Identifying Overdose and Preparing Take-Home Naloxone

NOTE: Quotes are presented word for word apart from minor editing for readability and clarity. Identifying details have been removed. Square brackets show text that has been added or, where ellipses (three dots) appear, removed. For example, ‘Since I actually participated in this Narcan [training], I’ve administered it to two people and it’s brought them around […] I wouldn’t think twice about [doing] it. Saving someone’s life is the main thing.’

The people whose stories appear on this website describe giving take-home naloxone in a range of overdose situations. Sometimes it’s fairly obvious that someone has overdosed and needs naloxone, such as when they fall over after consuming opioids. At other times, the need for intervention is less clear, with the overdose only becoming apparent after some time. These stories highlight the different ways people discover the need for naloxone, and the variety in experiences of overdose more generally.

People also use different kinds of take-home naloxone equipment. Ampoules, often referred to as ‘vials’, and Minijets® (no longer available in Australia) are the two forms of naloxone that feature in the stories they tell. (Since the interviews for this website were conducted, Nyxoid^®, a form of naloxone sprayed into the nose, has become more widely used.)

Overall, while our participants’ experiences of witnessing overdose and using take-home naloxone vary in many ways, the stories recounted here all demonstrate the importance of the actions of those responding to overdose and averting loss of life.

As in some other sections of this website, this section doesn’t include experiences of participants who consumed prescribed opioids because none had used naloxone before.

Recently, Karen (F, early 30s, Vic, non-prescribed opioids) was consuming heroin with a group of friends. Her friend Patricia had also consumed other drugs (‘pills’), and while Karen was concerned about this, she remembers that she didn’t feel able to intervene. Karen’s concerns turned out to be justified when Patricia began experiencing an overdose. Karen was quick to respond, and began preparing some naloxone that was in her husband’s bag. (Note: strong language) (Read her personal story here)

So we all went to our normal spot and had it [the heroin]. The next thing you know, I finished getting myself and I turned around and she’s, like, swaying, and I’m, like, ‘Are you all right?’ And she went, ‘Yeah, I’m all right,’ and then the next thing you know, her head’s just hit the cement slab. Just gone donk instantly, and I’ve gone, ‘Oh shit.’ […] Everyone else sort of moved back, because, I suppose because I’m a pretty strong-minded person, but everyone moved back. One was turning her on her side, and I was going into my bag, because I had my husband’s bag, so I was getting [the take-home naloxone] out.

Karen revived Patricia with the naloxone and looked after her for the rest of the day.

Some time ago, Tony (M, mid 40s, NSW, non-prescribed opioids) and another person used take-home naloxone to revive a man soon after he had purchased and consumed heroin. The need for naloxone was obvious on this occasion because he was ‘unconscious’ almost immediately after injecting. (Read his personal story here)

I did the training and I got it. I still kept one for myself at home, even though I passed the others on. They seemed to be all right with it up there as well, because they just came out, they said, ‘We don’t care. That’s all right.’ And the time when I actually had to use it was at my dealer’s house.

We had a guy come in to my dealer’s house and he said he was a regular user, but I don’t think he used very much because [after taking] what he had, like the $50 worth, he was unconscious pretty much straight away, you know. So that was the vial. [I] was a bit more sort of nervous [than other times I’ve witnessed an overdose], [it was a] bit more fiddly [than the Prenoxad which I’d used in the past], and yeah, it was just injected in the leg.

Although Tony found the naloxone ampoule, or ‘vial’, a bit ‘fiddly’, he successfully opened it and used the contents to revive the man by injecting it into his leg.

This time recounting an overdose that occurred in his own home, Zippy (M, late 50s, Vic, non-prescribed opioids) describes giving his friend take-home naloxone after he consumed particularly strong heroin. Zippy keeps syringes containing naloxone in his fridge, ready to be used in an emergency. (Read his personal story here)

I scored for this bloke and I said, ‘Try this mate, but be careful, it’s really strong.’ And he had too much, mate, he had the whole lot, and I’d said to him, ‘Don’t have the whole lot.’ He’s used to having a $100 hit at once, and $100 of this other stuff that I got was a lot stronger. It was probably like having $150 worth, but he set it all up at once. And he’s another big guy [like another mate I’d revived in the past], you know, and all of a sudden, he’s just looked at me and it was as though he was looking straight through me, and he just sort of went, ‘Ooohhh’ and he just started shaking, and his legs had buckled from under him and he had to grab hold of the bench […] It was as though I wasn’t even there, and I could see that he was just hanging onto the bench and his legs buckled and I thought, ‘He’s going to drop, he’s going to drop, he’s just going to smack his head on the floor.’

Zippy successfully revived his friend, but explains in the interview that overdoses cause him a great deal of stress.

At other times, our participants were not present when the overdose occurred, but instead were called on the phone by those present or, in some cases, simply came across the situation by happenstance.

These stories also emphasise that the effects of drugs can be unpredictable.

For example, Simone (F, late 40s, Vic, non-prescribed opioids) describes an overdose when her partner hadn’t consumed what she thought of as ‘a lot’ of heroin. In this instance, it only took one dose of naloxone to revive him. (Read her personal story here)

It was my daughter’s father. He had just … he hadn’t used for a while, but he didn’t tell me that. I didn’t give him a lot, and then he just dropped, so I gave him the shot of naloxone and he came through [or came to], but he wouldn’t listen to me to just sit down and rest or anything like that […] He didn’t really know what had happened to him, so I had to explain why I was telling him to sit down and relax.

Unlike situations in which the need for naloxone is clear, some were not immediately aware of the need for action.

Emma (F, mid 50s, NSW, non-prescribed opioids) tells the story of consuming heroin with a group of friends. One young man overdosed after consuming more heroin than the rest of the group, but as Emma and the others were preoccupied listening to music and chatting, they didn’t immediately realise what had happened. After noticing the overdose, Emma quickly got an ampoule of naloxone and snapped the top off so she could administer it. (Read her personal story here)

These boys knew that we used [heroin] and used to pester us all the time. They were […] first year uni[versity] students or something, and in the end, someone, I can’t remember who it was, I think [name] who was a doctor, medical student, said to me, ‘Look, if we don’t sell it to them, if we don’t get something for them, then they’ll just get it from somewhere else, and this way we can show them how to do it properly and at least they’ll be a bit safer.’ So [we] went back to their house and did some [heroin], and the first lot was okay because I mixed it up, and I gave it to [everyone]. Then we hung around, and we were just, there was music and we were talking, and then we suddenly noticed someone hasn’t moved for a while, and he’d had some more and he still had the fit in his arm. So he’d obviously just gone ahead and done some [more heroin]. And so I noted, ‘I know what to do here,’ and it was like, I mean, even before [my other friend] said anything, it was like [section removed to preserve anonymity], ‘Cool, so I just snap the top off.’

The young man was revived and initially didn’t realise what had happened. The rest of the group explained that he had overdosed and Emma had revived him with her supply of naloxone.

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Identifying Overdose and Preparing Take-Home Naloxone

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