Thousands of opioid users are saved from overdose each year thanks to the reversing effects of Narcan (naloxone). What is this miracle drug and how does it work?
Have you ever seen someone overdosing on heroin?
It is a terrifying sight, like something out of your worst nightmare. If someone smokes, snorts, or injects too much heroin, their breathing slows or stops entirely, decreasing or cutting off the supply of oxygen to the brain. When someone is overdosing, they are usually nonresponsive or passed out entirely. Without immediate medical intervention, their risk of sudden death is incredibly high.
15,446 people died of heroin overdoses in 2016 alone according to data collected by the Centers for Disease Control and Prevention. An additional 20,145 died from a synthetic opioid (prescription painkiller) overdose.
However, overdoses can be reversed with a proper dose of naloxone, a life-saving antidote to opiates and opioids. Naloxone blocks the effects of heroin and prescription painkillers, allowing the user to breathe again and introducing oxygen back into the brain.
The Overwhelming Effects of Opioids
Opioids are a type of drug derived from morphine, a substance that comes from the pods of an opium poppy plant. They include both heroin and prescription painkillers, or synthetic opioids. Synthetic opioids include:
Opioids react with the opioid receptors in the brain, helping relieve pain and providing a sense of euphoria. Use often starts with a prescription for painkillers from a doctor to relieve discomfort following a surgery or other type of medical procedure.
A seemingly innocent prescription can quickly lead to dependence and possibly to addiction. Once the refills run out or they become too expensive to afford, some painkiller addicts turn to heroin for a cheaper alternative.
Taking too many opioids and blocking all the opioid receptors in the brain leads to an overdose.
What is Narcan and How Does It Work?
Narcan is the brand name for the opiate antidote Naloxone. When someone is overdosing on heroin or painkillers such as morphine, oxycodone, codeine, or Vicodin, someone can inject a dose of Narcan to block the effects of these drugs by removing opioids from the opioid receptors. This reverses the effects of the overdose, helps the user to start breathing again, and brings the individual back to consciousness.
It should be administered as soon as possible following the overdose. You want to get the individual breathing as soon as possible. Cutting off the oxygen supply to the brain for even short periods of time can cause brain damage. The use of Naloxone allows time for emergency personnel to arrive and provide immediate medical assistance.
Is Evzio the Same Thing?
Ezvio is another brand name type of Naloxone medication. It comes pre-packaged in a box similar to an Epi Pen. It is an auto-injector that administers a single intramuscular dose of Naloxone, simplifying the process for family members and others who are uncomfortable with needles.
It is the first auto-injector of its kind made available outside of a medical or other health care setting. As medications like Evzio continue to be released, the medical field simplifies the process of saving overdosing addicts one at a time.
How Do You Administer Naloxone?
Naloxone medications come in two different forms: injections and nasal spray. The injection is administered as an intramuscular (IM) injection, into a muscle in either the upper arm, thigh, or buttocks. Nasal spray is delivered through the nose.
The intramuscular injection form is more commonly carried due to its immediate delivery and effectiveness. Nasal spray is still used but not seen as commonly as the intramuscular injections. Larger cities tend to utilize the nasal spray due to its lower cost; it makes it easier for emergency medical technicians (EMTs) to stock an appropriate amount.
Can It Only Be Administered by Medical Professionals?
Many people think you have to be a doctor, nurse, or EMT in order to save an overdosing person with the help of Narcan. However, the American Medical Association encourages doctors to prescribe Narcan to patients at risk of an overdose. Every addict and most addicts’ family members know what to look for when someone overdoses and can be trained to provide a dose of Narcan.
By making Naloxone available to at-risk addicts, doctors have a better chance of saving lives by proxy. Any adult can administer a dose of the antidote with even limited training. If an addict has a prescription for Narcan on hand, their chances of surviving an overdose until medical help arrives increase substantially.
How Long Does It Take to Take Effect?
Once it has been administered either intramuscularly or nasally, Narcan takes about 5 minutes to take effect. If the person overdosing does not respond to the medication, additional dosages can be administered until they begin to breathe again.
The opiate-blocking effects of Narcan last mainly for about 30 minutes and its effects last for roughly 90 minutes. Individuals who take longer-acting opioids like methadone may need an additional dose to hold them over until paramedics arrive onsite.
This also means that after the medication has left someone’s system, they are able to get high again. How long after Narcan does it take to get high? Roughly 90 minutes to two hours. This is why it is so important for someone who receives life-saving treatment with Narcan to immediately seek help both for their physical health but also for their addictive behaviors.
What Dosages Should Be Administered?
The initial intramuscular dose of Narcan that should be administered for an overdosing adult is 0.4 mg to 2 mg. If there is no response to the initial dose, you should supply additional doses in 2 to 3-minute intervals until the person responds. If they are still nonresponsive after administering a total of 10 mg, there is a chance of opioid-induced toxicity that should be treated immediately by medical professionals.
Evzio simplifies the process of administering Naloxone because it delivers a single shot of the medication at a time. Administer one shot of Evzio at a time, in similar 2 to 3-minute intervals until the individual responds.
Dosages for nasal spray are even easier: administer one spray into one nostril and wait to see if the effects take hold. If there is no response from the individual, continue to administer in 2 to 3-minute intervals until they begin breathing again or until medical help arrives.
Can You Overdose on Naloxone?
Naloxone only has an effect on those who take opioids. The medication poses no danger to those who do not take opioids. There is no way for someone to overdose on Narcan; it is not a narcotic. Again, it functions as an opioid blocker and does not provide any sort of euphoric high.
The only minor threat it poses is for those who use opiates but are not overdosing. When a shot or spray of Narcan is administered to someone who isn’t overdosing but actively uses opioids, they will go into immediate withdrawal symptoms.
Is Naloxone Effective for Long-Term Addiction Treatment?
Naloxone should not be used as a long-term treatment for addiction. Since it is used only to reverse overdoses, it is not a medication used to treat addiction. However, it can be used as a way to kickstart someone’s transition into recovery. Surviving an overdose can be the wake-up call that jumpstarts an addict into taking action.
There are other medications that should be used instead for long-term treatment. If they attend an addiction treatment facility, they will receive a treatment plan created to help them manage early recovery and work their way into long-term sobriety.
What is the Effectiveness of This Life-Saving Drug?
Data collected from emergency medical services in Massachusetts looked at over 12,000 Naloxone doses administered between July 2013 and December 2015. The research revealed that 93.5 percent of people who received the medication lived through their overdose. This shows its effectiveness as a way to keep addicts from overdosing.
There is still a surprising 84.3 percent of people still alive a year after being revived from their overdose. However, its immediate effects do not necessarily imply long-lasting benefits. In another study, roughly 35 percent of those who received treatment with Naloxone were dead within a year due to another opioid overdose.
Naloxone does its job well but needs to be followed up immediately with a course of action to handle the addict’s problem as a whole. Without instant intervention from addiction treatment, a 12-step program, or some other alternative, they are likely to return to their old habits. An overdose isn’t always the jolt that an addict needs to make them realize what they are doing.
Naloxone vs. Naltrexone
Naloxone and Naltrexone may be confused by some due to their similar names, but they are completely different medications. Naloxone is used to treat addicts in an active overdose while Naltrexone is used for long-term addiction recovery treatment.
Naltrexone (brand name Vivitrol) is also offered as an injected shot but administered on a monthly basis. It is an opioid antagonist, meaning it attaches to opioid receptors in the brain similar to the way that opiates do. The difference is that it doesn’t provide a high in the way that other drugs do. Instead, it reduces cravings for and blocks the effects of opiates which leads to a lower chance of relapse.
Its use isn’t introduced until the addict is completely detoxified from all drugs. Unless they are entirely clean, Vivitrol and other Naltrexone medications can lead to serious complications.
How Should You Follow Up After Being Saved with Naloxone?
Again, Naloxone is not a medication for long-term use. It does not reduce cravings or block effects of opiates for an extended period of time. Its sole purpose is to block the effects of opiates during an overdose for long enough to allow medical professionals to intervene and take over. As Dr. Scott Weiner, an emergency physician at Brigham and Women’s Hospital in Massachusetts, says, “It doesn’t treat the underlying problem.”
And he is right. After being saved from an overdose, an addict should immediately follow up their release from the hospital with a plan of action. Most addicts who reach the point of an overdose need some type of intervention in order to halt their behavior. Without something to interrupt their habit, they will continue getting high.
Addiction Treatment for Opioid Addicts
Addiction treatment can provide the necessary interruption in day-to-day life to help an addict stop using. Treatment provides addicts with an environment where they are surrounded by people with the same goal of getting clean. They learn more about their addiction, what fuels it, and how to put a stop to it. There are a number of options for addiction treatment depending on a number of factors.
Detox is often the first stop for those with serious drug addiction problems. When an addict suddenly stops using drugs after using for months or years, they will experience withdrawal symptoms. They can be as minor as chills and aches or as severe as seizures and heart problems.
Medical detox provides a safe environment to clear an addict’s system of the drugs they were using. Usually detox includes medication assisted treatment where the intensity of withdrawal symptoms are lessened with the help of various medications.
Inpatient addiction rehabilitation combines intensive day treatment with a residential program at night. During the day, clients attend individual and group therapy sessions led by counselors and other treatment staff. Often, they work directly with a case manager who guides them through their stay in treatment and helps to set up an aftercare program.
Inpatient rehab is helpful for addicts that need to be removed from their living environment in order to get sober. A change of environment can be helpful in keeping addicts away from their “stomping grounds” in order to develop a healthy, solid groundwork for their recovery before returning home.
Intensive Outpatient Program
Intensive outpatient programs (IOP) offer the same type of intensive treatment but on an outpatient basis. Clients are not required to stay overnight but still work with counselors to dig into the causes of their addictive behaviors. IOP usually takes place for a few hours a day, which provides a treatment option for those who work or go to school full-time.
Keeping Clean with Naloxone
Naloxone gives thousands of addicts a chance at a new way of life each year. As long as the addict follows up their life-saving treatment with further action to stay sober, they have a chance at long-term recovery.