IF YOU SUSPECT AN OVERDOSE.....

IF YOU SUSPECT AN OVERDOSE  

 An opioid overdose requires immediate medical attention! An essential first step is to get help from some- one with medical expertise as soon as possible.

***Call 911 immediately if you or someone you know exhibits any of the symptoms listed below.
All you have to say: 

“Someone is unresponsive and not breathing.” 
Give a clear address and/or description of your location. 

Signs of OVERDOSE, which is a life threatening emergency, include the following:

 The face is extremely pale and/or clammy to the touch.
 The body is limp.
 Fingernails or lips have a blue or purple cast.
 The person is vomiting or making gurgling noises.
 He or she cannot be awakened from sleep or is unable to speak.
 Breathing is very slow or stopped.
 The heartbeat is very slow or stopped.



Signs of OVER MEDICATION, which may progress to overdose, include:

 Unusual sleepiness or drowsiness.
 Mental confusion, slurred speech, or intoxicated behavior.
 Slow or shallow breathing.
 Extremely small “pinpoint” pupils.
 Slow heartbeat or low blood pressure.
 Difficulty in being awakened from sleep.


Info from website:

https://www.samhsa.gov/  

Article for Parents to Read: Common Ingredients Used for this Dangerous Mix

Parents: 

Read this article on AddictionBlog.Org on Purple Drank made from candy, cough medicine and prescription medications. You might have these ingredients in your medicine cabinet right now!

Kids like to experiment and these ingredients are common but dangerous when mixed together in large amounts. Even cold medicine can affect your liver and/or kidneys and cause damage! Not to mention what can happen when sedated or drowsy from taking this stuff.

http://prescription-drug.addictionblog.org/what-does-purple-drank-do-to-you-how-to-tell-someones-drinking-lean/

Talk LOUD; Don't Die

                                      Takoda the Rescue Dog Says:  Talk LOUD; Don't Die

Let's talk about
Opiate
Use and
Drug abuse

Takoda the Rescue Dog got a second chance at LIFE......YOU Might NOT......Your KIDS MIGHT NOT.......talk LOUD !!!
     with your kids, your parents and your friends!

Kids and Overdose. Alert to Parents and Kids!

Tragically, in the news, you may hear about a child getting hold of an opioid and overdosing (stopped breathing). If the child was very young, then the drug was probably was hanging around, and like kids do, they put it in their mouth or mimic what they see the adults do. If was a preteen or teenager, then most likely they overdosed because they chose to use an opioid of some kind. Once you reach a certain age, it's all about choices. Why would a preteen or teenager decide to use an opiate? The first thing that comes to mind is Peer Pressure. Their friends are doing it and they want to be part of the gang and fit in. OK for maybe one time, but there are root causes for continued opioid use. The one that comes to mind is physical pain: a football injury, cheerleader injury or a sports injury of some kind. Or it could be pain from an accident such as a car accident. So what is the other reason? Emotional pain. Any type of chronic emotional pain such as teasing at school for any reason, poor relationship with parents/siblings, childhood trauma of any kind, ....anything that a kid would consider hurtful that continues on. The kid wouldn't know what to do about it and that could lead to hopelessness. To stop the emotional pain, a kid might drink alcohol or use drugs to temporarily feel better. Dangerous, yes, but kids don't think that far into the future, especially if they are hurting in some way. Now we all have had some childhood issues at one time, but I am talking about months to maybe even years of emotional pain. To a kid that is forever. Parents, what can you do to help prevent your child from falling into this death trap? I call it LOUD. Tell your kids you want to talk LOUD. It stands for:

Let's talk about
Opiate
Use and
Drug abuse

You see, kids like to think they are fooling their parents when taking certain risks. Let your kids and teenagers know that you are AWARE and KNOWLEDGEABLE. It opens the door to drug talk. It is at that time that a kid might say how they are feeling hurt over something in their life or even alert you to the behavior of another kid or teenager. There is a 2017 phrase, "Take 5 to save lives". It is about kids supporting each other to prevent suicide. Well, the same can be done for drug abuse to help prevent overdoses! Parents, tell your kids you want to talk LOUD! Kids, band together and help each other prevent drug use and overdoses. Stay alive, Don't Die! Talk LOUD to your parents! Talk LOUD to your friends! 

My Friends Keep Calling and Stopping By Even Though They Know I Started Recovery!

You will hear about how "friends don't tempt friends when they start a recovery program". Just think about it.....those friends are addicts too! Don't get angry. Addiction likes company. No matter how much a friend wishes you the best in recovery, the addict in them can't leave you alone. If you truly believe that your addiction is a disease then you must believe the friends knocking at your door have a disease also. But, the fact is, you must do what is best for YOURSELF, or recovery will not work for you. You can offer support while they seek treatment but don't put yourself in the position where they are using in your presence. Even if you don't participate in the drug use, the temptation will seep into your brain. You might start dreaming of using or have severe cravings when you are really stressed about something in your life. It will spiral down from there. So don't go there. If a friend is not ready to seek treatment then just let them know that you will be there when they decide to take that first step. Tell your friend that until that happens, they must stay away from you, out of respect of the friendship. No phone calls, no visits. This is the best approach with friends. Anyone else who is not a friend you can just say no and go away! If a person continues to bother you despite your request, say what you must to discourage them. This is your life and you want to live!

Can I die from withdrawal symptoms if they are bad enough? What can I do for withdrawals?

You will not die from the symptoms of opioid withdrawal, no matter how bad they are. You will feel like you are dying and others looking at you might agree. You will not die, but there is no doubt you are suffering :(     What can happen medically is severe dehydration from the sweating, vomiting and diarrhea. Being badly dehydrated is a feeling of extreme weakness, pale skin, sunken eyes, cracked dry lips, possibly even dizziness. If the person cannot drink a large amount of water and Gatorade or Powerade, then go to an Urgent Care for IV fluids to rehydrate. In a dehydrated state you are at risk for injury from a fall due to weakness. How many of us had a real bad flu and nearly fell in the bathroom from feeling weak and dizzy? Be safe.....getting hydrated is necessary whether it is from drinking lots of fluids or getting IV fluids. Always have some Gatorade or Powerade in addition to water and IV fluids to replenish your electrolytes. It will help bring back your strength. Over the counter products can help with other withdrawal symptoms such as Immodium for diarrhea, I would avoid Kaopectate and Pepto Bismol since it contains a substance similar to aspirin and anyone ages 12-18 should not take aspirin since there is a chance it can cause a disease called Reyes Syndrome (serious/ fatal disease) if conditions are right. Imodium takes a little time to work so take it at the first signs of diarrhea. If you are pregnant, go to the Emergency Room since you don't want to risk taking any medication, and dehydration when pregnant is much more serious! For muscle cramps take ibuprofen or naproxen but don't exceed the max dose recommended or you can damage your kidneys. I would avoid acetaminophen unless you are absolutely sure you do not have Hepatitis C Antibody; it might overload your liver. Over the counter magnesium supplements also may help muscle cramping if taken according to directions and you do not exceed the recommended dose. Need some sleep? Only at night, use generic benadryl (diphenhydramine) 2 caps and try some melantonin: anywhere from 3mg - 5 mg any brand, or a 10 mg time release tab by Natrol. Melantonin is a hormone your own body makes which regulates the wake-sleep cycle. Taking a supplement helps some people with sleep disturbances get a decent night's sleep. If you end up going to Urgent Care it is best to have someone with you who knows about why you are in this condition. If ER staff suspect you are in withdrawals then whoever is with you might find out. If the Emergency Room takes blood...if they draw any blood they might do some drug testing......if they get a urine sample they might do some drug testing.....that is all I will say on that. If you are drug tested in any way and you are on probation then your probation officer might find out and have concrete evidence against you. Be wise. Go for IV fluids and don't ask for any narcotics or benzodiazepines (like xanax or ativan) and you should be treated well, be rehydrated, & released. Simple as that.

The Intake Appointment Final Part 3

You did the business in Part 1. Saw the Addiction Counselor in Part 2. Now the last part is seeing the nurse. It is usually the Nurse Manager, Charge RN or seasoned staff RN who interviews you in this last stretch of the Intake appointment. All this is in preparation to see the doctor for your first medication dose. If you have any prescription medications that ARE PRESCRIBED TO YOU then bring them in for the nurse to log into your chart. Don't bring old bottles from last year and don't dump the new prescription pills into an old prescription bottle to condense it. The nurse needs current prescriptions in the current bottles, if possible. Please don't try to deceive the nurse and bring only some of your medications. Believe me, a nurse just knows! If you doctor shopped, say so. A history of doctor shopping or fraudulent prescription writing will NOT get you rejected from being admitted into the program. This is why you are here, right? Honesty is needed. By the way, programs do NOT report you to the police for such crimes. Consider it in the past. Just don't continue such behavior since it is counterproductive to your recovery and sets a bad example to other patients who are doing their best. Criminal behavior might get you kicked out if you choose to continue and get arrested. It is all about choices. Back to the nurse: the nurse will take a medical history such as diseases, injuries and surgeries. Please be sure to report any heart or respiratory issues, concerns or problems. Detox medications are serious business and the doctor needs to know of any heart or lung problems before prescribing your suboxone or methadone. It is his doctor's license on the line and he deserves to be informed. Methadone in combination with certain medical conditions and medications needs to be given with caution. Methadone and suboxone can affect your breathing and oxygen level in your blood, especially when combined with other prescription medications and medical conditions. If you have a medical history and are followed by a specialist then you will be asked to sign a "release" for that specialist. The same goes for your Primary Medical Doctor, your Psychiatrist and your Pharmacy. Why? It is coordination of medical care. Methadone and suboxone are actual prescriptions and all prescribing doctors need to know what the other doctors are prescribing, for medical safety. You might think it is overboard until something happens, some interaction of medications and medical conditions that go awry, and harms the patient in some way, including death. Most treatment centers also ask you to sign a form saying that you will tell any provider you are on methadone and you agree to use only one pharmacy. That is standard practice. After the medical history the nurse will ask about your mental health history, including asking if  you are suicidal or homicidal. Again, be honest. They are just getting the details to better serve you in your recovery process. Next step is actually seeing the doctor for admission into the recovery program of an outpatient clinic. It could be the same day or most likely it will be a few days later at the next available appointment. Again, do not come in impaired, sedated, drunk or high on anything in any way. **you must be in withdrawal when you see the doctor for admission. Enough withdrawal to make it safe to give you a low dose of methadone (or total withdrawal for suboxone). If it is methadone treatment then be in mild to moderate withdrawals and do not use after 8 pm the night before! Seriously, you might not be medicated if you use too late in the evening the night before. If it is suboxone treatement then you have to be in total withdrawals and not have any opiate of any kind for 2+ days. Sounds terrible, I know, but it is the nature of suboxone. If you do not follow the instructions that the clinic tells you, then you will be putting yourself in the worse withdrawals ever on admission day when you take your first dose of suboxone. You will do it to yourself! It is all about choices.

Recovery: The Intake Appointment Part 2

So you already gave you address, phone numbers, emergency contact, paid your fees and have been told countless of instructions and rules. Don't worry about remembering all that. You can always ask and most likely you will be reminded by both staff and other patients. The mindset of patients in recovery seems to vary according to what state or part of the USA you live. I have been told countless of times by "visiting" patients from other states how this is true. So this is straight from the patients themselves. (By the way, in NH, we are very friendly and helpful to all.)
So the Addiction Counselor is the next professional you will see after the business part. This is a long detailed meeting but it is very important! Please do NOT use right before this Intake appointment and do NOT use in the bathroom in between seeing professionals! You nod off, and you have to reschedule! You are cranked up and can't sit still, you have to reschedule! and that postpones your first medication appointment with the doctor so it is pointless. Now, we don't want you vomiting either so plan accordingly....you know what I mean. The appointment is at least 2 maybe 2 1/2 hours. When you see the Addiction Counselor you will be asked everything from the first day you ever used in your life until present day. Questions about every drug you tested including cigarettes and alcohol. Please be honest but don't embellish. No one will be impressed. They will ask about your childhood, your family, employment, legal stuff etc...all this plays a significant role in your recovery. If Uncle Brian beat you every Christmas morning, we aren't going to ask you how your Christmas was. If your friend overdosed in March, we will be on the alert for depressive behavior and possible alcohol/drug use near springtime. All the questions are for a reason. We don't like paperwork that much. A big thank you for being patient with all the questions! The last professional you will see is the nurse in The Intake appointment part 3.
.

Recovery Program: The "Intake" Appointment part 1

You made the phone call and have your first appointment. It is commonly called the "Intake" appointment. This appointment is the most important! From my experiences, this appointment is where all info on you is gathered by MULTIPLE healthcare/addiction professionals. These professionals have heard every story so don't leave out any details and please BE HONEST & precise. After all, this is YOUR life! First piece of business is getting your address and a reachable phone number such as your cell number. If you give a second phone number, please specify if it is OK to leave a message. Don't worry, no one will call you mindlessly or call to check on you. It is needed in case your counselor has the flu and has to cancel counseling, in case of fire and the place of business is in a temporary location etc....in other words, for something very important. You will also be asked for at least one emergency contact name and phone number. This is in case you have a medical emergency or injury, so someone close to you can be told. Otherwise, an emergency contact is NEVER called. Confidentiality is taken seriously. The other piece of business is the payment. Programs can't run on love and good intentions. There should be an "intake" fee or it could be called an administrative fee for the admission process. You will also be asked for the first week's payment up front. Yes, that is a big blow to someone who spends all their money, and other people's money on drugs. But it is necessary for two reasons: 1) It is common for addicts to act on impulse by being admitted to a program then not showing up or paying. It is a lot of work to admit someone into a program. It is considered a waste of time and money when this happens. Someone else who is ready for recovery could have come to that appointment. and 2) If you pay a week in advance with your money or borrowed money, you will be sure to show up that first week to get your money's worth, right? Commitment it what it is. That commitment of one week in treatment opens the door to maybe another week, maybe even another month and bingo! You are on your way to a BETTER life and loving it!

Myth: Methadone rots your teeth

FALSE. Teeth do not rot within months of starting a methadone program. It takes time, lots of time to have more than one tooth rot enough to be pulled. It is the amount of time you spent using that is the culprit. Years of not eating properly (and not taking vitamins), years of not brushing, years of not seeing a dentist for preventative cleanings will lead to tooth decay. A poor diet for an extended period of time will leave your body deficient in nutrients. Then your body start taking nutrients where it can, at the least vital place...your teeth. Once you are in recovery, you start noticing what you couldn't see or feel while you were using all those years. Your gums are sore, they might bleed easy, you have uncontrolled bad breath. You start taking care of your health and think you escaped any health issues. Then one day you bite into something and start chewing and....snafoo! A broken tooth. It is easy to blame methadone and since there is some amount of sugar in the liquid form. It might sound like a very logical blame to you. But know it takes years to do that kind of damage. Nothing you can do about it now except take care of what is, and do what you can to prevent any further damage. At the first sign (or before) of trouble with teeth or gums, make an appointment with a dentist. Don't wait until you are in pain, have an infection or break a tooth since there will be a period of waiting until an appointment is available. Worst case scenario:  having a legitimate infection with pain and going to the Emergency Room as an addict asking for an antibiotic and pain med. If they don't want to give you pain med, you suffer. If they give you pain med, you should give the med to a family member who can dispense the correct amount of tablets to you during the prescribed time frame. Until you are further along in recovery it is way too tempting to abuse the prescription. You don't want to make your situation worse, make yourself feel worse or lose any ground you gained while in recovery. If you made progress in recovery, be proud and ask someone to help you with your prescribed med!

The First Step: The Phone Call

So you don't want to tell your family or friends you have a problem with misusing substances or medication...OK. It's your life, but if you want to take that next step towards a BETTER life, then you need to talk to professionals who can help you with tackling this disease and head towards recovery. So it is a matter of making that first phone call. NOT always a  simple task!  You might feel a rush of all kinds of feelings that are very uncomfortable. Feelings you have numbed and shoved back inside of you all this time. One way to help minimize this experience is to have someone with you when you make that first call. It can be someone from a recovery group or local community service. Heck it can be a firefighter or a social worker or nurse in the local Emergency Room. All public service professionals will be willing to sit with you for a few minutes as support while you make your first phone call for help with your disease. If you have someone in your personal life with you at the time of the phone call, make sure they are stable, sober, not impaired and have your best interest at heart. FYI:  The first phone call will 1) give you basic info on the service,  2) info on insurances accepted or cash payment and either 3). make your first appointment for an Intake or put your name on a wait list. ***This phone call, entire conversation and any info given is completely confidential.  NO ONE can call and see if you called, NO ONE can check to see if you have appt or are on the wait list. NO ONE, period. Not even your mom! This is the law! A violation of this law can get a person jail time. So congratulations if you made your first phone call :)  I will talk about the first Intake appointment in another section with the word Intake in the title.

Do I have to tell anyone?

Have you ever tried to explain the mechanics of what is wrong with a car and how to fix it to someone who doesn't have a clue?  That is what you will get trying to talk addiction to friends and family who are not educated on the subject. It is a foreign language and a foreign land. Not their fault and not their problem. It's your problem and your recovery. Some family are open to the subject and if they are ....well, you are very lucky!  Not everyone is open to the subject when it comes to family. Could be pride, or maybe they are addicts/alcoholics themselves! Who wants to look in the mirror? If you don't have the support of family and/or friends then there are plenty of support groups and others in recovery you can turn to. If it's one thing I know to be true:  addicts will always accept other addicts and be there for that 2 am phone call when you really want to use. You don't have to be BFF, but some type of support is needed in recovery. Someone who understands exactly what you are going through and can listen without judging. With the opioid crisis going on there are many new hotlines, support groups, treatment centers and professionals in this field. If one doesn't suit you, there are plenty more to try.

"I'm getting clean...now what....I still have problems!"

Problems, problems, problems! You had a problem and turned to drugs/alcohol to fix it, then got addicted. You had a problem and did drugs to distract you or numb you, then got addicted. You did drugs/alcohol, you got addicted, and it caused problems in your life. Addiction ruins every aspect of your life: personal, family, social, employment, legal. It is a vicious cycle: problem....drugs, drugs....problems...back to drugs etc...Your mind makes up excuses and reasons to continue using drugs. In the old day it was called, "Stinkin Thinkin". Your mind wants to win, and your mind is strong! That's where Addiction Counseling comes in with Addiction Focused Problem Solving to break the cycle. It is a specialized approach to .....everyday shit.  You need Addiction Counselor to show you how it works. With focus and 100% effort it can be done!

HOPE

Like the Phoenix, the addict can rise from the ashes of  the old self into the new self!

Misconceptions

"I can detox myself"
If you take another person's methadone or suboxone, you buy it off the street (it is probably diluted or altered somehow). You try detox yourself slowly so you don't go into withdrawals. So, intentions are there...but....can you really do this and wean yourself completely off, and stay off ... off ANY narcotic or alcohol? NO. I know because addiction is an official disease. and even if you don't believe that, think about it: How many addicts have tried but couldn't stop on their own? or if they did, how long could they maintain that? When an addict sees how it destroys their life, they don't WANT to do it but they MUST so they don't get physically ill and can function normally at work, at home etc... and even when an addict physically weans off the drug, there is a psychological component that is not addressed. Therefore the cycle eventually starts over and continues until addressed. That is where outpatient treatment centers come in. Could be methadone or suboxone. The "medication" is an actual prescription by a certified psychiatrist. It is dispensed by Registered Nurses who are trained in Addiction. Yes, you are usually routinely drug tested to check your progress and there is Addiction Counseling. The physical addiction part is easy. It is the psychological component that a person normally cannot do on their own without guidance, monitoring and support. It is the only way to change your thoughts and behaviors long term. Remember, Addiction is a disease and needs to be treated seriously as a disease or it will come back as that awful problem and cause problems.

Recovery CAN be successful!

YES it can work!
But I have often heard these statements:
"i can't"
"I've been doing this for x years, I can't stop...recovery won't work for someone like me...it's my life".
Yes you can!
But don't expect it to happen in 1 day or 5 days. Patience is NOT a virtue of any type of addict!

**So you must PUT IT INTO PERSPECTIVE:
It took ____yrs to become addicted to opiates. It didn't happen overnight. So it will take a little time for recovery. Like something that has been out in the rain for years and has lots of rust....it takes more time to get all that rust off. But if you don't START cleaning it, it will never get clean! So, think about it, and decide what it is you want to do. Everything is a choice that YOU make. Start cleaning or let it rust some more