Emergency Help for Opioid Overdose

There is an opioid abuse epidemic in Georgia and throughout the entire country. Opioid deaths in District 4 continue to rise. Opioids are used to dull the sensation of pain. Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine, and many others. Many produce a sense of euphoria and result in addiction.

Opioid drugs also pose the danger of accidental overdose, which can stop breathing. By definition, overdose is ingesting more than the recommended amount of a substance. Drug overdose often implies the toxic and overwhelming effect of drugs taken in amounts greater than the body has a capacity to handle.

Death and permanent organ damage can occur.

Naloxone blocks or reverses the effects of opioid medication, including extreme drowsiness, slowed breathing or loss of consciousness. Naloxone is used to treat a narcotic overdose in an emergency situation. It should be used until the patient can receive emergency medical care for an overdose.

Signs of Opioid Overdose
#1 sign of opioid overdose is unresponsiveness

Other signs include:

  • Awake, but unable to talk
  • Limp posture
  • Face is pale or clammy
  • Blue fingernails and lips
  • For lighter skinned people, the skin tone turns bluish purple; for darker skinned people, the skin tone turns grayish or ashen
  • Breathing is very slow and shallow, erratic or has stopped
  • Pulse is slow, erratic or not there at all
  • Choking sounds or a snore-like gurgling noise (sometimes called the “death-rattle”)

Naloxone is a short-term measure for an overdose – it is essential to notify medical professionals as quickly as possible.

Georgia’s Amnesty Law

  • Although most overdoses occur in the presence of others, fear of arrest and prosecution prevent many people from calling 911
  • Georgia’s Medical Amnesty Law protects victims and callers seeking medical assistance at drug or alcohol overdose scenes
  • Limited liability for possession of small amounts of drugs and/or alcohol- this applies to the victim as well as the caller
  • Limited liability for breaches of parole, restraining order, probation and other violations
  • Naloxone immunity for prescribers, pharmacists and first responders

Steps to take for opioid overdose victims

Call 911 immediately, report a drug overdose, and give the street address and location of the victim. If there are other persons available, send someone to wait in the street for the ambulance and guide the emergency medical technicians to the victim.

Try to rouse the victim by speaking loudly, pinching, or rubbing your knuckles vigorously up and down the sternum (the bony part in the middle of the chest.)

Make sure the victim is breathing. If not, administer rescue breathing (mouth-to-mouth) by pinching the victim’s nose shut and blowing into the mouth. Lay the victim on their side after they have resumed breathing on their own.

Administer an opioid antagonist, such as Naloxone, if you have it and know how to use it.

Stay with the victim until help arrives, and act quickly to administer rescue breathing if they stop breathing. Encourage the victim to cooperate with the ambulance crew.

How to Administer Naloxone
Administering Naloxone
EMS Training Videos for Administering Naloxone

Most Commonly Abused Opioids
Prescription opioids can be prescribed by doctors to treat moderate to severe pain, but can also have serious risks and side effects. Common types are oxycodone (OxyContin), hydrocodone (Vicodin), morphine, and methadone.

Fentanyl is a synthetic opioid pain reliever. It is many times more powerful than other opioids and is approved for treating severe pain, typically advanced cancer pain. llegally made and distributed fentanyl has been on the rise in several states.

Heroin is an illegal opioid. Heroin use has increased across the U.S. among men and women, most age groups, and all income levels.

Pharmacy Access to Naloxone
There are two ways to access a naloxone rescue kit from a pharmacy in Georgia:

  • Obtain a prescription from your prescriber and take it to a pharmacy that stocks naloxone
  • Go directly to a pharmacy and request a naloxone kit. A standing order for naloxone was issued to all pharmacies in Georgia on Dec. 14, 2016; a prescription for naloxone is not needed.

Drug Overdose Surveillance Unit
The Drug Overdose Surveillance Unit monitors overdose trends in Georgia, and provides overdose data to the public and to partners working to end the opioid epidemic. This data is also used to detect and respond to rapid increases, or clusters, of overdoses, such as the Counterfeit Percocet-Related Overdose Cluster in Macon during June 2017.

The Georgia Prescription Drug Monitoring Program (PDMP) is an electronic database used to monitor the prescribing and dispensing of controlled substances. The PDMP can help eliminate duplicative prescribing and overprescribing of controlled substances and provide a prescriber or pharmacist with critical information regarding a patient’s controlled substance prescription history and protect patients at risk of abuse.

Georgia House Bill 249

During the 2017 legislative session, the Georgia General Assembly passed House Bill 249 which provided for several changes to the PDMP:

  1. Effective July 1, 2017, dispensers will be required to enter prescription information for Schedule II, III, IV, V controlled substances within 24 hours. This will provide prescribers more efficient access to information with less wait time as they make the best clinical decisions possible for their patients.
  2. All prescribers will be required to register in the PDMP by Jan. 1, 2018. Currently only about 10 percent of prescribers in Georgia are registered in the PDMP. Prescribers already registered DO NOT need to re-register.
  3. Beginning July 1, 2018, prescribers will be required to check PDMP before prescribing opiates or cocaine derivatives in Schedule II drugs or benzodiazepines. (Prescribers are currently encouraged to check the PDMP but are not yet required to do so.)

House Bill 249 was designed to reduce prescription drug misuse in Georgia. Download a fact sheet to learn how prescribers comply with the law.