peer overdose prevention program (popp): key …€¦ · peer overdose prevention program (popp):...
TRANSCRIPT
Peer Overdose Prevention Program
(POPP): Key Messages in Opiate Overdose
Prevention
Cynthia Horvath, RN, BScN, MScN, CCHN(C) Nursing Project Officer, Ottawa Public Health
October 2015, OHRDP Conference
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Ottawa Public Health’s Site Program The Site Needle and Syringe Program
has been in operation since 1991. We operate within a harm reduction
framework to prevent transmission of communicable disease, primarily HIV and hepatitis and to minimize the negative effects of drug use whenever possible.
Provide a supportive environment and encourage self-esteem in substance users and other clients.
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Who Are Our Clients?
Direct Clients: include injection drug users as well as steroid users, sexual partners of individuals who use drugs, sex industry workers, and homeless/street-involved people.
Community: we continuously work with community partners, internal and external stakeholders to raise awareness and provide evidence related to drug use through a public health lens.
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Site Hours of Operation
Site Office
179 Clarence Street Monday to Friday
8:30 a.m – 4:30 p.m
Mobile Van
(613) 232-3232* 7 nights a week
5 p.m – 11:30 p.m
*Collect calls accepted
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Site Services Offered Needle provision and disposal Safer drug use and disposal equipment Safer injecting/use and disposal
teaching/substance use counseling General counseling and support First aid and basic wound care Health education/promotion Confidential Hepatitis B/C testing Hepatitis A/B and influenza vaccination
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Site Services Offered (2): Contraceptive advice/pregnancy testing Plan B STI testing/treatment/case management Condoms and lubrication Anonymous HIV testing including Point-
of-Care (POC) Referral to health, social service
agencies and drug treatment services Peer Overdose Prevention Program
(POPP)
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Ottawa Overdose Context Drug overdose results in 115 hospitalizations
and 40 deaths in Ottawa annually. (OPH: Overdose and Hepatitis C Infection Among People in Ottawa
Who Use Drugs, 2014).
OPH has issued 6 warnings r/t increased potency and/or alteration to heroin/fentanyl and opiates within a 6 month time frame. (June-December 2014).
CDC concluded that Naloxone is a public health issue and can save thousands of lives among people who use opiates. (CDC: Community-Based Opioid Overdose Prevention Programs Providing Naloxone, 2012).
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Peer Overdose Prevention Program (POPP) POPP has been operational since
August 31, 2012. Adapted with permission from TPH’s
POINT Program. As of October 7, 2013, the MOHLTC
began its Provincial Naloxone Distribution Program.
OPH met eligibility criteria as we are a public health unit that manages a core Needle Exchange Program.
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POPP Stats Initial target of 1 kit/week or 50
kits/year. 149 new certifications 98 refills 58 OD reversals Top OD drugs:
1. Fentanyl (34) 2. Heroin (10) 3. Morphine (7)
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POPP Eligibility Criteria
For Site clients whom Naloxone is indicated (self-reported opiate dependence or self-reported risk for opiate overdose such as relapse)
Valid consent has been obtained Completed the overdose training Who agree to non-secondary
distribution No contraindications
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POPP’s Key Messages in Opiate
Overdose Prevention
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Drug Education
Discuss and debunk overdose myths. Describe drug categories with
examples: • Depressants • Stimulants • Hallucinogens • Opiates
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Signs of an Opiate Overdose
Trouble breathing or slow, shallow breathing.
Slow heartbeat. Severe drowsiness or loss of
consciousness. Unresponsive to stimuli. Cold, clammy skin. Fingernails and/or lips are blue.
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General OD Prevention Counselling
Avoid using alone. Fix with a friend and leave the door
unlocked. Avoid mixing drugs with prescription and
over-the-counter drugs, alcohol, benzodiazepines, other opiates and/or uppers like cocaine and crack.
Use one drug at a time if you are mixing and take a break between drugs.
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General OD Prevention Counselling (2) Inject, snort, or smoke a very small
amount first to test its strength. Carefully check the product - does it
look, taste and smell normal? Know your dealer and try to use from
the same dealer when possible. If you’re feeling sick or “off”, use less
and be more careful. Use less when your tolerance is low
(haven’t used in 3 or more days).
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POPP Training and a Naloxone Kit
Eligibility assessment Medical chart Lived experiences OD prevention Drug education Recognizing an overdose Responding to an overdose Importance of 911
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Working with Community Partners
Advise clients to notify community agencies if changes in drugs/ trends/overdoses occur.
Shared community communication. Consistent overdose prevention
messaging and POPP referrals. POPP promotion, drug
advisories/warnings, prevention strategies.
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POPP Expansion Community partners and people who use opiates continue to advocate for broader access to Naloxone. OPH aims to increase its POPP kit target by: Improving awareness of the POPP program among
community partners. Increasing training opportunities for overdose prevention
and outreach activities. Broaden medical directives to include non-medical OPH
staff. Increase role of peers to promote and expand access to
Naloxone, including involvement in OPH training.
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For More Information
Visit OHRDP’s website: http://www.ohrdp.ca/ How-to Manual on Implementing an Opioid
Overdose Prevention Program: http://issuu.com/ohrdp-guidancedocument/docs/7stepsmanual
Community-based Overdose Prevention Education and Naloxone Distribution- Resource Document: http://issuu.com/ohrdp-guidancedocument/docs/guidancedocfinalweb-_13
