Information to kick-start your safety and health SafetySwap committee meetings!

Safety topic: Opioid exposure

Opioids are a class of medications that are commonly prescribed opioids include , morphine, oxycodone prescribed by doctors to help manage acute or chronic (Percocet), hydromorphine (Dilaudid), and fentanyl. Heroin pain. They are one of the most commonly used drugs in is one example of Canada. Prescribed opioids are sometimes diverted from a non-medicinal opioid. their intended use as pain relief and are used to get high. When used incorrectly, opioids are associated with many adverse health effects, including addiction and death. How can a person be exposed to opioids? Opioids can be ingested through your mouth, inhaled Opioid use may be present in almost any workplace. through your nose or mouth, or absorbed through your A person working in or visiting your workplace could eyes or skin. be using an opioid as part of medical treatment, or for non- medical reasons.

This Safety Swap provides information on: What are the signs and symptoms of opioid overdose? • common opioids and the forms they are available in • Lips turning blue or bluish • responding to someone who may be experiencing opioid • Pinpoint pupils (that may later become large) overdose • Slowed breathing (or no breathing) • protecting yourself and others from inadvertent opioid exposure. • Drowsiness/a decreased level of consciousness • Slow heart rate and low blood pressure Note: All staff in your workplace should be trained to call 911 immediately and follow the 911 operator's What do I do if I suspect someone has instructions if they encounter a person with the signs and been exposed to opioids (e.g., person is symptoms of an opioid overdose. displaying signs and symptoms; white powder or other drug paraphernalia is Questions that could be used to present)? Am I at risk if I perform ?: spark discussion: • Survey the scene. • Call 911 for further instructions. What is an opioid? • Follow the 911 operator's instructions. Perform first aid if instructed to do so by the 911 operator. Opioids are drugs that dull a person's perception of pain. They are often prescribed by doctors for pain relief. • Do not touch your face (mouth, eyes and nose). • Wash your hands and other exposed areas with Prescribed opioid medications are available in various soap and water. Do not use as this can forms: tablets, capsules, syrups, liquids for injection, nose increase the absorption of an opioid (due to sprays, skin patches and suppositories. Some commonly the alcohol content of the hand sanitizer). see over Information to kick-start your safety and health SafetySwap committee meetings!

I work in the public. How do I protect my Top Tips: staff and clients from potential opioid 1. Make sure all staff at your workplace are aware exposures in my workplace? of the signs and symptoms of opioid exposure. • Assess the risk of opioid exposure happening in your 2. All staff should be trained to call 911 immediately if workplace. they suspect someone has been exposed to opioids. • Seek training if there is a higher risk of opioid use They should then follow the instructions or exposure in your workplace. Training in naloxone of the 911 operator. administration (an antidote that reverses the effect of opioid drugs) and overdose recognition and response is 3. Develop a safe work procedure for responding to available through some pharmacies. Visit The College of opioid incidents and train all staff in how to follow it. Pharmacists of Manitoba website to see a list of pharmacies in Manitoba that offer training. 4. Wash your hands regularly with soap and water. Avoid touching your face if you think you have been • Develop a safe work procedure for responding to opioid in contact with an opioid. incidents. • Train all staff on the safe work procedure. 5. Develop a drug and alcohol policy for your workplace All staff should be trained to call 911 immediately if they and ensure that all staff understand suspect someone has been exposed or has overdosed. and follow it. • Ensure that there are sufficient supplies in your workplace first aid kit, including gloves and a resuscitation mask. Remember to follow the instructions of the 911 operator Additional Resources when responding Resources were valid as of date of publication. to a person experiencing opioid exposure. • Ensure that you have a drug and alcohol policy for Fentanyl, Government of Manitoba, your workplace and ensure that all staff understand http://www.gov.mb.ca/fentanyl/index.html. This site also and follow it. has a list of additional Manitoba resources related to opioids.

Remember, The Workplace Safety Get the facts on the opioid crisis in Canada, and Health Regulation for Alcohol Government of Canada, canada.ca/opioids. and Drug Consumption requires: Part 2.19(1) Employers to take all reasonable steps to ensure that a worker does not work while under the influence of alcohol or a drug that impairs or could impair the worker's ability to perform work safely.

Part 2.19(2) A worker must not work while under the influence of alcohol or a drug that impairs or could impair the worker's ability to perform work safely.

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For naloxone and overdose recognition and response Sources training in Manitoba: Sources were valid as of date of publication. Naloxone, The College of Pharmacists of Manitoba, http:// Comprehensive Guide for First Aid and CPR, Canadian Red Cross, www.cphm.ca/site/naxolone?nav=public. http://www.redcross.ca/crc/documents/Comprehensive_Guide_for_ FirstAidCPR_en.pdf Additional SAFE Work Manitoba resources are available at safemanitoba.com: Fentanyl: A Briefing Guide for First Responders, U.S. Department of Justice Drug Enforcement Administration, https://www.dea.gov/ • Frequently Asked Questions - Impairment in the druginfo/Fentanyl_BriefingGuideforFirstResponders_June2017.pdf Workplace: What Employers Should Know Fentanyl: Incapacitating Agent, Centers for Disease • Sample Drug and Alcohol Policies Control and Prevention (National Institute for Occupational Safety and Health), https://www.cdc.gov/niosh/ershdb/ emergencyresponsecard_29750022.html

Share your ideas! Fentanyl: Preventing Occupational Exposure to First Responders, Share your ideas! If you would like to share your best Centers for Disease Control and Prevention (National Institute for practices with other safety and health committee leaders, Occupational Safety and Health), https://www.cdc.gov/niosh/topics/ fentanyl/risk.html we’d like to hear from you. Your idea might be featured in an upcoming issue of Safety Swap! Email us: information@ Opioid Overdose, Government of Canada, https://www.canada.ca/en/ safeworkmanitoba.ca. For more information: Visit health-canada/services/substance-abuse/prescription-drug-abuse/ safemanitoba.com or call 204-957-SAFE (7233) or toll-free opioids/overdose.html 1-855-957-SAFE (7233). Opioid Overdose, Government of Manitoba, http://www.gov.mb.ca/ fentanyl/opioid-overdose.html

11/2019