Harm Reduction Can CNS stimulants be used in emergencies for OD caused by CNS depressants?

[tricomb]

Okay this is the second time tonight, or technically this morning that I've turned my computer back on because I think I'll forget if I wait til tomorrow. Anyways.

In an emergency, like if naloxone is not available and you or your friend is overdosing on opiates or worse, opiates and benzos, is not breathing or responding, can you use improvise and use epinephrine (this one I'm fairly sure would work very temporarily) or methamphetamine (not so sure, this is what inspired this thread) to give them enough CNS stimulation so they can breathe until you get to the ER?

Or would the large amount of CNS deps in combination with CNS stims cause a heart attack?

Note: this is hypothetical, don't tell me my friend needs to seek medical attention, this is just something I've been thinking about a lot since I lost my vials of naloxone and I have epinephrine and methamphetamine hcl. I'm obviously gunna get more Narcan but anyways..... What do you think?

 

[Tripman]

It actually could cause a heart attack if you were already in respiratory depression - according to a medical professional I just asked.

 

[tricomb]

It actually could cause a heart attack if you were already in respiratory depression - according to a medical professional I just asked.

But if otherwise you know your friend would not make it to the ER without being DOA?
And what about if it wasn't a major OD but breathing became a problem?

 

[Albion]

But if otherwise you know your friend would not make it to the ER without being DOA?
And what about if it wasn't a major OD but breathing became a problem?

If they aren't dying, just breathing shallow, could you not just ride it out?

Or perform basic first aid (kiss of life etc). Could paramedics hook you up to a saline drip to flush the drug outta your system faster (or does that only work for kidney failure?))

 

[sockpuppet]

edit

 

[lazylazyjoe]

agree. 100 percent.

 

[madog11]

Stims will not help - likely make things worse - certainly waste time - leave you open to manslaughter if your friend dies.....



LEARN RESCUE BREATHING! (mouth to mouth)

In a genuine opioid-only OD maintaining breathing is all that's necessary. In many cases simply breathing for the person for a few minutes is enough to get them over the hump.

DO NOT waste time and/or make things worse by trying to shoot up the victim with speed/coke/milk/etc!

OBTAIN NALOXONE (Narcan)! Naloxone will totally reverse a true opioid-only OD immediately. It is widely available in the harm reduction scene - legally in some places and under the table in others. If you search around a bit online you should have no trouble finding some.

EVERYONE around people using opioids should know how to do rescue breathing and should have access to naloxone. If you do not have naloxone to administer the ONLY thing do do is to keep doing rescue breathing while you wait for EMTs. If you are not prepared to call for help you better improve your med skills and be prepared to hide bodies if you fail.

Opioid/benzo combos probably WILL kill your friends in the end though if they keep using them FWIW...

The government (UK one that is) is actually discouraging people from attempting mouth to mouth over here now. For reasons such as:

People not tilting the head back and the oxygen goes into the stomach rather than the lungs

Survival rate is actually LOWER than just doing chest compressions

So I would either learn mouth to mouth from a first aid course or get your friend to a doctor if their breathing becomes problematic.

 

[NeighborhoodThreat]

-Acquire Narcan (naloxone)
-Take a professionally-taught CPR class (in the United States these are taught by the American Red Cross and other organizations)
-Take a professionally-taught first-aid class (same note as above).

About ten years ago now I went to the Virginia SAR (Search and Rescue) College and took more first aid/CPR/battlefield medicine classes than I can remember... and they stressed the same points that madog11 is stressing in her post. Mouth-to-mouth is only effective if done right. I'm not a medical professional - and as Tripman mentioned - administering stimulants to somebody who is suffering from a depressant/opioid overdose could possibly do more harm than good. However, it could be used a stop-gap if absolutely no emergency medical care is available. In 99.99% of cases, however, a telephone is all you need. Contact an ambulance... and let the professionals do what they do. In most cities, calling an ambulance is the best course of action. While time is very important, most emergency medical services arrive at lightning-speed these days.

Unless you're with somebody and you're out in the wilderness and have no telephone or two-way communications access (there are some places where this is the case)...let the professionals do the work. I remember reading somewhere (on either Bluelight or Erowid) about the old morphine-containing patent medicines of the late 19th and early 20th century mentioning a "coffee enema" as the cure for overdosage...

Not saying that anybody should attempt to give their friend a coffee enema if they're overdosing on a depressant, however.

If you have Narcan, that's another story (and another thread).

 

[rk7p5]

Where can you aquire narcan? It would probably save alot of lives, especially if you're gonna be dosing some heavy duty ope's and benzos.

 

[madog11]

Where can you aquire narcan? It would probably save alot of lives, especially if you're gonna be dosing some heavy duty ope's and benzos.

That is a prescription drug and we do not allow drug sourcing of any kind on here.

Please read the BLUA and OD guidelines.

 

[NeighborhoodThreat]

^Indeed.

In most places it is a prescription drug and therefore controlled in one way or another. While having Narcan could save somebody's life, one must be trained in its correct use, etc.

Either way, we're not here to help you locate it. There are other resources available for Narcan training in some places (different countries/states have different laws regarding such things). Do a Google search.

 

[kokaino]

Narcan is not a controlled substance actually, and in certain cases it can be given out without any prescription. It's not an OTC drug, but a prescription for it is not necessary in order for it to be dispensed.

Actually in some cities Narcan is given to people on the streets by big medi-buses that go into major drug neighborhoods with harm-reduction education and overdose prevention (either by injecting a user on sight or by giving out Narcan ampules to people and teaching them how to use it). This is done here in Detroit in a few neighborhoods as we have a huge heroin epidemic and I know it's also done in Chicago and Baltimore. I'm sure they have similar harm reduction techniques on the street level in other cities like LA, San Francisco, New York City, or Philadelphia.

 

[NeighborhoodThreat]

^Indeed.

However, Narcan should only be given out with proper training/education on how to use it.

 

[kokaino]

^Indeed.

However, Narcan should only be given out with proper training/education on how to use it.

Obviously, the people on these buses that are on the streets along with the addicts are nurses, laboratory technicians (to take blood from addicts and check for HIV and Hep C free of charge), and during daytime there are therapists to talk to if needed.

 

[tricomb]

Narcan can be legally obtained at the needle exchange, since this is HR I don't think it's sourcing. Kokaino, they have clean needle exchange that give out naloxone and stuff in san francisco and oakland.

I am getting more naloxone, and neither I nor my friends (that I allow into my house, or under my supervision) are at immediate risk.

This is all hypothetical it's something I wondered about all the time. Remember in pulp fiction (YES it is a MOVIE I know) the girl OD'd on heroin and they brought her back with epinephrine. This seemed totally fake to me because 1) it worked, and 2) it worked for so long without readministration. As we know even naloxone must be readministered in severe OD.

I'm trained in CPR and first aid. <snip> sorry I have to take this part out I don't feel comfortable sharing this traumatic story publicly

I was very young at the time when I experienced this trauma, and since then I've witnessed or been involved with way too many overdoses, I've saved friends/family, I've had friends/family die in front of me. During one overdose, I thought a family member used epinephrine, but i guess it could have been naloxone, on another family member who OD'd and was pronounced dead for 8 minutes until the medevac chopper could land. I remember he would always carry these glass ampoules of epinephrine, I actually have some of them that I stole at like 12 years old because I thought they could be used in overdose if naloxone wasn't available. I am guessing now based on your responses that he carried naloxone too. He's a surgeon, he wouldn't give adrenalin if it caused heart attack like you guys said.

Thankyou for all the answers guys, I don't know why he'd carry around adrenalin instead of naloxone when you're married to an addict with the biggest opiate problem you veterans could ever imagine. But for all I know, he carried both, I just don't know what the adrenalin would be for?

 

[sockpuppet]

edf breathing and naloxone.