Wednesday, 31 August is International Overdose Awareness Day, and the timing is sadly relevant for South Australians.
The South Australian government has issued a public health warning following the tragic drug overdose deaths of 10 South Australians in recent weeks.
Eight of the deaths were due to heroin use, while the other two cases are linked to the use of fentanyl, an extremely potent synthetic painkiller (which has recently been trialled by the Women’s & Children’s Hospital for use by women in labour). The recent overdose deaths involved people aged between 31 and 56 years old.
If someone is showing symptoms of overdose, anyone with them should commence immediate first aid and administer naloxone, if available…
On average there are usually between one and two deaths as a result of heroin overdose each month in South Australia.
If someone is showing symptoms of overdose, anyone with them should commence immediate first aid and administer naloxone, if available, before calling 000. Don’t be frightened of any legal problems, because police will not attend the scene unless paramedics call for help or a death occurs.
Naloxone is a medication designed to block the effects of opioids like heroin, especially in the case of an overdose. When given intravenously, it works within two minutes; when injected into a muscle, it works within five minutes.
Naloxone attaches to the same parts of the brain that receive heroin and other opioids, blocking them for 30-90 minutes in order to reverse the respiratory depression that would otherwise lead to death from overdose.
Naloxone only reverses the effects of opioids such as heroin, methadone, morphine, opium, codeine, or hydrocodone. It does not counter the effect of other types of drugs, such as benzodiazepines (drugs including diazepam, midazolam, or alprazolam), antihistamines (like pheniramine or phenergan), alcohol, or other sedatives (drugs such as phenobarbital) or stimulants such as cocaine and amphetamines.
You cannot develop tolerance to naloxone, so it can be used in every opioid overdose situation no matter how many times a person has overdosed in the past. Naloxone has minimal side effects. It has no effect on somebody who does not have opioids in their system, and it is not addictive.
…remember to keep the expiry date in mind, as out-of-date Naloxone loses its impact.
In Australia, naloxone has been available over the counter since February this year. Australia is just the second country in the world to make naloxone available without a prescription, making it as easy to purchase as strong cold and flu tablets.
Naloxone is inexpensive: a single dose is only around $25, and keeps for 6 months or more. A more expensive 5-pack can be kept for 18 months. If you do buy some for emergencies, remember to keep the expiry date in mind, as out-of-date naloxone loses its impact. It will not hurt someone if given to them, but will probably not work as well as it should.
Hepatitis SA hopes that the Therapeutic Goods Administration will also soon approve a nasal-spray version of naloxone, which is currently being trialled in Sydney. This offers an alternative way to deliver the drug, in a form that many people will find less stigmatising to carry around with them.
Resources
There are many resources available providing information and instructions on overdose and administering naloxone. The Pennington Institute has a video, Naloxone: Saving Lives, which is certainly worth looking at.
Hepatitis SA has information on overdoses and safer injecting on our website. We also have printed resources available: ask one of our CNP peers or else call us on 1800 437 222.