 Thank you all so much for being here. I'm Olivia Leclerc and I'm the opioid overdose rescue box program coordinator here What a title. I know I'm also an American Vista and I'm gonna be leading part of the training here tonight Before we get started I also want to thank Orca media here for being here and making this event being able to be hybrid is really awesome Thank you for everyone joining on zoom as well as in person here today Um, I also wanted to quickly bring you guys through the agenda If you didn't grab one when you grabbed it or walked in no worries So I'm gonna pass them out for anyone who didn't get them, but we're gonna do a quick pre assessment to start Then we're gonna go through an opioid overdose prevention training I'm going to take you guys through a naloxbox project Session and then we're gonna do a quick post assessment And then we're gonna have time to have an open questions and answer session ask questions voice concerns And yeah, I'm here and joined by some other professionals in the field. We're gonna go ahead and introduce themselves as well It's everyone Martina I'll let you introduce yourself and Yeah Can everybody hear me, okay? My name is job of mashed curry. First of all, thank you for coming tonight. This is great to see this many people This is important what we're talking about and to see people in the community come out wanting to learn and help This is really a great feeling. I'm an emergency medicine doctor here at central mom medical center I've worked there for about 12 years and my interest is in low barrier access to Treatment or harm reduction or whatever people want that are struggling with substance use I'm also here tonight on behalf of the central Vermont prevention coalition who works in central Vermont with people in the community So we have treatment partners. We have recovery partners. We have recovery coaches That work with us and basically what this organization does is we are there to help people with prevention so they Don't struggle with substances. So there's work that's done in school We have treatment partners that offer treatment for people that are struggling with substance use We have harm reduction specialists like Martina who will give part of the training tonight that Our goal there is to support people that use drugs to keep them as healthy as possible. Yeah And then we have recovery Centers like the turning point and we have recovery coaches like I mentioned people with lived experience who will come in the emergency Department come to the hospital go out in the community and work with people that are you know having having trouble So it's it's a really nice local organization that serves central Vermont. So We appreciate any support you can get from the community This is support coming out to talk about stuff So we have a lot of great folks that are going to give some training tonight And then we'll do some questions and answers at the end. So again, thank you for coming And then is it Martina's gonna come up next. It's like to present Martina She works in Vermont care, she'll tell you a little bit about our organization. She is our harm reduction specialist harm reduction ninja Yeah Thanks, everyone. My name is Martina Anderson. I use she day pronouns and I'm the harm reduction program manager at Vermont cares and Wow, this is unexpected. I think like we thought okay But this having this room full is really exciting having you all show up tonight To learn more about overdose prevention and then a box box project really really dear to my heart and living on pillars And this is also my community and what cares Works all over the stage But I mainly Washington County. So this is really exciting. Thank you for being here Um, I always okay Okay, awesome. Yeah, no, I got it. I got it Um, so has everybody had a chance to fill out the three questions for the pre-assessment I'll talk about a couple other things first, but this is just so Vermont cares and CBPC and the Department can assess if these trainings are useful Engaged engaged in knowledge of our communities. So thank you so much for filling those out The same questions will be asked at the end. So if you just want to hold on to your piece of paper and then Oh, thanks Um, this is for all the people on zoom, please if you can fill them out right now as well And then you will just let me know when I can Okay, so thank you I always love starting out with this quote of a dear colleague of mine whose name is Andy seaman And he used to say or he still does say this We need to shift our thinking from an us versus drugs mentality to an us versus human suffering And with this quote, I just want to take a moment to Acknowledge the trauma that substance use can bring with it, right? At Vermont cares, we truly and deeply believe that people who use drugs deserve love compassion respect Connection and care because only by fostering those and extending them will we truly be able to come together and heal on a collective Sphere And I think it's so desperately needed With that being said though, we also want to acknowledge the sometimes immensely difficult experiences that family members and friends of people who are engaged in a destructive use kind of way Experience, you know, it's it's a struggle and it's hard and it's easy for me to stand here and say love everyone You know, but I'm pretty sure that there's a huge likelihood that people in this room Know someone or maybe personally have experienced the struggles and the trauma of substances and I do want to hold space for them And you know, things might come up, right? In the training or in the question session the question and answers and I really encourage you to please take care of yourselves Do you need a break? That's okay. You can step outside But also show up today with an open heart and an open mind and to think about how each of us on an individual level can contribute to this collective thing and Super important also besides taking care of yourselves is that I really want this training to be useful to you all Right, so please make this your own stop me at any time Ask questions. Thank you Eva for monitoring the chat Um, and there's going to not going to be any stupid unnecessary or silly questions at all Um, and if anybody wants to share anything, please I want to have a space for that as well Okay, so this is a very high text slide here. Um What happens during an accidental drug poisoning or an accidental opiate overdose So what do you see right here these screwdriver kind of thing and maybe Because I'm not a doctor But these are the receptors in our brain that are responsible for breathing And in this blue little balls that you can see are the opioids when we get introduced into our system And you can see that they bind to those receptors So the more opioids bind onto these receptors. What what happens? Yeah, you stop breathing. So your body doesn't Doesn't tell you any or your brain doesn't tell your body any to keep your respiratory system going So now what happens if you introduce naloxone, so we have access to naloxone called narkin This is a nasal spray and we'll learn tonight how how we use this. It's very simple But what happens when naloxone, which is the medication? Narkin is just a brand name. There's different naloxone out on the market What happens when that gets introduced? So the narkin or the naloxone are these fuzzy lighter blue balls and they come in And they kick off the opioid off of the receptor and they take its place And then it allows your respiratory system to start breathing again It's that simple. It's not going to feel That easy or simple when you are in a room with someone or you yourself are experiencing An accidental drug poisoning of course, but this is what happens doing an opioid overdose. Yeah I saw something recently that made me think that he would maybe overgo some narkin Okay, that's not possible. Thanks for that question. Yeah Is narkin specifically for opioids or is it going to be for any kind of drug poisoning overdose? Yeah, it just works on opioids But what is happening in the In the drug supply in the state is like when we're talking about street drugs It is so adulterated that you will find Most likely an opioid in many other substances as well Which is why this is so important to talk about so even people who might not expect To have an opioid in their powder or their peel might have it So even people who might be using a stimulant There's a lot of people who like to use cocaine or crack They might also be at risk of an opioid overdose But they might not know what's going on because they're expecting a different feeling on their body So the opioid is, say, fentanyl. Would it still work? Yes, absolutely. So fentanyl is an opioid Just one of the strongest opioids out there where it is best to draw this open fentanyl has many analogs And so absolutely. So this this is where Narcan really really comes to play Um, I do want to take a quick moment and I know I don't have this on the slide here, but there is a new Drug, well, it's not in the drug at all, but it's new in our area that is cut into the drug supply That is called xyloxamine. Has anybody heard of that? And anybody want to You look animal-friendly Yeah, exactly What is it called? It's xyloxine and it's an animal tranquilizer. So it's actually not FDA approved for human use. It's also easy to get your hands on Therefore, but um, so what what happens is it's it's an it's an incredibly powerful sedative So it's not an opioid. So then Narcan doesn't work on the xyloxine. However, usually What we see is there is still an opioid in Most of the powders or the pills that are being consumed So please still use Narcan And then what's really important is to just usually what we've seen before xyloxine was cut into the drug supply Is that people come back from their their overdose, you know, and and we can tell that they're back With the xyloxine people are still sedated Even when they start breathing again, so it's really important to like ensure That the person's breathing is being restored. So rescue breathing just just compressions are really really helpful In aiding someone who is experiencing an overdose. Yeah Can you talk about talking more about how it shuts the body's respiratory system down? The opioids yeah, yeah, it's because your receptors in the brain are overfilled with the opioid and so You you are in your brain doesn't tell your body any longer to breathe And that's the first thing to happen in terms of well, you're a great segue into my next slide And then please tell me if I don't answer your question So there's a few different things that that we want to look out for When we think a person is experiencing an accidental opioid overdose So as we just learn it's messing with our receptors for breathing, right? So our breathing or the you know, whoever is experiencing the poisoning Will be abnormal so that can be different for different people Um It usually sounds pretty strange. It's can be like gargling sounds Somebody's just like really it's it's pretty labored breathing coughing it can sound pretty scary like it's it's it's Yeah, it's really scary Um, or it could already be very slow and the person is not really breathing anymore So it depends how far along they are, right? So we want to look out for that Um, I'm going to jump down here for a second So a person's skin changes a little bit for lighter skin people around lips and nail beds You might get a little bit bluish and for darker skin people It's more grayish ash and color and then also they might feel cold and claiming But then what the not the biggest because this is there's not like a contest here But an important one is that the person is unresponsive So if a person is still like crawling across the floor or they're slurring their speech, they do not need narkin We'll talk about that in just a little bit. Why not? But um, but they they are unresponsive So how can we check if someone is unresponsive? Take them for Joan to call her name Exactly, yeah, I'd be a little bit careful with like vigorous shaking But we want to inflict a little bit of pain and so we can take our knuckles We can rub in a person's sternum that doesn't feel super great But I personally like even less if somebody pinches me down here We're pretty sensitive skins. If you pinch someone really hard there, he's probably been sponsored Calling their name, you know yelling out that you're going to call 911 Anything like that. So if they don't stir, they're going to be unresponsive No ahead of ahead of things because perhaps you're going to cover this but no How do we differentiate this from something that's like a stroke or a heart attack or Dominably, I mean all the other yeah, it's tricky things that can cause It's not it's not that easy. So the good news is so I would always encourage everyone to call 911 And I also want to say that doesn't feel safe to everyone for multiple reasons, right? No lock zone is super safe So even if this person is not actually experiencing drug and drug overdose and overdose overdose If you give the person an American and they don't have an operating system nothing happens So I could spray this up and else right now. Nothing would happen. I could give this to my 10 year old Nothing would happen. So if you're not sure and I was taking a long time to get there. It's okay to shoot that And so no locks on in our hands Yes, and the locks on is the medication And narcan is this particular On the lock zone that you all can take home today if you want So this is a nasal spray. Why is it important to also know the term naloxone because who are we kidding? This is big pharma and there is other naloxone out there and there will be more out there What's also important is There is other opioid antagonist medication that will hit the market that is not naloxone So there will be other medication You know turn it down the road. So just think about opioid antagonist medication Which will do the same thing. There is naloxone in other states in other countries Um at syringe service programs. This is a place where I work where we give out an arcane We give out stale syringes. We give out safer smoke and smart supplies Um, you can also get um intravenous naloxone. We do not give that out in Vermont currently This is just the easiest the easiest form But there's a lot of people who would prefer intravenous naloxone Yes, I would like this when I take somebody and said, you know, are you okay? That means cpr Yeah, so it is really We want to encourage everyone And we know that this doesn't feel good to everyone We like to encourage everyone to offer cpr Especially between the first and the second dose so This medication takes a little bit To start working in our system So we really encourage folks to wait two to four minutes, which is easier said than done It's going to feel like a lifetime But it needs two to four minutes until you will see, you know If it's working or not, it's totally safe to give a second dose or a third dose or a fourth dose Usually the the you wouldn't need four doses It might be that the narkin wasn't stored in the right way and we'll talk about it in just a second And it might not be as potent anymore But um when first responders get to the scene they administer narkin or naloxone Sorry, the administering naloxone in 0.25 milligram And most of the time people can be revived with one milligram So this is a good dose It doesn't mean that it's bad to give someone four or eight or 12 milligrams again I'll get back to that in a little bit But please if you feel comfortable offer Rescue breathing and chest compassion between the first and the second and the second and the third dose It's very helpful because sometimes as we talked about the the breathing It's really important that a person still has minimal respiratory action or function going on And we might not be able to hear that or see that but this medication needs to get into your system with with some respiratory action And so your rescue breathing could be what the person needs in order to have this medication work Yeah, great question and rescue breathing So is that is compression more important than breathing or does it matter? I mean if you only feel comfortable offering one of them offer one of them but the combination would be best Yeah And as a reduction organization, of course, we want people to be as safe as possible So in your harm reduction bag there is a CPR Mouth shield so There is these blue little bags in the back that you guys are going to hold up just now They have two doses of Narcan A CPR rescue breathing mask, eight fentanyl test strips I feel like I'm in an airplane Are you there? Yes, exactly It's a hard one to say Eight fentanyl test strips Yeah, if anybody doesn't want to use them, please leave them They're like the good adults have used those I can't, yeah, it's not part of this particular thing, but I would love to Yeah, I would love to Yes, if we have time at the end too All right, any more questions? Is it okay to, is this the video now? Yeah, okay, great So I'm going to jump into the next slide and the video will begin to play immediately And it's going to show you how to use Narcan, but we can talk about it afterwards as well Super quick, but also it is really easy Yes, one, just initially just one Yes, so there is, if you push the plunger on the bottom, the whole dose will bring the plunger So please, please, please make sure that this Sorry, I'm going to turn the top of this Is the person's nostril before you push the plunger? Do you close the other nostril? No So the second dose, putting it in the other nostril is advised, no worries Like you, you know, it's a very stressful situation, so if you give somebody three doses in the same nostril, it's totally fine So they don't need to inhale through their nose? No, you really want to make sure that the person's head is tilted back so that, you know, your gravity is helping the medication to go with And also look that there's nothing obstructing in the nostril But yeah, just a tiny bit of respiratory infection will make the medication The nose is ideal because you have a lot of blood flow going into your nose in that position, so it really is sort of a drug Well, like Martina said though, it helps if there's some respiratory problems Get in and chest impressions get spread The nose is a great question So there's a few things that I would love for you all to know about Narcan So the effect of time, not limit, so it's about 30 to 90 minutes, which I know is a huge difference, right? But it depends, you know, like maybe body weight, did the person hydrate, you know, it's all those different things, right? Sometimes I can drink more coffee in the morning than other days before I get chittery Sometimes I can have more wine in the evening than other days, so it just depends It's very similar with this medication as well So this is also important to know because in the past, we've heard a lot of the times that there is a huge risk of people re-overdosing So you might revive someone, but then you could potentially, after a little bit, go back into another overdose Sadly, I mean, I don't know, so I don't know Fentanyl is so highly prevalent in our drug supply and even people who are trying to get hair in can't because Fentanyl is usually what's on the street And that is so much shorter of, what is it called? It's so much faster acting Yeah, so after 15 minutes, usually Fentanyl is already out of it, but this is where people, you know, there's so much more risk of an overdose in the first place because people need to use more often because it's just shorter acting Yes, thank you So still I want to say like be mindful, it's always good to stay with the person best to have them at the hospital, of course, where they can be monitored, but we've heard so much less re-overdosing happening because of the fentanyl We already talked that it only works in opioids, but I also already told you that fentanyl isn't everything, I really try not to be a fear education person, but it's real, right? I also want everybody to have the information they have I have a 10 and a 13 year old, some might think they're pretty young to talk about this, but we talk about this every single day, and you know, I train in colleges and everywhere and I do have to say it does scare me a little bit to also see fentanyl be in a lot of press pills that younger people might take, like Adderall If you were studying for a test or if you're driving on a road trip or whatever, people might take an Adderall Recently we had two overdoses in a college because they thought they took an Adderall So I'm again not saying this because I want to scare people, but I want to say this because it is a reality I do want to debunk something for a second, we've also heard, you know, that maybe you've read the stories about cannabis laced, I mean, so I fentanyl laced cannabis And all those new stories from down south were debunked, but that doesn't mean that there wasn't fentanyl in the cannabis product most likely We think that can happen because people who might sell cannabis might also sell other stuff and maybe they didn't clean their scale between packaging different substances And we know that fentanyl is so potent that even like the tiniest little bit is going to show up However, the maybe goodness in all of this is that we smoke cannabis very differently than fentanyl gets smoked, for example Most cannabis will be smoked or cooked And that would actually kill off the fentanyl because fentanyl is a vapor so you heat it underneath the pipe, for example, whereas you light the cannabis to smoke it So there is so much less risk of fentanyl overdose by smoking fentanyl even if it's pure fentanyl it's the harm reduction approach actually way less overdoses can usually happen by smoking it and injecting it Injection is always going to be the most intense smoke So if people have cannabis that might be based with just like residue of fentanyl and you're lighted with a lighter, there's almost zero risk of an overdose So I just want to say that There is or there isn't There's almost zero, I mean I don't ever want to like not using drugs, there's always inherent risk But it's the direct heat that kills it all versus like the vapor as we go cooking it So Narcan is temperature sensitive, but the goodness is and we printed those out to They've done extensive testing so we noticed, you know, we knew this with COVID tests too right like the longer we have things the more testing can happen so now we know that COVID testing So this is the same thing that happened with Narcan so when it first came out people are like a little bit more timid about you know what are all the the guidelines around it I learned this the hard way second day on that first day on the job I had like my entire car filled with Narcan completely forgot about it because I never had Narcan in my car before Left it went to bed and it froze that night So I was like oh my god I'm gonna get fired I researched I called it multiple health departments really confessed to my loss And actually freezing Narcan does not change the molecule structure so if it's frozen in here it's not going to come out right But if it thaws again and the container is still intact the molecule structure hasn't changed so it should still be as potent as it was prior Now if this happens 25 to 50 times it's gonna be a little bit of a different story Getting too hot is more of an issue We live in Vermont so that's not that big of an issue here but please don't leave it in your car because that's a sauna where things can really bake so even if you only have a one week of 90 degrees in this state It's still like in a car it will get too hot for too long and then the only thing that happens is it's not as potent anymore right So still use it if it's the only thing you have you cannot harm someone but this is then the story where you might need two or three or four We have a lot of people who are more transient you know who might live in your car and so we've definitely seen that it's a lot more Narcan had needed to be used and then we asked these questions as if oh it's because it got too hot It does have an expiration date you will see this on the back here all of the doses that I brought today are good till May 2025 Again if it's expired please still use it it is just not as potent and we already mentioned that it's always best to call 9-1-1 Yes Great I just wanted to add All this culture and this practitioner I've been working in addiction medicine for four years I think it's really important to add that Sylasin is added to fat more because of the short duration of fat more than Sylasin The premise behind it will extend your high The unfortunate thing about that is and we're seeing now certainly people are often needing four to five doses of Narcan This is becoming commonplace now So in the old days it was give Narcan and you know maybe in two or three minutes someone will wake up Now we're telling everybody give Narcan call 9-1-1 Don't wait the two or three or four minutes you need to see this reaction just call 9-1-1-1 In general I think always you want to call 9-1-1-1 if you feel safe Yeah Yeah thank you absolutely I would definitely say give the Narcan before you call 9-1-1 But always like even before the Sylasin but we do recognize that not everybody feels safe to do that you know because of histories and systems But absolutely but then also still continue to give give Narcan until first responders arrive Thank you Could you tell me how many doses are in each container? Two Two doses per Yeah feel free to take more bags One dose per Oh per container Yes Sorry I meant in the blue bag No no no this is one dose That's just one dose If you need more than what we have here today I'll give you my phone number How many more Yes please no I recently read maybe two weeks ago a state health department rate that says that probably 30 to 50% of the chemical supply in Vermont is now Yes Sylasin So this is not kind of like 5% or a rare thing Yeah it's higher Yeah In Philadelphia and we're seeing I mean it's off topic but there's some really grizzly wounds that are associated we're starting to see those in the two clinics that I'm working with So are you starting to see what's going on? We will sort of Again it's off topic but this is how we know but because we can't test for it Now there's no during the show There will be soon hopefully yeah they're working on that and we're working really hard on getting a drug testing machine on site We can send it into a lab currently and you can test it like that which is important But I love yeah can I just hand it over to me? This is usually like an hour and a half so we really had to shorten there usually is a Sylasin portion in here that I have only cut out But I love how it's coming up So I just want to say if you google Sylasin wounds to see what it is it's a lot to take in They're horrific, they happen very quickly They don't just happen at an injection site and they also happen for people who are maybe only smoking or ingesting Sylasin in different ways than injecting So it is not it's not it's not just an injection And Sylasin as you said Yeah it's the animal tranquilizer and the reality is that people are I mean I had one person who was out for over a day Yeah It's definitely multiple hours usually Okay this is my last slide I think I'm sorry I don't know what I'm talking about So I just want to talk about these all at once so just throw them all up here But so the biggest thing and this is real is if you give a person an arcane you will put them into an immediate draw This is why earlier I said if somebody is not unresponsive please do not give them an arcane yet because people will not be you know it's just not the compassionate thing to do So if a person experiences withdrawal they don't feel great right it's a wrecking ball has gone to their head like the worst flu possible they're feeling terrible So they I have never I mean you know I am not saying that I don't believe this but but it really depends on the setting so if you're compassionate if you're quiet if you're not asking questions if you offer somebody a glass of water You there is not any reason for the person to become bad right if somebody is handcuffed and somebody yelling at them what they did and they've been scared, then you might not say thank you so much for saving my life right so I think it really depends how how we set the stage and if we set it in a therapeutic way people can come back to a more compassionate place People will be really confused they're missing what just happened right and so then there's like the denial and the disorientation and is coming in here too and I you know I a lot of the times when I do these trainings I hear well of course you're not going to admit it because it is there something you should not done and my first response is well who cares It doesn't really matter I don't need anybody to tell me you know I don't know my business, but also the reality is that there is a lot of people who really don't know what just happened we have a dad and a daughter who are close to our organization the daughter used opioids the dad knew and they had a good enough relationship where she was able to be honest with him was heartbreaking for the dad you know the dad had administered larkin to his daughter five times and the daughter was always pissed because she knew that he knew that she would put into needed withdrawal and she always thought that he was trying to teach her lesson until one day he videotaped her going out again and then not right after but you know days later showed her the video and she was in tears she had no idea that her dad saved her life five times per person people really don't know what happened at first we again we don't need to pry and it's none of my business and people know or not but I I do really want to say there's a lot of folks who don't know what just happened it's a traumatic experience and we don't need to you know blame or shame someone in that moment so the best thing would be to just sit with them probably until number one gets there and yes engage a kind of yeah common conversation yeah yeah I'm so glad you're still here this must be really scary and you know we do lose my gosh control of our bodily functions right so somebody might have you know peep themselves or something like it really embarrassed depending on who is all in the room by the lot of the times there's people who experienced drug poisoning there's 20 different people sitting in the room that were not there prior and it's a lot it's a lot alright Olivia is up nice to add something yes I see a lot of people leaving notes it's amazing I also want to just let you know that it's really nice little pamphlets from the health department that outline kind of what we talked about tonight so if you're worried that you missed something don't worry you can just take a look at this and it has all of this stuff on it for you yeah thank you all for all your amazing questions this is really great now that you've learned a little bit about Narcan we're going to shift gears a little bit and talk a little bit about the naloxbox project which is the second half of tonight I wanted to start off with just this graph this is a graph that depicts the opioid related deaths over the past 10 years in the state of Vermont so this is statewide to reiterate but over the past 10 years you can tell that the increase has been pretty drastic in 2019 there was a little bit of a dip and then it jumped back in 2020 due to the pandemic and then in 2021 there was 217 opioid related deaths and we don't know the data yet for 2022 but it is projected to be higher so sometimes it's helpful to visualize things like this in a graph and we wanted to start off with just showing this I think I just skipped a slide a bit so as you've learned Narcan is a really safe and effective way to reverse and overdose and save a life and so we wanted to have a moment to see where we can get Narcan and these are locations that you should be able to get Narcan for personal use as Matina mentioned we also have it tonight here for you all if you'd like to take with you and then I did want to acknowledge that while these are places for that you can get Narcan for personal use there's also businesses and organizations that might have Narcan such as like a school nurses office but as far as personal use there's really not a community system in place to access Narcan like there is for an AED for example for a heart attack I also wanted to acknowledge that as you see it's a little blocked off but for the pharmacy section down here that is an option for people to get Narcan there's a standing order in place in the state of Vermont which we have a copy of in the back and the standing order essentially means if you don't have a prescription for Narcan it acts as your prescription so you can go into a pharmacy you should be able to have be able to get Narcan but we want to which correct me if back here if I'm wrong but we want to acknowledge that you might be met with not maybe the most welcoming experience you also might have a great experience. We also want to probably recommend calling in advance, seeing if they have Narcan available, maybe going with a copy of the standing order which we have back there and oh and also there's there there might be a copay is correct so I say this all to say that there's other options obviously to on the screen to get it but if an pharmacy is where you decide to go there is it's not always the simplest process but it also might be so it really just depends but we did want to acknowledge that so the locks next project. This is a little overview that I wanted to talk to you all about and essentially in 2020. There were 31% of the overdoses that happened in the state of Vermont happened outside of the home and so and because of that we decided that we wanted to address this issue and a work group formed. The work group includes partners including the very fire department very police department Vermont cares. essential Vermont Medical Center EMS Department of Health and others and we learned about no locks boxes. They are also happening in other places throughout the country and we thought that this would be a great initiative to bring here. But we also wanted to contact the community and gauge community interest so because of that in the fall of 2022. We conducted a survey. And these surveys ask questions to gauge community ready readiness gauge people's questions maybe regarding our can and the survey results helped us plan and set goals and one of the big feedbacks we got from the survey was a want for more education regarding our can which is how these trainings came to fruition we have three one was last week in Waterbury here tonight I'm not clear we have one on April 11th also in or I'm sorry it was Waterbury last week and then we have one April 11th coming up in Barry. And then the goal essentially is to have some pilot locations and then broader installation in central Vermont of these locks boxes. I actually do. I can yeah I'll put those out. Yeah. Um, so we also did that survey and we got some key points that I just wanted to touch upon here tonight. We had 248 people take the survey and people who took the survey were from Barry Montpelier, Waterbury matter valley. East Montpelier, Plainfield and Marshfield so we had a variety of locations where we got responses from 70% people agree that having our can available and public places would help their community which was very exciting statistic. 73 responses said that they didn't know where to access our can in their community. 63% said they did they did not know how to administer in our can in the event of an overdose. And then 53% said they did they also did not know the science and symptoms of an opioid overdose. That was the survey that we put out in the fall of 2021. We put it out on some social media platforms we threw our coalition with our partners and. And those are just some key points that we want to touch upon and are also why we're here tonight. So no locks boxes, we have one right here and everyone can take a look at it after they contain a Narcan and one package of Narcan as you saw and then a rescue breathing kit. They resemble an ad box or other first respond kits and they provide quick and easy access to Narcan in the event of an overdose. We put it, this picture kind of depicts a way that it could be displayed which is right next to an ad and kind of shows that they're both for emergency situations they're both similar. This pack has one package of Narcan but we I think Eva has mentioned she has seen one filled with Narcan so there can be more than one in there as well. We have so many transients we have so many homeless folks we have people I mean it would just be so great to have so easily accessible. So we're going to anticipate having these sorts of fits installed. Yeah, so we are this is our first time bringing them to central Vermont so we're starting with some of our partners and their organizations I'm thinking. We were saying that. They work for it, but I imagine them in a grocery store. This might be also a little bit of like, do we have any kind of system of places that visits people that are on the street and a lot of that in the middle of the streets were distributed so that almost have it on there. Do you have an outreach worker who is in Washington County every Wednesday and goes through the streets and works with them away. And I'm sure there's other. This is also here. And really that sort of take home tonight it's we want as much. You know, if everyone carries in their purse in their backpack, even if you're afraid to give it there will be so many. The more it's out in the hand that you know, you guys are killing members that are around is what we're shooting for and then you know, we want to get to an old white box just like you see them being. They do the same thing. It's a life saving device. It has to be a lot simpler than anything, but it's really important but the more nor can that is out available. Better off, we're going to be using Wilson. I'm homeless by Terry is my first. I've given out 15, you know, we get that one of the more jobs. They are, they are, they are asked for. So they know how to use it they don't know how to use it. And they are using it. They're asking for. That's great. They want to take care of each other. Thank you for sharing. So, I was going to learn that I cannot keep it in my car because it won't store that is the criminal place for me to have it. And I'm not able to have a safe medication so I really like that. I think I almost needed to work the other day someone was turned purple. And, and, yeah, I didn't have it. I doubt anybody else even do. So, yeah, it's cool. Yeah. Thank you for sharing. This is one of my last slides and we have more time for questions as well but I just wanted to touch on how there are no locks boxes throughout the country and they actually are available in some other spots in Vermont, including White River Junction and aviation facility in Vermont, but this project would be the first time bringing it to central Vermont and it's empowering to hear that everyone seems to at least in this room feel really excited about that so I also wanted to just say that, I'm beginning to treat opioid overdose like any other bystander emergency is what it really does reduce the stigma and save people's lives so it's really great to hear that these are going to be able to be around more. This just brings me into the end of the slides, but if you all have that post assessment, that's just staple to the pre assessment that you did in the beginning of the night. If anyone needs a pen, let me just raise your hand and look at you and take a couple minutes and people on zoom they'll be a poll that will just launch for you to take it as well. Is Mark Levine still our commissioner? Yeah, yes. Is there a limit to how many Narcan? No, you can't overdose on Narcan. There's no limit. Eva whenever does it look like the zoom all set okay. And so now we will just transition. And to, I mean, it looks like we have a little bit of time left to the questions and answers portion of the night. Yeah, of course, yes. But I know job is here to answer questions and I'm here to answer questions. Um, it's not right now, but that is an idea that we I mean, we would like to have a potentially. Do you want to put the. Oh yeah. Mine is just my first name Latina at v2cares.org. Also, if you go online for my department, there's an outfall on your right heading. You click on that there's videos on our administration. And all in all those statistics that you saw about. I mean, it's really good information and real practical. I mean, it'll, it'll reiterate everything that you heard tonight. So I'm thinking about my next her neighbor, the guy last year. We have you. We need to be relaxed. But what could we have done. I mean, it looks like we think that we have a marker about people like on the street and more public ways. But there are a lot of people inside their house. So I just bring in like, if we had no camera, but how could we even have no. It was happening when it was. Yeah, one of the. Reduction. Not to use a lot. Not to use a lot. And there are, but they're, but they're, you know, again, the point is, there was someone in the house. That had. You know, right. And there's, there's even, there's even an organization. Yeah. I think that, you know, a lot of people don't feel they can share with other people because of the stigma. And then the stigma really is internalized. So, you know, I think it's really important to be individual. Reach out and serve care, you know, all of that. So there's like, we have a big. Something really large that individual, you know, can just. But I think the offering. Information. Education. Yes, I've been having my kid at home. What's happening, what's happening, but then also letting people know about our organization. So we do drop off. People don't have to walk into our office because it takes a lot, you know, to do that. We don't call this, but like, we, we meet people where everything would have been that we don't have to. Offer our reaction tools. And then, and I've never used it. Also, it's a national hotline, but there is a local one to that I volunteer for the state on the phone with the person. You know, the. Yeah, if we had all, if we all had a better relationship with that person, I think we could have just said to them. I know you're struggling. Yeah, I just want you to know that I have a house. We'll give you some or also pizza at home. We need it to like the importance of relationships and your neighbor. Right. Like, we really have to make friends with people, which, you know, will also help them. possibly as well, but yeah, I didn't feel like we all know, but we didn't feel like we could say, Hey, I've got this. Okay. Sometimes it's not. And the father found him in the morning. So he went to bed. And then, you know, nobody was not preventable because he, he passed in his sleep. And so we even if there have been dark enough, there's just some death or just not preventable. You know, we can do the best we can, you know. So how do you approach people without like, without having that thing might fall when I spoke to the guy that almost overdosed, he got really, really ugly. So, yeah, what are some good techniques even for each. When I, when I'm doing my outreach, I, the ones that I know are using. I just have to say, hey, I have not came if you didn't get the word out from I have it. People come to me and say, hey, you know, if you've got some. Just have as we mentioned, I have not can they can just just make it normal to people that it's out there that you have it and you attend to that. It doesn't have to be attached to any kind of conversation or just availability. Yeah. If I hear this one at the workplace, right. So we are invited into lots of places that we get over those trees, you know, to leadership but then also something to staff and to make sure and I think that shows people like, wait a second, I don't know about this here, you know, so that, and I understand that not every organization will be open to that, but it has been really helpful for many organizations we work with to just like have it be like a steamer free workplace. To those cost money. No. Cool. Yeah, you get the training as much as you want. Another thing I want to add about the never use alone for people that have a smart phone. There's an app called the brave app that you can, you know, you're about to use alone. You can call and just get someone to the app to stay on with you and they're working on so I had the pleasure to meet the people behind brave at the harm reduction conference and they're working. I think they might actually have it out but it's this little device that can be in public restrooms. That if there is no motion detected for what I thought about it immediately calls my mom. Yeah, or like people can have it. Right. Yeah, yeah. She was saying that that's helpful for any sort of medical. Yeah, yeah. I would just say that I think that's very normal response. You know, because the person can feel caught. And so it's very common. I think just saying, you know, okay. I just care about you. I think that person. I think nine out of 10 people will go home and really think about that. And realize, wow, there's somebody who worked with notice. And who knows. Now a year from now. Yeah. Exactly. Yeah. Yeah. There's so much shame. I think it's so important that people can just automatically get defensive. Just because it's so engraved in our culture. But it's a shameful thing as opposed to brain disease. And you know, I think once people can sort of, we can get rid of the stigma. And people can let that compassion in your future and things around. People often can't let that in. Absolutely. Yeah. So. Now just a comment, but keep up the work you do. I think it's, you're so good at what you do. And it's so important. Thank you so much. That's great. Any more questions. It's time. Yeah. The places where the. The off zone is available. Would you also show us. On another one somewhere. Maybe they're out street addresses. Because the phone numbers don't really tell me where they are. Yeah. Yeah. That's a great point. Actually, that's great. Yeah, we do have. Let's see. Yeah. Yeah. And also feel free to reach out again to. And we can get out of there. Yeah. Just repost it. Yeah. I asked if anyone wanted to join me and I reposted it. And. Yeah. Yeah, I had. She joined us with this. I think all of my friends. Yeah. It's just like, if we could possibly. By the way. Yeah. I have. To me. That's always easy. But my kid goes to Harvard and I can't. I mean. Yeah. Yeah. So thank you for being here. I would love to. Yeah. Yeah. Yeah. Yeah. So it was. M a R T I N a at the T. C. A R E S. Also right. And you know, could we help to like get these programs into our schools? Was that me like talking to school nurses or. Yeah. Yeah. I want them to be as educated as possible. If you get older. Yeah. I'm a mom. School mom and a nurse and I work with these folks in the coalition. And I've, in my experience in the community as a parent, it is the gold that the parents are saying we want this. You know, I think that's a good thing. I think that's a good thing. Can be. Conservative and fearful. Yeah. That it's too much or that if we talk about it, it's going to influence kids to do it. But it's already happening in some families with their parents or their foster parents or their older, you know, siblings. Or maybe the students too. Exactly. Yes. Yeah. Other kids that need to know how to use the start. In case. A little bit. Do you have a question back there? I'm just going to add. It might be worth mentioning too. In terms of preventing death. Yeah. So we started that actually. Yeah. So again, what it wouldn't allow is people are. Try to live itself. Specifically in a community where. Wanted. It started on medication. You can provide that, but more importantly, we can provide people with lived experience to talk to people about what they're going through. And then we. Most importantly, link them then to a treatment provider in our community. So it's got started back. And I remember we had all people couldn't get into housing, get treatment right back. So when they were waiting list. We decided, you know, we have a lot of people there. We trained that. So we started it. And then the prayer always started this sort of copy. And it's a very successful way because it's easy access. And that's sort of our interest is to make it, you know, decrease the barriers for people to get into treatment. You can always walk in their rooms. That's kind of what it's there for. So why not use it for that? We've done some work this year on alcohol as well. We're offering similar services. Because we believe that, you know, any door should be there. And if you're not interested in treatment, you're just either being safe with whatever substance to use or whether it's alcohol. We offer advice about that. And again, it's a really nice service. And I think it's good. Yeah, I think when they want to point out is real, all you thanks for coming in there. The more we have meetings like this and talking about these things in our community, that's only stigma is going to get. We read this phrase. Congratulations. Sharon. It's great. With that. So. I also want to quickly note that we have lock boxes in the back. And they're made for. If there's somebody in a household using. If there's any medications in the household, even if it's. And bill. And you don't have to worry about that. So I think it's really important that you have the same, you know, I think that's the right way to go. even if it's Advil, and you don't want it to get in the wrong hands. It's a lockable box, there's a key, and it can make your household or any location a little safer. A lot of people are using pandas now. We have so many of these. We only have some here tonight, but they make them and we can always get more. No, they're free. Thank you. Thank you so much.