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1. How do Opioid Overdoses occur? 2. What are the signs of Opioid Overdose? 3. What could the therapist say to a patient/client who expresses fears about opioid tapering? 4. Can first responders develop toxicity from just entering the room where someone has fentanyl overdosed? 5. What is Street Fentanyl?
Answers:
A. Unconsciousness or inability to awaken orally or upon sternal rub; Slow or shallow breathing or breathing difficulty such as choking sounds or a gurgling/snoring noise from a patient who cannot be awakened; Fingernails or lips turning blue/purple; Slow heartbeat and/or low blood pressure. B. a patient deliberately misuses a prescription, uses an illicit opioid (such as heroin), or uses an opioid contaminated with other even more potent opioids (such as fentanyl) or a patient takes an opioid as directed but the prescriber miscalculated the opioid dose, or an error was made by the dispensing pharmacist, or the patient misunderstood the directions for use. It can also occur when opioids are taken with other medications—for example, prescribed medications such as benzodiazepines or other psychotropic medications that are used in the treatment of mental disorders—or with illicit drugs or alcohol that may have adverse interactions with opioids C. In order to create clinically significant toxicity, an adequate dose of fentanyl must be absorbed into the blood stream and enter the central nervous system. Simply being in a room where fentanyl is present will not result in toxicity or overdose. D. “I know you can do this” or “I’ll stick by you through this.” Make yourself or a team member available to the patient to provide support, if needed. Let patients know that while pain might get worse at first, many people have improved function without worse pain after tapering opioids. E. any fentanyl used by someone it was not prescribed for. Fentanyl is a powerful pain medication. It is an opioid, like morphine, codeine, oxycodone (oxys) and methadone. Fentanyl is most often prescribed as a slow-release patch to people with long-term, severe pain. Fentanyl is much stronger than most other opioids—up to 100 times stronger than morphine—and is very dangerous if misused. Even a small amount can cause an overdose and death... may be swallowed, smoked, snorted or injected.
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