Will Matteson, substance use prevention coordinator for Healthy Lincoln County (HLC), presented a “Overdose Response and Narcan Administration Training” seminar and demonstration at Boothbay Region High School (BRHS) Tuesday, Dec. 5, on invitation from Boothbay Adult Education. Matteson provided attendees with bags containing two doses of 4mg Narcan (naloxone) nasal spray, a portable Narcan administration flyer, a copy of his slide show presentation, supplies for taking notes, and contact information for both local and national crisis response.

Matteson works in “harm reduction,” a philosophy that advocates care and reducing risk of harm for people still using illicit drugs. Last year in Maine, 716 people died from opioid overdose, and about 8,000 overdose reversals occurred from naloxone administration, of which 2,200 of those reversals were administered by community members, according to Maine Drug Data Hub. Matteson works to saturate the community in free naloxone as a way of saving lives, and he suggested it be kept with every first aid kit and anywhere else it makes sense to store it. “Narcan should be out there in the environment because drugs are out there in the environment,” he said. “Often getting Narcan administered is the wake-up call needed to get into a recovery program.”

Training included how to recognize signs of someone overdosing, safe and effective Narcan administration, aftercare, and Maine’s Good Samaritan Laws, which prevent legal liability for anyone administering Narcan. Proper storage of Narcan includes keeping it out of sunlight, in temperatures between 59-77°F, and, since it is universally safe, even for pets, Matteson recommends not keeping it locked away. He said there is no need to keep away from children and, if using it, time is of the essence, he said.

Matteson recommends attending one of the free training seminars to gain contextual knowledge from a presenter and to benefit from the conversations around each step. This is a generalized outline of the steps:

1. Make sure you, as the administrator, are in a safe environment and not personally at risk.
2. Check for signs of overdose: loss of consciousness, limp body, shallow or slow breathing – choking, snoring, or gurgling sounds, vomiting, pinpoint pupils, blueish tint to lips, face or nails, unresponsiveness.
3. If the person is not breathing, rush straight to Narcan administration, both doses. Call 911 immediately after, consider performing CPR if you are comfortable.
4. If the person is still breathing but otherwise unresponsive, perform a sternal rub on the chest bone or a philtrum (the area between nose and upper lip) rub to try to rouse the person.
5. Call 911 if you have not already done so.
6. Administer Narcan every two to three minutes until the person wakes up, help arrives, or you run out. To administer, make sure the person is on their back, lift their chin, insert the Narcan tip into a nostril and press the plunger. You will hear and feel a pop when the plunger has released the naloxone, which is a powder (not liquid) and will be absorbed quickly in the nasal lining. The CDC offers a 30-second video on administering naxalone at  https://www.youtube.com/watch?v=odlFtGNjmMQ 
7. Naloxone wears off after 30-90 minutes and more than one dose may be required.
8. Adjust the person into the recovery position, laying on their side with their upper arm under their head to ensure an open airway, the top leg across the body to stabilize them. Give them space. Do not give them food or water. Receiving Narcan immediately puts the person into withdrawal, and they will feel foggy, confused and sick. Explain to them what has happened and that help is on the way.

Free naloxone, no questions asked, is available from HLC 207-622-7566 x256, Lincoln Health (Boothbay, Damariscotta, Waldoboro, Wiscasset family practices) 207-563-4747, Maine OPTIONS Program 207-468-3483, Community Resource Council 207-350-7477, and the Peer Recovery Center in Newcastle 207-563-6374. As an over-the-counter treatment, it is also available for purchase at most pharmacies. 988 is the national crisis helpline.

HLC is a Maine Tier II naloxone distributor under MaineGeneral Medical Center, and content for the training seminars was developed by the Prevention & Healthy Living Center of MaineGeneral. Maine Prevention Services oversees and funds Matteson’s work through HLC. Matteson is available to any Lincoln County business/organization wishing to host a training, (207)563-1330, wmatteson@healthylincolncounty.org