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Go through the instructions below with your friends, and practice the recovery position until you can all do it without thinking.

If someone overdoses don’t assume they’ll come round. If they are unconscious and breathing, put them in the recovery position and dial triple zero (000) from a land line or (112) from a mobile phone and ask for an ambulance.

TO PUT SOMEONE IN THE RECOVERY POSITION:

• Place the arm furthest from you at right angles to their body.
   
• Take the arm nearest to you and place it across the person’s chest.
   
• Get hold of the near leg, just above the knee, and pull it up, keeping the foot flat on the ground.
   
• Keep hold of the near leg just above the knee, and while supporting the person’s neck and shoulder,
  roll them away from you, and onto their side.
   
• The person’s face should be pointing towards the ground.
   
• Open their airway by tilting their head back and lifting the chin.
  This will make sure they can breathe easily.
   
• Make sure that both the hip and the knee of their upper leg are bent at right angles.

If you don’t they may die.

In Queensland, for non-emergency enquiries about overdose contact the Alcohol and Drug Information Service on (07) 3236 2414 or regional freecall on 1800 177 833.

Below is the information the briefing paper gives to pharmacists to support the text on the calendar card.
It will hopefully be of interest both to professionals and injecting drug users.

Overdose is currently the most common cause of death amongst IDUs.

The overdose mortality rate amongst IDUs rose steadily during the 1990s - from approximately 250 in 1991, to 600 in 1997, to over 950 in 1999 (the Commonwealth Department of Health and Aged Care (2001) reported that there were 958 deaths attributable to opioid overdose amongst those aged 15 - 44 years in 1999).

Many of these deaths could have been prevented: up to 60% of injecting heroin users report having experienced at least one overdose, while up to 70% have witnessed someone else overdosing. Research shows that around 60% of overdose deaths occur in the presence of others and that sudden death immediately after injecting is rare, happening in only 15% of cases.

If services in contact with injectors provide appropriate information and support on how to respond to an overdose, it is likely that the number of overdose deaths can be reduced.

This is because people who witness overdoses often try to help - unfortunately the things they do often make the situation worse.

Myths
If you can initiate a conversation about responses to overdose, the key myths to dispel are:

• walking people who have overdosed around doesn’t help (in fact it increases blood flow
  and might therefore increase metabolism of drugs/alcohol taken orally);
   
• when people have overdosed, putting them in a cold bath doesn’t help
  (many drug users do not realise that stimulation cannot bring someone round
  from unconsciousness - it can only rouse someone from semi-consiousness); and
   
• high purity heroin isn’t a major cause of death (in fact it is usually combinations
  of drugs that cause death).

Learning first-aid in a workshop organised by a drug service with a qualified trainer can also help improve responses to overdose.

Key interventions
Conversations with injectors about overdose that can save lives could be as simple as to suggest practicing the recovery position with a friend when they get home (explain that it isn’t as easy as it might look, and is therefore well worth practicing so that they can do it without thinking in an emergency).

It is also important that injectors are aware that when someone overdoses they should:

• stay calm
   
• put them in the recovery position
   
• dial 000 from a land line or 112 from a mobile phone and ask for an ambulance; and
   
• stay with the person until the ambulance has arrived.

Further reading
Commonwealth Department of Health and Aged Care. (2001). National Heroin Overdose Strategy. Canberra: Commonwealth of Australia.

Manly Drug Education & Counselling Centre. (2001). Chemical Reaction. Sydney: MDECC.

Preston, A., Hardacre, P., Hunt, N. & Derricott, J. (2001). Preventing Overdose (Second Edition). London: Exchange Campaigns.

Warner-Smith M, Lynskey M, Darke S, Hall W. (2000). Heroin overdose: prevalence, correlates, consequences and interventions Monograph No. 4 National Drug and Alcohol Research Centre, University of New South Wales.

Zador D, Sunjic S, Darke S. (1996). Heroin-related deaths in New South Wales, 1992: toxicological findings and circumstances. Medical Journal of Australia 164: 204-207.

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