Narcan – Lifesaver or Enabler for Opiate Overdose?

Narcan – Lifesaver or Enabler for Opiate Overdose?

By In First Steps, Opioid Addiction, Uncategorized
Posted March 19, 2015

Naloxone is also known by the brand name, Narcan.

What is it? How does it work? Why the controversy?

Drug overdose is a major cause of preventable death in the United States, with numbers that have tripled since 1990—primarily due to increasing rates of abuse, and misuse, of prescription painkillers. Drug overdose has surpassed even motor vehicle accidents, with over 38,000 overdose deaths in 2010 alone.

We’ve reached a national crisis.

Naloxone, the only drug of its class, has been safely used to reverse opiate overdose since 1971, but in many areas of the country it is impossible to access it outside of an ambulance or emergency room.

What Is Narcan?

Narcan is a prescription medication that is an opioid antagonist. It immediately reverses the effect of opioids, and as a result, has the ability to save lives. It is not harmful, won’t get a person high, and is simple to administer. A take-home prescription in the form of an injectable or nasal spray can be made available to both those at risk for an opioid overdose and those who may be at risk for witnessing an overdose, like friends and family members of an opioid user. First responders are also being equipped and trained to administer in some cities.

According to the American Medical Association, the use of this medication, as well as continuing to educate individuals on drug use, can help prevent unnecessary deaths.

How Does Narcan Work?

Narcan acts as an antidote to opioid drugs like heroin, morphine, hydrocodone, oxycodone, codeine, methadone, and Vicodin. When opioids are taken, they can slow and even stop an individual’s breathing, resulting in death. Narcan can be administered by first responders and bystanders who may find the user unconscious and unable to wake.

When Narcan is given, it functions by blocking opiate receptors. This prevents and reverses the harmful effects of the narcotic, restoring breathing and making the individual easier to wake up.

Is Narcan Readily Available?

According to the Overdose Prevention Act, trained individuals are allowed to possess and administer Narcan (naloxone) to a person experiencing an overdose. Physicians may also train people who can then go on to train others.

The Interim Joint Committee on Health has recommended for passage legislation to open the doors and allow all police, firefighters and emergency service personnel to carry and administer Narcan.

Is Naloxone (Narcan) Safe?

  • Narcan is not a controlled substance
  • Narcan has zero potential for abuse
  • Narcan is an inert, non-addictive, medication
  • It can be administered repeatedly without harm
  • It could meet over the counter (OTC) standards

When and How to Use Narcan

The telltale signs of overdose include shallow breathing and slow pulse. From the onset, it typically takes 30- 90 minutes for the victim to die. This provides a precious window of opportunity to save a life by calling 911, providing rescue breathing and CPR, and administering Narcon.

When using the intranasal spray, a foam tip is placed on a syringe and then placed into the nostril and administered. While this use of Narcan can be legally prescribed by approved pharmacists and physicians, it has not yet been approved by the FDA.

The most common way of administering Narcan is through injection. The drug should be injected into the muscle in the upper arm, known as the deltoid or in the outer thigh. In emergency situations, injecting through clothing is safe to do.

Once the drug is administered, it will take two to five minutes to work. If the person does not wake up during this time and breathing does not return to normal, another dose may be given after five minutes. If a bystander has given the drug, they should perform rescue breathing while waiting for the prescription to work. This will help oxygen get to the opioid user’s brain.

After Taking Narcan

After taking this medication, individuals who are addicted to opioids may experience any or all of the following withdrawal symptoms:

  • Abnormal skin sensations
  • Diarrhea
  • Fever
  • Nausea
  • Pain
  • Rigid muscles
  • Runny nose
  • Hallucinations
  • Tremors
  • Sweating
  • Difficulty sleeping

While this prescription reverses or prevents an opioid overdose, its results don’t last forever. The medication typically wears off in 30 to 90 minutes, and the user could quit breathing again if their initial opiate dose was large enough. Because of this, it is important that 911 is called and medical care is provided as soon as possible.

Possible Side Effects of Narcan

Like all medications, Narcan does have some possible side effects. A doctor should be consulted if any side effect becomes bothersome or continues to occur. Some of the most common side effects are:

  • Mood changes
  • Nausea
  • Nervousness
  • Trembling
  • Vomiting
  • Restlessness
  • Increased sweating

Immediate medical attention is required if any of the following side effects occur:

  • Severe allergic reaction
  • Changes in heart rhythm
  • Onset of chest pain
  • Headache
  • Irregular or rapid pulse
  • Dizziness
  • Fainting
  • Seizures

Narcan is a prescription medication that is FDA approved and has been used safely by hospital and emergency personnel to prevent deaths caused by opioid overdose. If you or someone you love is using opioids, this medication could save their life. Unfortunately, Narcan is not readily available to the general public. A pilot Narcan training program in Massachusetts, covered in VICE News’ documentary, proved the value of empowering members of the public to access and administer the antidote. According to figures from the Massachusetts Department of Public Health, more than 27,000 people have been enrolled in the program in that state. As of July 2014, bystanders in the state had overseen 3,131 overdose rescues with Narcan — about six times more overdose reversals than the number reported by first responders.

The Narcan Controversy

If Narcan (naloxone) is so useful, then why the controversy? What is being said and how could the opportunity to save a life come into question or be up for debate? The following are quotes from around the web, both FOR and AGAINST Narcan.

“Millions of adults already know about the dangers of heroin. They know people die from overdoses. Almost all of the people taking heroin know about the dangers, and yet they still choose to do it…Is it our job as a society to look for ways to rescue these addicts? They went down a well-traveled road, knowing the possible destination before they left on their journey. I think it would be nice to save them sometimes. But it’s also emotional blackmail. It might be best to let them go. In all likelihood they will be in the very same situation again. They are seeking oblivion. Are we rescuing them or ruining their plans?” —Dennis H, from a comment at the end of a Huffington Post article.

“Nobody dies from Narcan. They die from not getting Narcan.” – Dr. Mike Miller, Vice Speaker, Wisconsin Medical Society

“This is like treating the symptom and not the cause. Making Naloxone more available doesn’t actually reduce the number of overdoses, it only gives people the perception of a safety net, sort of a get out of jail free card for abusing opiates.” —Quote from an EMT forum

“The death of a peer or a near death experience does not teach drug users a lesson. Increased psychological distress or trauma can actually increase substance use. The actual definition of addiction (called “dependence” or “abuse” by the American Psychological Association’s DSM IV-TR) includes one important criteria that relates to this issue: Use continues despite knowledge of adverse consequences. This means that someone who is addicted by definition may not modify behaviors based on bad outcomes such as overdose.” —Quote from The Harm Reduction Coalition

Bottom line, you can’t recover if you are no longer alive. Naloxone, or Narcan, is a way to save a life, much like CPR or providing snake-bite antidote. Whether or not the individual caused the situation or has a “right to live” is certainly not ours to judge, —at least not the last time I checked.

What is your opinion on the use of Narcan to prevent and reduce overdose fatalities?

For more information on addiction and recovery for yourself or a loved one, contact the Shores Treatment Center today.

Editor’s Note: More information can be found on Shatterproof.org, an excellent resource for legislative news and addiction information. You can also follow them on Facebook here: Shatterproof Facebook.

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