Narcan is the brand name for naloxone, a drug used to reverse the effects of an opioid overdose. As the opioid epidemic continues to expand at an alarming rate, the demand for this drug also increases. Narcan is an opioid antagonist, which binds to the opioid receptors in the brain to reverse and block the effects of other opioids.
Narcan quickly restores normal breathing and respiration to an individual whose breathing has drastically slowed or stopped altogether.
This drug has reversed roughly 30,000 overdoses within the last few years, but is it truly relieving the burdens of the opioid epidemic?
WHO SHOULD HAVE NARCAN?
Narcan should be used for anyone who is at high risk of encountering an opioid-related overdose. In some states, all police and paramedics are required to obtain Narcan at all times. However, is not only available to paramedics, police, or medical professionals. Narcan is available, in 46 states, over-the-counter at pharmacies for anyone to obtain. It is also available at safe injection or harm-reduction sites.
Every package of Narcan has instructions making it easier for those needing it to use it in times of emergency. While the open availability of Narcan has been effective, with the growing overdose numbers caused by synthetic opioids, it’s not enough.
NARCAN EDUCATION FOR PRISON INMATES
Since opioid use and overdose is becoming more widespread than ever, a correction facility in Lake County, Ill. is trying something different. A program funded by a federal grant aims to educate inmates on the importance of harm-reduction by targeting the use of Narcan. The idea of this program is to reduce the number of opioid-related deaths in inmates as well as their affiliates.
The Daily Herald’s article on the subject captured all aspects of addiction and Lake County’s efforts to slow down the opioid epidemic. The article quotes sheriffs and directors supporting the program saying, “Research determined that former inmates are at high risk for death from drug overdose, especially in the immediate post-release period.” Health Department Executive Director Mark Pfister said, “A person’s drug tolerance can diminish during their time in jail, so the risk of overdose is higher.”
How to Administer Narcan
Narcan comes in multiple forms: an injectable form and a nasal spray. Both forms of the antidote have proven to be effective. They also contain two doses within their individual packaging in case the first dose is ineffective. Sometimes, one or two doses of Narcan are not enough, requiring additional medical attention and possibly a larger amount of the reversing agent.
People who are given Narcan should be under observation for a couple hours after receiving a dose. There have been events where breathing continues to get progressively shallower despite having received Narcan. These cases typically occur in individuals with a low tolerance to opioids or in individuals who take opioids in extremely high quantities.
If an individual is experiencing an overdose and you need to administer Narcan, here are a few steps you must follow:
- Put the person in a position which opens their airway
- Perform CPR or give a few mouth-to-mouth breaths
- Call an ambulance immediately
- If Narcan is at the site of the overdose, give the intramuscular dose in the thigh. If the nasal spray is the only form of the drug available, follow the directions in the packaging.
- After dosing the individual, continue rescue breathing until paramedics arrive or the person wakes up.
AFTER NARCAN SETS IN
Opioid overdose looks more painful than it feels. There are no studies suggesting that Narcan has negative side effects. However, there are cases where an individual being revived from an opioid overdose reacts negatively to the process.
The person will wake to feel the complete opposite of the bliss felt prior to falling out. Narcan completely detaches any opioids from the mu-opioid receptors in the brain, leading to dope-sickness and an inability to get high or well. It blocks any access of opioids to the brain for roughly 24 hours after receiving a dose.
WHY DOES THE CRISIS CONTINUE TO GROW?
The opioid epidemic is growing despite the numerous attempts to keep the overdose numbers at bay. In the late 1990s, the rapid use of opioid prescription and non-prescription painkillers later became known as the opioid epidemic. Drug overdoses became the leading cause of death in people under the age of 50.
Fentanyl and carfentanil more than doubled the overdose death rates over the last five years.
Fentanyl is a synthetic opioid 100 times stronger than morphine. It is often found in heroin and pressed pills. Fentanyl is cheap and it is easily accessible in online marketplaces. The drug is extremely potent in small doses, as little as a grain of salt is worth of fentanyl is enough to cause death in a human.
Carfentanil is even more potent and is not intended for human consumption, period. Despite the fact that it is used as a tranquilizer for large animals, carfentanil has made its way into street drugs and contributed to a portion of the death toll.
Unfortunately, as synthetic opioids become more common, the rate of overdose deaths increases while at the same time lowering the number of successful Narcan attempts at overdose reversal. Narcan is only so effective, especially when it comes to stronger opioids.
The overdose death numbers are and will continue to skyrocket. However, the use of Narcan has significantly benefited the United States and Canada. Although Narcan has saved a fraction of people from death, it is only a small number compared to the number of overdose fatalities in one year alone. Narcan and harm-reduction sites are leading health care professionals and government officials in the right direction, but will the opioid epidemic completely be put to a stop?
SIDE EFFECTS OF AN OPIOID OVERDOSE
So exactly what happens during an overdose?
The side effects of an overdose are generally the same, regardless of which opioid is being used.
Rarely does an individual, who is on the verge of an overdose, realize that they are overdosing. The feeling is pretty much the same as a typical high, except the intensity might be a little stronger.
The beginning stages of an overdose result in the drugs spreading throughout the entire body. Opioids bind to and activate the opioid receptors in the brain, causing an overwhelming feeling of euphoria throughout the body. Since opioids enter the bloodstream, wherever there is blood flow, there is bliss. As the rush or high evens out, you might begin to feel more drowsy than usual and drift between waking and sleeping.
This is often referred to as a nod.
During a nod, the respiratory system begins to slow. Since opioids are depressants, they decrease the amount of carbon dioxide and oxygen entering the body. As the breath gets shallower, the effects of an opioid overdose begin to suppress neurological signals, ultimately affecting the heart.
By this point, the brain is not receiving the correct signals to function properly, causing the body to shut down. The longer the brain and body endure these conditions, the less likely the individual is to function properly if they do get revived. Sometimes, opioid overdoses cause you to foam at the mouth and choke on the fluids that enter the lungs because the natural responses (such as swallowing or spitting) are suppressed.
Other side effects of an opioid overdose consist of seizures, permanent brain damage, paralyzation, and, of course, death.
With a simple spray or injection, these effects can be reversed. Narcan invades the receptors where the opioids are attached and replaces them with agents that reverse and block their effects. Narcan is always an option if the individual suffering from an overdose still has a pulse.
However, Narcan is less likely to be effective if the overdose caused death before medical attention is sought.
WILL NARCAN RELIEVE THE U.S. OF OPIOID ADDICTION AND OVERDOSE?
Despite Narcan’s ability to reverse opioid overdose, it is not taking down the entire epidemic. It is, however, paving the road to a future without crisis. It is highly beneficial to have Narcan readily available considering the number of people abusing opioids in today’s society. However, it is not the answer to the epidemic. There is clearly more that needs to be done by a number of organizations and institutions.
Narcan is relatively easy to administer, effective, and inexpensive. It is also widely available over-the-counter in pharmacies. People who suffer from addiction can also obtain this competitive agonist through local programs like needle exchanges or harm-reduction sites. There is evidence suggesting that the availability of Narcan does not encourage opioid users to increase their dose or use for a longer duration.
Most harm-reduction sites have drastically decreased the number of overdose deaths and prevented numerous diseases in intravenous (IV) users. These places also inform individuals about the laws in the community, one of them being the Good Samaritan or immunity law. This means if someone is overdosing around you and you call for or provide emergency medical attention, you will not face consequences for having drugs or drug paraphernalia.
All of these efforts are helping to decrease the alarmingly high number of drug-related overdoses, but these things alone are not enough. Although there are no new revelations on curbing the number of people who are addicted to an overdose of opioids, health professionals and government officials in the U.S. are leaning towards a way out.
DO YOU NEED HELP?
Seeking drug treatment in a facility can help educate individuals suffering from addiction while also isolating them from the environments that could lead to relapse. Widely available and affordable rehabilitation programs can be the next step in the goals to drastically cut the number of deaths associated with the opioid epidemic.
Call 855-969-8748 today to talk with one of the addiction specialists at Maryland House Detox. They will be able to answer any of your questions and lead you on the road to recovery.