RESOURCES & REFERRALS

A person can overdose on either prescription opioids (like oxycodone or hydrocodone) or non-prescription opioids (like heroin and fentanyl). An opioid overdose can make a person stop breathing and die or suffer brain damage. If you suspect that someone has overdosed on an opioid, you should call 911 so that he or she can receive immediate medical attention. If you have naloxone, administer it. If trained, you may also need to start CPR even before medical personnel arrive. Every minute counts. Call 911 immediately!

When medical personnel arrive, they may administer naloxone. Naloxone is a medication that can treat an opioid overdose when given right away, though more than one dose may be needed.

Most states have now passed laws that allow pharmacists to dispense naloxone without a prescription. This allows friends, family and others in the community to obtain the auto-injector and nasal spray versions of naloxone (also called Narcan) in advance so they can be prepared to save someone who is overdosing.

If you or someone you know is prescribed high dose opioids, uses illicit opioids, or if you live or work in an area where overdoses are common, it is important to obtain the naloxone now, before you need it. This will let you be prepared to take action immediately in the event of an overdose until medical personnel arrive. Minutes count.

If you have administered naloxone to someone who has overdosed, you should still call 911 immediately, even if the person wakes up and starts talking. Naloxone’s effects can wear off before those of the opioids in the person’s system and they can stop breathing again. It is common to need to administer naloxone multiple times. If you give the naloxone and the person does not wake up, you may need to do CPR to keep them alive.

The Massachusetts Substance Use Helpline website has additional information regarding naloxone/overdose prevention, available here.

Those who misuse opioids are at heightened risk for suicide. If you, a friend, or a loved one is suicidal or exhibiting any suicidal warning signs, please contact a mental health professional, healthcare provider, or the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255). Upon calling the Lifeline, you will be connected to a trained counselor at one of the 150 crisis centers in the National Suicide Prevention Lifeline’s network. These counselors can offer mental health support as well as referrals to local services. Calls are routed to the nearest available crisis center based on the caller’s area code. You can also dial 911. You can assist with getting to the nearest emergency room. Treat it in the same way you would treat any other medical emergency – like choking or a heart attack– and get help immediately!

The Crisis Text Line: The Crisis Text Line provides free, 24/7 support via text messaging for those in crisis. Crisis is defined as “any painful emotion for which you need support.” To connect with a crisis counselor, text HOME to 741741 from anywhere in the United States. It usually takes less than five minutes to connect, but may take longer during high-traffic times. The crisis counselor is a trained volunteer who will provide support, but not medical advice. You will then text back and forth with the Crisis Counselor. The goal of any conversation is to get you to a “calm, safe place.” Sometimes that means providing you with a referral to further help, and sometimes it just means “being there and listening.” A texting conversation usually lasts anywhere from 15-45 minutes.

A common misconception is that asking people about suicide will put the idea into their heads. This is simply not true. A recent literature review found that “acknowledging and talking about suicide may in fact reduce, rather than increase, suicidal ideation…” In fact, many people with suicidal thoughts are relieved by talking about them.

The Suicide Risk Inventory tool can help people know what questions to ask. So ask those questions. Positive responses should be listened to and responded to with medical/mental health intervention. Listen to your loved ones. Many will drop hints or give warnings to friends and family about their suicidality, even if they won’t tell a clinician or counselor. Seventy percent of suicide victims tell someone or give a warning before taking their life.

For more information, visit the Action Steps provided at stopasuicide.org.

The Massachusetts Substance Use Hotline provides the following suggestions to help mitigate risk and potentially save the life of an individual who is actively using opioids:

1. Don’t use alone. Make sure you use only when you’re with other people, in case something happens.
2. Don’t mix drugs. Benzodiazepines (“benzos”), alcohol, and opioids all slow your breathing. Mixing them can cause an overdose.
3. Use less if you haven’t used for a while. Tolerance goes down after not using for a while.
4. Use less if you’re sick or not feeling well. Tolerance can go down when you’re sick or not well.

Peer support services are non-clinical services that are often used alongside medical and behavioral treatment for opioid and other substance use disorders. These services are typically provided by “peers” who are also recovering from addictions. The idea is that those who are already in recovery will be able to use their own personal experiences to help those who want to work towards recovery.

Examples of peer support include help with transportation to and from treatment and recovery-oriented activities as well as employment support. They can include special living situations, such as sober living houses, where residents in recovery live together in an alcohol and drug-free environment. Support groups, such as Narcotics Anonymous, can also provide a supportive community for those trying to get away drugs.

People with substance use disorders who participate in treatment approaches that also include peer support have higher success rates of abstinence and reduced rates of relapse and infections from HIV and Hepatitis C. Adding peer support to treatment is also associated with greater feelings of self-efficacy and less guilt and shame. In one study, living in a sober living house after inpatient treatment for substance use disorder led to higher income and fewer incarcerations.

Family members (e.g., spouses, children, parents, and siblings) of people with addiction can also benefit from participating in support groups, located in school and community settings.

Millions of American families are affected by the opioid epidemic. An article in the Washington Post (2018, July 3) by Alexandra Rockey Fleming describes how family members suffer collateral damage from their loved one’s addiction. Fleming calls these family members – who love and worry about the person – “Opioids’ Other Victims.” She states: “Many parents don’t survive the midnight calls about arrest, overdose, violence, and hospitalization emotionally intact.” (p. E3).

Peer support has helped many parents suffering from isolation and anxiety caused by their children’s addictions. Some peer support groups offering free meetings or online support to family members include Nar-Anon, Families Anonymous, Parents of Addicted Loved Ones, Magnolia New Beginnings, Learn to Cope, and Partnership to End Addiction.

Younger children in these families need guidance and support. It is important to talk honestly with children about what is happening in the family and to help them express their concerns and feelings. The Substance Abuse and Mental Health Services Administration provides some free educational booklets to help start this conversation. Family therapy can help both the person with addiction and their family members.