Guidance on Preventing Opioid Overdose
Dear Editor,
We are now amid the worst drug overdose crisis in our nation’s history, with an estimated 109,680 lives lost across the country in 2022. In Massachusetts six people die each day from overdose, and our community of Charlestown has been tragically impacted by this crisis for over two decades. Overdose deaths have been increasing due to the presence of a very strong opioid, fentanyl, in the illicit drug supply.
However, no one should die from an overdose, and we as a community can learn about proven tools to prevent and reverse overdoses and to treat addiction.
How can we recognize and prevent overdoses?
The signs of opioid overdose include slowed or stopped breathing, unresponsiveness, pinpoint pupils, and blue lips or skin due to low oxygen levels. Death from overdose is often because of a prolonged period of not breathing, which eventually causes the heart to stop.
If you witness an overdose, or see someone you worry may have experienced an overdose, the first thing to do is see if the person responds to your voice or touch. If the person is not responding to you, follow the below steps (“C-A-R-E”):
1. Call 911 immediately
2. Administer naloxone, if you have it (see below).
3. Rescue breathing: plug their nose shut, tilt their head back and open their mouth. If there is nothing in their mouth or throat, blow one strong breath every 5 seconds into their mouth, making sure you see their chest rise.
4. Emergency services will arrive, wait with the person until then.
What is Naloxone (also known as Narcan)?
If someone is showing signs of an overdose, we can use a medication called naloxone to reverse the effects of the opioids (including strong drugs, like fentanyl) to help them breathe again. Naloxone is a medication that is delivered as a nasal spray. Everyone should carry naloxone, which is available by request at any pharmacy including CVS Charlestown under a state-wide standing prescription or is available by direct prescription from your physician.
Does naloxone work for all overdoses?
Naloxone can reverse overdoses due to many powerful opioids (ie, there is no such thing as a naloxone-resistant opioid drug). However, many overdoses involve multiple drugs, so naloxone alone may not work to reverse someone’s overdose if other drugs are involved. For this reason, when you suspect an overdose it is critical that you call 911 for help in addition to administering naloxone.
What is xylazine, and why are we worried about it?
Xylazine is a powerful drug, used in veterinary settings to put animals to sleep. It has been in the illicit drug supply in Philadelphia since 2006, but more recently has appeared in Massachusetts. With the addition of xylazine, people are at risk of injury and trauma due to heavy sedation, as well as serious skin wounds. Most drugs that contain xylazine also contain fentanyl, so it is important to use naloxone even if you suspect a xylazine overdose.
What resources do we have in the community?
If you are worried about your or a loved one’s substance use, it is important to know that treatment for substance use disorders is available and is effective. Here is a list of nearby resources:
Resources based at Mass General Brigham:
1. Any person, regardless of insurance or where they get their medical care, is welcome to walk into any of our four Mass General Brigham Bridge Clinics, which offer walk-in, drop-in, outpatient substance use disorder treatment and other services. These are located at MGH, the Brigham, Salem hospital, and in Haverhill. The MGH Bridge Clinic (617-643-8281) is located on the first floor of the Cox building on the MGH Main Campus and is open Monday through Friday, 9 to 5.
2. The MGH Addiction Recovery Management Service (ARMS) specializes in supporting teenagers and young adults between the ages of 14 and 26 and their parents as they deal with their substance use and related problems. Phone: 617-643-4699
3. To find treatment resources, you can also call one of our neighborhood’s two Community Health Centers, MGH Charlestown (617-724-8135) or NEW Health Charlestown (857-238-1100).
Resources from the Charlestown Coalition:
1. We honor and support the Charlestown Coalition and their Call to Action to prevent overdose, which includes a series of overdose prevention workshops across the neighborhood taking place throughout the Summer. Please see Navigation Assistance through Drug & Alcohol Recovery – Charlestown Coalition for more details and to sign up for their overdose prevention information email list.
2. The Charlestown Coalition’s Trauma Response Team serves as a support in the community and connecting people to treatment concerning issues around loss, community violence and substance use disorder. If you would like to make a self or community member referral, please contact: 617- 726-0058 (9AM to 5PM) or 617-643-0449 (5PM to 9PM)
Support Groups:
1. The Sun Will Rise Foundation provides online and in person support regarding substance use disorder. The in person meetings in Charlestown are facilitated by Shannon Lundin-White and Michael “Smokey” Cain, two of the Coalition’s Trauma Response Team members. These meetings occur on the third Wednesday of each month from 6-7pm at St. John’s Church, 27 Devens Street. For more groups, please visit: http://www.thesunwillrise.org/new-page or contact Shannon at 617-320-9058.
2. COASA (Children of Alcohol and Substance Abuse) Support Group. This virtual family support group is held on Thursdays at 5:30pm for individuals who have a family member or loved one with an alcohol or substance use disorder. Contact Facilitator Maureen McGlame at 617-726-9216 or [email protected].
3. The Depression and Bipolar Support Alliance (DBSA Boston) has a drop-in peer facilitated support group for individuals with mood disorders as well as their family and friends. This group meets in person every Thursday from 7:00 pm – 9:00 pm at the Erich Lindemann Mental Health Center. Email: [email protected], Phone: 617-855-2795.
4. NAMI Connection is a free, peer-led support group for people who are concerned about their mental health. Groups are led by NAMI-trained facilitators who’ve been there. NAMI Connection groups allow you to talk about your experiences in a safe and confidential setting. The groups encourage empathy, productive discussion, and a sense of community. namimass.org/nami-connection-recovery-support-groups
Hotlines:
1. The Massachusetts Substance Use Helpline is available at 800-327-5050.
2. Family Support Hotline. This hotline provides real team crisis support for those struggling with behavioral health symptoms. Clinicians will help to assess the situation and make recommendations for interventions, including but not limited to: mobile crisis evaluations, connection to inpatient and outpatient services and follow up visits. Call: 888-309-1989
Wildflower Alliance peer support line is answered by a trained peer supporter who has their own first-hand experience with psychiatric diagnosis, trauma, addiction, and/or other challenges. This line does not collect personal information, perform assessment, or call crisis or the police. Call: 888-407-4515, By phone every day: M-TH 7pm-9pm, FR-SUN
Sarah Wakeman, MD, Ryan O’Brien, Recovery Coach,
Shraddha Damaraju, MD, MPH, and Jim Morrill, MD