions, and you could save their life.
Giving chest compression
1. Find the place where the ribs meet the breastbone, and lay two fingers there.
2. Put the heel of your other hand on their breastbone, just above where your two fingers are.
3. Put your first hand on top of this hand, locking your fingers together
4. Keeping your shoulders above the centre of the person’s chest and your arms straight, press down on their chest by about 4 to 5 cm (1.5 to 2 inches).
5. Release the pressure, but keep your hands where they are. This is a chest compression.
6. Do 15 chest compressions in just under 10 seconds.
7. Give two breaths of mouth-to-mouth.
8. Continue to give 15 compressions followed by two breaths of mouth-to-mouth, until help arrives
If their heart starts beating again, and their colour changes from blue to pink, stop chest compressions and continue with mouth-to-mouth if necessary
Recovery Position
Recovery Position Video
1. Open the person’s airway by tilting their head back and lifting their chin.
2. Straighten their legs.
3. Put the arm nearest to you at right angles to their body.
4. Pull the arm furthest from you across their chest and put the back of their hand against the cheek which is nearest to you.
5. Get hold of their far leg, just above the knee, and pull it up, keeping the foot flat on the ground.
6. Keep their hand pressed against their cheek.
7. Pull on their upper leg to roll them towards you, and onto their side.
8. Tilt their head back to make sure they can breathe easily.
9. Make sure that both the hip and the knee of their upper leg are bent at right angles.
Naloxone and Naloxone Training
What is Naloxone and how to get it
The overall aim of the National Naloxone Programme is to contribute to a reduction in fatal opioid overdoses in Scotland. Naloxone is a medication that temporarily reverses the effects of opioid overdose, available to anyone at risk of opioid overdose.