Providing prevention education and harm reduction resources while connecting youth to health and social services

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Trigger Warning

Why receive this training?

In NYC, every 3 hours a person dies from an overdose.

That’s 2,920 people every year.

(8 people everyday)!

(NYC Health)

Why receive this training?

Opioid overdoses are now the leading cause of accidental death in NYC and in the US.

Overdose deaths are preventable.

With the help of fentanyl test strips and naloxone, you can save a life!

(NYC Health)

What is stigma?

Stigma refers to any harmful/negative feelings, mindsets or stereotypes about something or someone.

Stigma can lead to discrimination based on the following:

Age

Sexual Orientation

Religion

Race

Place

Mental Health

Housing Status

Drug Use

Body Shape

(Healthline)

Words Matter: Use Non-Stigmatizing Language

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You can lead by example by using non-stigmatizing language when talking about addiction.

What are opioids?

Opioids are a class of drug

used to relieve pain.

Common Opioids (Painkillers)

Heroin OxyContin Percocet

Vicodin Methadone Morphine Fentanyl

(NYC Health)

What is an overdose?

An overdose (OD) is a dangerous dose of a drug.

An opioid overdose may stop breathing entirely, which can lead to death.

Overdose Facts

In NYC, most overdoses:

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• Occur 1 to 3 hours after the drug is taken

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• Happen at home

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• Are witnessed by other people

(NYC Health)

What is fentanyl?

Fentanyl is a powerful synthetic opioid that increases the risk of an overdose.

Associated with more than 80% of opioid-related deaths.

(NYC Health)

Facts about Fentanyl

• Fentanyl is commonly found in heroin, cocaine, crack, meth, ketamine, ecstasy/molly (MDMA), and other non-prescription drugs.

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• Fentanyl cannot be detected by sight, taste, smell, or touch.

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• Fentanyl is 50 to 100 times stronger than morphine.

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• Knowing if a drug contains fentanyl can lower the risk of an overdose.

Fentanyl

Overdose Prevention Training

What are fentanyl test strips?

Fentanyl Test Strips (FTS)

FTS can detect if a drug

contains fentanyl.

Cannot test how much fentanyl

there is or how strong it is.

FTS can prevent an overdose

when used correctly.

Single-use only

How do you use FTS?

Ways to Test Drugs for Fentanyl using FTS

Option 1: Dissolve All

Option 2: Use Residue

Option 3: Test 10 mg

Most Accurate Way

Most Common Way

Least Common Way

Option 1: Dissolve All Drugs

Option 1: Dissolve All Drug (most accurate)

Step 1: Dissolve all of the drug in a small container with water.

Step 2: Place wavy end of the FTS into the dissolved drugs.

Step 3: Wait 15 seconds for FTS to absorb the water with the dissolved drugs.

Step 4: Remove FTS from water and place it on a flat surface for 2 minutes.

Step 5: Read the results.

Option 2: Use Residue

Option 2: Use Residue (most common)

Step 1: Place the drug in a small ziplock bag and zip it close.

Step 2: Finely crush the drug inside the small bag.

Step 3: Shake the bag to mix the drug.

Step 4: Empty the bag and put the drug in a dry, clean container.

Step 5: Add water to the bag, which now has drug residue.

Options 2: Use Residue (continued)

Step 6: Place wavy end of the FTS in the water.

Step 7: Wait 15 seconds for FTS to absorb the water.

Step 8: Remove FTS from water and place it on a flat surface for 2 minutes.

Step 9: Read the results.

Follow the same steps for using FTS.

How much water should you add?

How Much Water to Add

All Other Drugs

meth

ecstasy/molly

(MDMA)

1 teaspoon per 10 mg of the drug

(1 teaspoon = 1 NYCC4H vial (5 ml) or bottle cap)

half teaspoon per 10 mg of the drug

(half teaspoon = half NYCC4H vial (2.5 ml) or half bottle cap)

What do the test results mean?

Reading Test Results

No Fentanyl Detected

DO NOT INSERT PAST THIS SOLID LINE

(The opposite way of reading a COVID-19 or pregnancy test)

Fentanyl Detected

HOLD ON THIS END

INSERT AT THIS END

Invalid

(Use New Strip)

Safety Tips: Fentanyl Not Detected (Negative Result)

No Fentanyl Detected

No test is 100% accurate

The drug may still contain fentanyl or a similar opioid

Follow the next safety tips

Safety Tips: Fentanyl Detected (Positive Result)

Fentanyl Detected

Use with other people and take turns

Avoid mixing drugs

Take small amounts and go slowly

Ask someone to check on you regularly

Have naloxone available

Overdose Response Training

What is naloxone (NARCAN®)?

Naloxone (NARCAN®)

Naloxone (NARCAN®) is a safe medication that reverses an opioid overdose.

Blocks the effects of opioids for 30-90 mins.

Use it if you suspect an overdose, even if unsure which drugs were taken.

Available as a nasal spray and a shot.

Safe to use even if opioids aren’t present.

What are the signs of

an opioid overdose?

How do you respond to someone overdosing?

How to Respond to an Opioid Overdose

Step 1: Check for Response

Step 2: Call 911

Step 3: Give Naloxone

Shout!

Rub breastbone

911 Good Samaritan Law

Peel

Place

Press

Step 1: Check for Response

If they wake up, keep them awake.

Don’t give naloxone.

Give naloxone.

If they DO NOT wake up, it’s an emergency!

Step 2: Call 911

“We are at …”

“Someone is not breathing”

Step 2: Call 911 (continued)

The 911 Good Samaritan Law offers some protection to the person overdosing and the person calling 911 in NYS.

Protected

Not Protected

Having less than 8 oz of substances

Underage drinking

Having marijuana (any amount)

Having drug use equipment

Open warrants for an arrest

Probation or parole violations

Undocumented immigrants

Intent to sell substances (more than 8 oz)

How do you give naloxone to someone overdosing?

PLUNGER

Do not test it; the single dose can only be used once.

Step 3: Give Naloxone

Step 1: Peel, place, and press.

Step 2: Wait for 2 minutes to see if the person wakes up.

Step 3: Give the second dose in the opposite nostril if they don’t respond in 2 mins.

Step 4: Wait for 2 minutes once again after giving the second dose.

Step 3: Give Naloxone

Naloxone will block the effects of the opioids for 30-90 minutes, which is enough time for the ambulance to arrive.

What if they’re not breathing or don’t wake up after giving naloxone?

Rescue Breathing or CPR

If the person isn’t breathing, give rescue breaths.

Rescue Breathing or CPR

If the person isn’t breathing, give CPR if you know how.

Where you can find

CPR training in NYC

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CPR Classes, Training and Certification

Recovery Position

Whether you give naloxone or not, if the person isn’t fully alert, put them on their side into the recovery position to prevent choking in case they vomit.

What should you do after giving naloxone?

After Giving Naloxone

Explain what happened.

Make sure they’re okay.

Replace and report.

After Giving Naloxone

Talk to them.

They may be scared, angry, or confused.

Explain what happened.

“It seems you were overdosing.”

“I gave you naloxone.”

After Giving Naloxone

Naloxone may cause withdrawal symptoms such as:

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Another overdose is possible until it wears off.

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Stay until the ambulance arrives. If they don’t want medical attention, make sure you or someone stays with them for at least 3 hours.

Make sure they’re okay.

Chills

Hallucinations

Vomiting

Agitation

Nausea

Muscle Aches

After Giving Naloxone

Replace and report.

Notify NYCC4H

to get a free new rescue kit

Submit an anonymous report on the Stop OD NYC app

Email naloxone@health.nyc.gov

AND

OR

Content Review

• Opioids are painkillers.
• An overdose means difficulty breathing and can lead to death.
• Fentanyl is a powerful opioid that can cause an OD.
• Stigma means negative attitudes and can lead to discrimination.
• Fentanyl test strips can tell if a drug has fentanyl and can prevent an OD.
• You can dissolve drugs, use residue, or a few grains when using FTS.

Content Review

• Naloxone (NARCAN®) is the opioid overdose reversing medication.
• The sign of an overdose include unresponsiveness, snoring, blue nails, etc.
• Check for response, call 911, and give naloxone when suspecting an OD.
• Peel, place, and press to use naloxone, wait 2 minutes after each dose.
• After giving naloxone explain what happened, make sure they’re okay, and replace/report it.