SUBSTANCE USE RESOURCES
Treatment Resources - Contact CMPP for Help with All Options Below
Local -
Emerson Hospital Addiction Rehabilitation Programs - https://www.emersonhospital.org/SupportServicesAndGroups/SupportServices/AddictionPrograms.aspx
978-287-3520
Eliot Community Human Services - (978) 369-1113
Mclean Hospital - http://www.mcleanhospital.org/programs/alcohol-and-drug-abuse-inpatient-program 844.222.6037
Recovery Centers of America/Wicked Sober - https://recoverycentersofamerica.com/ 1-800-Recovery
Bedford Veterans Affairs Medical Center - https://www.bedford.va.gov/Mentalhealth/vcat.asp (781) 687-2000
Hanscom Air Force Base Alcohol and Drug Abuse Prevention and Treatment (ADAPT) - 781-225-6392
List of treatment options across the state -
Massachusetts Substance Use Helpline, Help in Finding Treatment - http://helpline-online.com/ 800-327-5050
Massachusetts Organization for Addiction Recovery (MOAR) Online Resource Guide/List of Treatment Locations - http://docs.wixstatic.com/ugd/8256b8_5e9737b473044491acbe3a1f931bf87a.pdf
William James College Interface Referral Service, Help in Finding Treatment - https://interface.williamjames.edu/topic-overview/substance-abuse-addictions 888-244-6843
Massachusetts Addiction Recovery Software - Real time inpatient bed locator
Substance Abuse and Mental Health Services Administration (SAMSHA) - https://www.samhsa.gov/
Granite Recovery Centers - Rehabilitation and Recovery Center
Support Groups
Alcoholics Anonymous - http://www.aa.org/
Narcotics Anonymous - https://www.na.org/
SMART Recovery - https://www.emersonhospital.org/SupportServicesAndGroups/SupportServices/AddictionPrograms.aspx
Section 35 - Involuntary placement into detox (court ordered)
http://www.mass.gov/eohhs/docs/dph/substance-abuse/sec35-faq-brochure-revised-11-16.pdf
Medication Assisted Treatment Options
Habit OPCO, Outpatient Methadone Treatment, http://www.crchealth.com/find-a-treatment-center/methadone-treatment508-586-6300
Buprenorphine/Suboxone Doctors, www.turntohelp.com.au
Vivitrol, http://www.vivitrol.com/
Family Resources
Learn 2 Cope - http://www.learn2cope.org/ 508-738-5148
Al-anon - www.ma-al-anon-alateen.org 508-366-0556
Nar-anon - http://www.nar-anon.org
SMART Recovery Family and Friends - http://www.smartrecovery.org/resources/family.htm (Emerson Hospital - 866-951-5357)
Substance Abuse Education
National Institute on Drug Abuse (NIDA) - www.drugabuse.gov
Substance Abuse and Mental Health Services Administration (SAMSHA) - https://www.samhsa.gov/
Opioid Epidemic Information- https://www.opioidhelp.com/epidemic/
Help.org- https://www.help.org/
Advocacy
Massachusetts Organization for Addiction Recovery (MOAR) - http://www.moar-recovery.org/
Grief Resources
Learn2 Cope Listings of Grief Support Groups - http://www.learn2cope.org/grief-resources/
How to Respond to An Overdose
STEP 1: CALL FOR HELP (CALL 911)
AN OPIOID OVERDOSE NEEDS IMMEDIATE MEDICAL ATTENTION.
An essential step is to get someone with medical expertise to see the
patient as soon as possible, so if no EMS or other trained personnel
are on the scene, dial 911 immediately. All you have to say is:
“Someone is not breathing.” Be sure to give a clear address and/or
description of your location. Good Samaritan Law
STEP 2: CHECK FOR SIGNS OF OPIOID OVERDOSE
Signs of Overdose, which often results in death if not treated, include:
- Face is extremely pale and/or clammy to the touch
- Body is limp
- Fingernails or lips have a blue or purple cast
- The patient is vomiting or making gurgling noises
- He or she cannot be awakened from sleep or is unable to speak
- Breathing is very slow or stopped
- Heartbeat is very slow or stopped.
Signs of Overmedication, which may progress to overdose, include:
- Unusual sleepiness or drowsiness
- Mental confusion, slurred speech, intoxicated behavior
- Slow or shallow breathing
- Pinpoint pupils
- Slow heartbeat, low blood pressure
- Difficulty waking the person from sleep.
Because opioids depress respiratory function and breathing,
one telltale sign of a person in a critical medical state is the “death
rattle.” If a person emits a “death rattle” — an exhaled breath with a
very distinct, labored sound coming from the throat — emergency
resuscitation will be necessary immediately, as it almost always is a
sign that the individual is near death.
STEP 3: SUPPORT THE PERSON’S BREATHING
Ideally, individuals who are experiencing opioid overdose should
be ventilated with 100% oxygen before naloxone is administered
so as to reduce the risk of acute lung injury. In situations
where 100% oxygen is not available, rescue breathing can be very
effective in supporting respiration. Rescue breathing involves
the following steps:
- Be sure the person's airway is clear (check that nothing inside the
person’s mouth or throat is blocking the airway).
- Place one hand on the person's chin, tilt the head back and pinch
the nose closed.
- Place your mouth over the person's mouth to make a seal and
give 2 slow breaths.
- The person's chest should rise (but not the stomach).
- Follow up with one breath every 5 seconds.
STEP 4: ADMINISTER NALOXONE (if you have access to it)
Naloxone (Narcan) should be administered to any person who
shows signs of opioid overdose, or when overdose is suspected.
Naloxone injection is approved by the FDA and has been used for
decades by emergency medical services (EMS) personnel to reverse
opioid overdose and resuscitate individuals who have overdosed
on opioids.
Naloxone can be given by intramuscular or intravenous injection
every 2 to 3 minutes. The most rapid onset of action is
achieved by intravenous administration, which is recommended
in emergency situations. The dose should be titrated to
the smallest effective dose that maintains spontaneous normal
respiratory drive.
Opioid-naive patients may be given starting doses of up to 2 mg
without concern for triggering withdrawal symptoms.
The intramuscular route of administration may be more suitable
for patients with a history of opioid dependence because it provides a
slower onset of action and a prolonged duration of effect, which may
minimize rapid onset of withdrawal symptoms.
STEP 5: MONITOR THE PERSON’S RESPONSE
All patients should be monitored for recurrence of signs and
symptoms of opioid toxicity for at least 4 hours from the last dose
of naloxone or discontinuation of the naloxone infusion. Patients who
have overdosed on long-acting opioids should have more prolonged
monitoring.
Most patients respond by returning to spontaneous breathing, with
minimal withdrawal symptoms. The response generally occurs
within 3 to 5 minutes of naloxone administration. (Rescue breathing
should continue while waiting for the naloxone to take effect.)
Naloxone will continue to work for 30 to 90 minutes, but after
that time, overdose symptoms may return. Therefore, it is
essential to get the person to an emergency department or other
source of medical care as quickly as possible, even if he or she
revives after the initial dose of naloxone and seems to feel better.
Do’s and Don’ts in Responding to Opioid Overdose
- DO support the person’s breathing by administering oxygen or performing
rescue breathing.
- DO administer naloxone.
- DO put the person in the “recovery position” on the side, if he or she is
breathing independently.
- DO stay with the person and keep him/her warm.
- DON'T slap or try to forcefully stimulate the person — it will only cause further
injury. If you are unable to wake the person by shouting, rubbing your knuckles
on the sternum (center of the chest or rib cage), or light pinching, he or she may be
unconscious.
- DON'T put the person into a cold bath or shower. This increases the risk of falling,
drowning or going into shock.
- DON'T inject the person with any substance (salt water, milk, “speed,” heroin,
etc.). The only safe and appropriate treatment is naloxone.
- DON'T try to make the person vomit drugs that he or she may have swallowed.
Choking or inhaling vomit into the lungs can cause a fatal injury.
NOTE: All naloxone products have an expiration date, so it is important to
check the expiration date and obtain replacement naloxone as needed.
(SOURCE - Arlington Opiate Outreach Initiative - http://www.arlingtonma.gov/departments/police/opiate-outreach-initiative)