THE FIGHTING FENTANYL CAMPAIGN
40xs
Fentanyl is a synthetic opioid that can be:
stronger than heroin
100xs
stronger than morphine
you don’t always know what/how much fentanyl is in your pills/drugs.
Where do we see fentanyl?
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Alone as a “crumbly” powder
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Adulterated in heroin (very little heroin in EDC)
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Illicit pills
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Cocaine and methamphetamines – driving increase in stimulant overdose deaths
Fentanyl in El Dorado County...
Two types of fentanyl: pharmaceutical fentanyl & illicitly manufactured fentanyl (IMF)
Pharmaceutical fentanyl is prescribed by doctors to treat severe pain. Most recent cases of fentanyl-related overdose are linked to illicitly manufactured fentanyl. It's often added to other drugs because of its extreme potency. This makes it cheaper and more powerful, addictive, and dangerous.
Rainbow Fentanyl –fentanyl pills and powder comes in a variety of bright colors, shapes, and sizes. (www.DEA.gov)
What is IMF?
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Synthetic opioid
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Not detected on most urine drug screens
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Significant variation in type, potency & purity which increases risk of overdose
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Repeated use leads to accumulation in adipose tissue –slowly leaves fat stores
Street names for IMF include:
•Apache
•Dance Fever
•Friend
•Goodfellas
•Jackpot
•Murder 8
•Tango & Cash
KEY TERMS + VOCABULARY
What is Stigma?
"A strong feeling of disapproval that most people in a society have about something, especially when this is unfair"
Cambridge Dictionary
​
"An attribute, behavior, or reputation that is socially discrediting, and substance-related problems appear to be particularly susceptible to stigma."
International Journal on Drug Policy
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MORE than just Stereotyping
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Ideas and attitudes that generalize and label groups
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MORE than just Prejudice
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Endorsing and promoting harmful beliefs within stereotypes
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MORE than just Discrimination
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Practices and behaviors that promote inequity toward labeled groups
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Stigma on 3 levels
​
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Structural: laws, regulations, politics
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EX: State health agency boards who make decisions, polices, and laws with no representation of individuals with lived experience
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Public: attitudes, beliefs, and behaviors of individuals and groups
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EX: Neighborhood perspectives regarding the presence of drug activity
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Self-Stigma: internalized negative stereotypes
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EX: Believing that you’re not worth treatment
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Stigma Impacts Recovery:
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Reduces willingness to seek professional support:
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Fear of being looked down upon, stereotyped, etc.
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Causes reluctance + aversion to attend treatment
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Limits access to healthcare, housing, aftercare, community support, + employment
Impacts on Stigmatized Populations:
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Increase in adverse outcomes
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Diminished self-esteem
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Affects personal relationships at a time they are needed the most
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Increases involvement in risky behaviors
What is Harm Reduction?
"Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. Harm Reduction is also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs."
Examples of Harm Reduction:
​
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Overdose Prevention
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Syringe exchange
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Disease testing
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Disposal containers
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NARCAN/Naloxone training
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Referral to treatment + resources
​Some Principles of Harm Reduction:
1. Accepts, for better or worse, that licit and illicit drug use is part of our world and chooses to work to minimize its harmful effects rather than simply ignore or condemn them
​2. Calls for the non-judgmental, non-coercive provision of services and resources to people who use drugs and the communities in which they live in order to assist them in reducing attendant harm​
​3. Recognizes that the realities of poverty, class, racism, social isolation, past trauma, sex-based discrimination, and other social inequalities affect both people’s vulnerability to and capacity for effectively dealing with drug-related harm​
​4. Does not attempt to minimize or ignore the real and tragic harm and danger that can be associated with illicit drug use
THE GOOD SAMARITAN
LAW
California’s 911 Good Samaritan Law provides limited protection from arrest, charge and prosecution for people who seek emergency medical assistance at the scene of a suspected drug overdose.
When calling 911 services, say:
​
**Give Location**
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"We have a person down. They are not breathing. Suspect an overdose."​
This will activate the Good Samaritan Law​ and your protections
​Do NOT interfere with first responders.
Step Back.
You will be risking your Good Samaritan Law protections otherwise
​Witnesses are protected even if they...
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Are under the influence of drugs
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In possession of small amounts of drugs
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In possession of drug paraphernalia
SIGNS OF AN OVERDOSE
Are they High or Overdosing?
(on opioids)
​
​
a. Are they responsive?
b. Are they breathing?
​
If yes to both, they’re just high
Here are some things to look for:
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Small, constricted “pinpoint pupils”
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Falling asleep or losing consciousness
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Slow, weak, or no breathing
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Choking or gurgling sounds
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Limp body
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Cold and/or clammy skin
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Discolored skin (especially lips & nails)
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Caucasian: Blue/Purple
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BIPOC: Grey-ish
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"Recognizing the signs of opioid overdose can save
a life."
WHAT TO DO IF SOMEONE OVERDOSES
(on opioids)
STEP ONE: Assess + Stimulate
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Assess yourself and the situation:
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Are you able to assist at the moment?
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Is it safe for you to assist? ​​
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Stimulate:
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VERBAL: YELL. Explain what you're doing before doing it.
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Ex: "Hey! Are you okay? Can you show me how you're doing?
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PHYSICAL: Arm pinch, sternum rub, etc.
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STEP TWO: Calling 911
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Give minimal information:
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Location ​
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Say "We have a person down. They are not breathing. Suspect an overdose."​
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This will ACTIVATE the Good Samaritan Law​
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Do NOT interfere with first responders, step back. You will be risking your Good Samaritan Law protections otherwise
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-
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If you're by yourself:​
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Call 911
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Retrieve and Administer NARCAN/Naloxone
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Preform RESUCE BREATHING
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If you're in a group:
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Delegate roles​
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Point to someone and say "Call 9ll"
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YELL out "Does anyone have NARCAN/Naloxone?"​
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Retrieve and Administer NARCAN/Naloxone
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Preform RESCUE BREATHING
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STEP THREE: Administering NARCAN/Naloxone
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Nasal NARCAN Tip:​
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Do NOT test (one dose per bottle)​
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3-5 minutes to work
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Intramuscular Naloxone Tip:​
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Draw ALL fluid into the needle​
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Inject needle straight into the upper side of the arm or middle side of the thigh (do not inject into the butt)
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Administer a 2nd dose of NARCAN/Naloxone if...
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The person is not awake in 2.5-3 minutes ​
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If the person stops breathing again
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STEP FOUR: Put the person in the Recovery Position​
- Lay them on their side with the bottom arm extended out, the top arm under the head, and the top knee supporting them on their side​
STEP FIVE: Stay with the person until emergency assistance arrives
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If you must leave, leave the person in THE RECOVERY POSITION
How to administer NARCAN/
Naloxone...
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Remove NARCAN/Naloxone spray from the box
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Peel Back the tab with the circle to open
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Place your thumb on the bottom and your middle/index fingers on either side of the top
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Tilt the persons head back and support behind the neck with your hand
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Insert entirely into the nostril and press plunger to administer the full dose
Fentanyl is not Narcan resistant...
it just might take a little more Narcan
Watch a YouTube video...
How to preform Rescue Breathing...
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Place face shield **optional**
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Tilt head back, lift chin, & pinch nose
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Give one breath into the mouth every 5 seconds
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Administer a second dose of NARCAN if:
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If there is no breathing after 2-3 minutes
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If the person stops breathing again
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SERVICES IN EDC
Substance Use Disorder (SUD) Services
in El Dorado County
SUD Services are drug and alcohol counseling, MAT, detoxification, and inpatient and outpatient rehabilitation.
Medication-Assisted Treatment (MAT)
in El Dorado County
​Medication Assisted Treatment is the use of medications, in combination with counseling and behavioral therapies, to provide a “whole-patient” approach to the treatment of substance use disorders.
NARCAN/Naloxone FREE
In El Dorado County
Definition of NARCAN / Naloxone:
Naloxone is a medication approved by the Food and Drug Administration (FDA) designed to rapidly reverse opioid overdose.
The medication can be given into the nose, into the muscle, under the skin, or via intravenous injection.
Harm Reduction Services
in El Dorado County
El Dorado County naloxone Distribution Sites
El Dorado County has established Narcan distribution sites to combat opioid overdoses. These sites provide easy access to Narcan (naloxone), a life-saving medication that can reverse opioid overdoses. The initiative aims to reduce overdose deaths and increase community awareness about opioid use.
For more detailed information and to download resources, please visit the provided link.
Sierra Harm Reduction Coalition (SHRC) services provide positive reinforcement to catalyze change for individuals using drugs in the unique community of EDC.
Their commitment is to scrape away the barriers created by stigma & discrimination towards drug users.
Their services include:
​
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Safer Using Supplies
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Syringe Collection and Disposal
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FREE Narcan Distribution + Fentanyl Testing Supplies
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Disposal containers
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Training and Education
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Case Managment
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Referrals to essential services
HOTLINE
(530) 212-0279
CAMPAIGN GRAPHICS
Campaign Brochures
**for best at home printing, print from web browser**
Campaign Wallet Cards
**for best at home printing, print from web browser**
Campaign Social Media Sets
Additional Graphics
GLOSSARY + CITATIONS
Campaign Glossary:
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BUPRENORPHINE
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​Buprenorphine is a medication approved by the Food and Drug Administration (FDA) to treat Opioid Use Disorder (OUD) as a medication-assisted treatment (MAT). As with all medications used in MAT, buprenorphine should be prescribed as part of a comprehensive treatment plan that includes counseling and other behavioral therapies to provide patients with a whole-person approach. (Substance Abuse and Mental Health Services Administration, SAMHSA)
-
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FENTANYL:
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a synthetic opioid narcotic analgesic with pharmacological action like morphine that is administered transdermally as a skin patch and in the form of its citrate where it is administered orally or by injection.(as it relates to medicinally purposes) (Merriam-Webster Dictionary)
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HARM REDUCTION:
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Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. Harm Reduction is also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs.(National Harm Reduction Coalition)
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Harm reduction incorporates a spectrum of strategies that includes safer use, managed use, abstinence, meeting people who use drugs “where they’re at,” and addressing conditions of use along with the use itself. Because harm reduction demands that interventions and policies designed to serve people who use drugs reflect specific individual and community needs, there is no universal definition of or formula for implementing harm reduction. (National Harm Reduction Coalition)
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MEDICATION ASSISTED TREATMENT (MAT):
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​Medication Assisted Treatment is the use of medications, in combination with counseling and behavioral therapies, to provide a “whole-patient” approach to the treatment of substance use disorders. (Substance Abuse and Mental Health Services Administration, SAMHSA)
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Learn what medications are used in MAT here (click)​
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METHADONE:
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Methadone is a medication approved by the Food and Drug Administration (FDA) to treat Opioid Use Disorder (OUD) as a medication-assisted treatment (MAT), as well as for pain management. When taken as prescribed, methadone is safe and effective. Methadone helps individuals achieve and sustain recovery and to reclaim active and meaningful lives. Methadone is one component of a comprehensive treatment plan, which includes counseling and other behavioral health therapies to provide patients with a whole-person approach. (Substance Abuse and Mental Health Services Administration, SAMHSA)
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NARCAN/Naloxone:
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Naloxone is a medication approved by the Food and Drug Administration (FDA) designed to rapidly reverse opioid overdose. The medication can be given by intranasal spray (into the nose), intramuscular (into the muscle), subcutaneous (under the skin), or intravenous injection. (Substance Abuse and Mental Health Services Administration, SAMHSA)
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OPIOID OVERDOSE:
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Opioid intake to the point of respiratory depression.
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Respiratory depression, refers to slow, shallow, and ineffective breathing. (Banyan Treatment Center)
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RECOVERY:
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A process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential. (Substance Abuse and Mental Health Services Administration, SAMHSA)
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Guiding Principle: Hope, the belief that these challenges and conditions can be overcome, is the foundation of recovery.​
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STIGMA:​
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A strong feeling of disapproval that most people in a society have about something, especially when this is unfair. (Cambridge Dictionary)
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An attribute, behavior, or reputation that is socially discrediting, and substance-related problems appear to be particularly susceptible to stigma. (International Journal on Drug Policy)
-
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SUBOXONE:
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​SUBOXONE (buprenorphine and naloxone) Sublingual Film® (CIII) is a prescription medicine used to treat opioid addiction in adults and is part of a complete treatment program that also includes counseling and behavioral therapy. (Suboxone)
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SUBSTANCE USE DISORDER (SUD):
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A Substance Use Disorder (SUD) is a dependence on alcohol, street drugs or prescriptions medications for non-medical purposes.
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Substance use disorders occur when the recurrent use of alcohol and/or drugs causes clinically significant impairment, including health problems, disability, and failure to meet major responsibilities at work, school, or home. (Substance Abuse and Mental Health Services Administration, SAMHSA)
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SUD SERVICES:
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Substance Use Disorder Services are drug and alcohol counseling, medication assisted treatment, detoxification and inpatient and outpatient rehabilitation.​
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Campaign Citations:
“Buprenorphine.” Substance Abuse and Mental Health Services Administration , SAMHSA, 27 Sept. 2022, https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/buprenorphine.
​
“Dea Warns of Brightly-Colored Fentanyl Used to Target Young Americans.” DEA, United States Drug Enforcement Administration, 30 Aug. 2022, https://www.dea.gov/press-releases/2022/08/30/dea-warns-brightly-colored-fentanyl-used-target-young-americans.
“DOPE Project Monthly Overdose Prevention & Naloxone Administration Training.” DOPE Project, 16 Aug. 2022.
​
“Fentanyl.” Merriam-Webster.com Dictionary, Merriam-Webster, https://www.merriam-webster.com/dictionary/fentanyl. Accessed 25 Oct. 2022.
“Fentanyl Facts.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 23 Feb. 2022, https://www.cdc.gov/stopoverdose/fentanyl/index.html
"Fentanyl and Overdose Prevention." Jay, D, Marshall Medical Center. [PPT]. 2022
​
“For Opioid Dependence: SUBOXONE (Buprenorphine and Naloxone) Sublingual Film® (CIII).” Patient Information for SUBOXONE® (Buprenorphine and Naloxone) Sublingual Film (CIII), Indivior PLC, https://www.suboxone.com/
​
"The Good Samaritan Law." Ewing, Tom, Sierra Harm Reduction Coalition. [PDF]. 2021
​
“Good Samaritan Laws.” County of Santa Clara Behavioral Health Services , County of Santa Clara , https://bhsd.sccgov.org/information-resources/opioid-overdose-prevention-project/good-samaritan-laws
​
"Know Your Rights." Ewing, Tom, Sierra Harm Reduction Coalition. [PDF]. 2021
"Mat Medications, Counseling, and Related Conditions." Substance Abuse and Mental Health Services Administration, SAMHSA, 2022, March 4. https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions#medications-used-in-mat
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"Mental Health and Substance Use Disorders." Substance Abuse and Mental Health Services Administration, SAMHSA, 2022, November 22. https://www.samhsa.gov/find-help/disorders
​
“Methadone.” Substance Abuse and Mental Health Services Administration , SAMHSA, 27 Sept. 2022.
​
"Naloxone." Substance Abuse and Mental Health Services Administration , SAMHSA, 27 Sept. 2022, https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/naloxone
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“Naloxone in New Hampshire .” Anyone. Anytime. New Hampshire, Anyone.Anytime.NH, https://anyoneanytimenh.org/naloxone-in-new-hampshire/
​
“National Harm Reduction Coalition.” Principles of Harm Reduction , National Harm Reduction Coalition, 31 Oct. 2022, https://harmreduction.org/about-us/principles-of-harm-reduction/
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"Preventing and Disrupting Stigma Associated with Substance Use Disorders." Wrangham, Nigel, Northwest PTTC. [PPT]. (2022).
"Recovery and Recovery Support." Substance Abuse and Mental Health Services Administration , SAMHSA, 13 Sept. 2022, https://www.samhsa.gov/find-help/recovery
​
“Stigma.” Cambridge Dictionary, Cambridge University Press, https://dictionary.cambridge.org/us/dictionary/english/stigma
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"Testing For Fentanyl." Ewing, Tom, Sierra Harm Reduction Coalition. [PDF]. 2022
​
"Using Narcan (Naloxone)." Ewing, Tom, Sierra Harm Reduction. [PDF]. 2022
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“Welcome to the California Overdose Surveillance Dashboard.” CA Overdose Dashboard, California Department of Public Health, https://skylab.cdph.ca.gov/ODdash/?tab=CTY
​
“What Drugs Cause Respiratory Depression?” Shapper, Alyssa, Banyan Treatment Centers, 29 Dec. 2021, https://www.banyantreatmentcenter.com/2021/11/23/respiratory-depression-caused-by-drugs/
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“Words Matter - Terms to Use and Avoid When Talking About Addiction.” National Institutes of Health, U.S. Department of Health and Human Services, 29 Nov. 2021, https://nida.nih.gov/nidamed-medical-health-professionals/health-professions-education/words-matter-terms-to-use-avoid-when-talking-about-addiction.
CAMPAIGN PARTNERS
This campaign was funded (in part) by the California Department of Public Health (CDPH), supported by Grant Number 6NU17 CE002747 from the Centers for Disease Control and Prevention (CDC). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC, the Department of Health and Human Services, the CDPH, or the El Dorado Coalition for Prevention & Education.