Reversing An Opioid Overdose With Naloxone – Could This “Antidote” Solve the North American Drug Epidemic?
Opiates steal more than 52 000 lives each year. And this number is growing in the wrong direction.
The United States is plagued with this drug epidemic due to a combination of drug offshoring, illicit market activity and increasingly, prescription drug diversion.
But there might be a solution to the problem after all.
What is Naloxone?
Naloxone, a prescription drug touted as an “opiate antidote”, has rescued tens of thousands of lives from fatal opiate overdoses since the drug’s inception.Naloxone is scientifically deemed an opioid antagonist, meaning it prevents receptors in the brain from binding to opioids in the bloodstream. Naloxone works effectively against prescription opioids, heroin, morphine and fentanyl.
Narcan® is another name for Naloxone under registered trademark. More branded names for the drug include:
Not surprisingly, nearly half of all reported overdose incidents are unintentional. An overdose is defined by a dangerous depression of the Central Nervous System as a result of more drugs being present in the bloodstream than a body can metabolize.
Opioid Overdose Symptoms
- Blueness of skin
- Slowed breathing and respiration
- “Pinpoint pupils”
Depending on the severity of overdose symptoms, there are several ways to administer a Naloxone dose:
- Intranasal Naloxone (nasal spray)
- Naloxone injection
- Naloxone pills
- Naloxone implant (lasts 2 to 6 months after surgical installation) Of all methods of Naloxone administration, a Naloxone injection yields the most rapid results. In extreme scenarios where an initial dose has no noticeable effect, Naloxone can be reissued in 2 to 3-minute intervals.
Naloxone has to be administered immediately in order to be effective, and should not be considered a substitute for emergency first response medical care.
It is not always possible to predict whether or not a drug abuser will survive even with Naloxone intervention. However, by making this drug accessible as over the counter medication, it becomes possible for friends and family members of opioid abusers to take control of potentially fatal situations before it’s too late.
Related Readings: The Dangers of Oxycodone Abuse
One of the most helpful, immediate procedures that can reverse the effects of an opioid or fentanyl overdose is the ability to administer CPR or cardiopulmonary resuscitation.
Unfortunately, some parts of the country express uncertainty regarding the availability of Naloxone despite its life-saving properties.
Laws governing acceptable Naloxone access points (i.e. pharmacies), Naloxone administrators (e.g. physicians, friends, family, etc.) vary from state to state.
Over the counter Naloxone is available for anyone to obtain in all but two United States. But in Michigan and Nebraska, the opiate antagonist is still available with a physician’s prescription.
Other Naloxone Prescribing Laws
- In 37 states, prescribers will not be criminally prosecuted for dispensing Naloxone to laypeople
- 50 states permit Naloxone dispensation without a doctor’s prescription
- In 38 states, laypeople may administer Naloxone in life-threatening cases with criminal immunity
Through municipal Naloxone training programs, it is possible to mitigate any risks associated with Naloxone administration from laypeople. Empowering friends and family members with the means to rescue their loved ones beyond first response can affect the opioid epidemic in a meaningful way. This allowance is particularly impactful in high-risk communities with a history of high overdose rates.
Hesitation about installing nationwide Naloxone mandates is partly due to the uncertainty of the long-term side effects of using the opioid antagonist.
But this doubt may be unwarranted. Naloxone has been approved by the FDA to combat opiate overdoses since 1971, and in the 45 years since its inception, the drug has boasted a 98% success rate when used in time.
Other countries who offer Naloxone as an OTC remedy are not limited to Australia, Canada, England, Germany and Sweden.
Naloxone Side Effects
Naloxone has no physiological effect unless opioids circulate the bloodstream. This opiate antagonist is safe to administer if the victim of an overdose does not take contraindicated medicine.
In very rare circumstances, people may experience Naloxone allergy symptoms which might be worth the risk in the scheme of things.
Some Naloxone symptoms mimic the side effects of opioid withdrawal:
- Body aches
As is the case with any medical emergency, the pros of treatment must be weighed against the cons. The benefits seem to offset the risks, as Naloxone can even be used outside of emergency settings.
Extended release versions of Naloxone are often prescribed within drug rehabilitation centers to gradually wean people from their opioid addictions, such as Naltrexone.
Naloxone vs. Naltrexone
Naloxone is sometimes mistaken with Naltrexone, since both medications contain the same mechanism of action. While Naloxone is used in emergency situations as a fast-acting remedy, Naltrexone is preferred for long-term relapse prevention.
Risk using Naltrexone over an extended timeframe, aside from a few mild to moderate side effects which are statistically less harmful than the prolonged use of opioids or illicit substances like fentanyl.
What is Fentanyl?
Fentanyl is a Schedule II synthetic opiate 50 to 100 times stronger than morphine.
This drug is intended for surgical pain relief in a controlled environment due to its potency, but offshore manufacturing has made the drug easier than ever to obtain and abuse.
Fentanyl overdose symptoms are not unlike opioid overdose symptoms; however, the side effects of fentanyl abuse arise in a faster, more alarming fashion. Exposure to fentanyl granules as infinitesimal as the size pin drop can end in fatality.
Many types of fentanyl are swarming the nation, including acetyl fentanyl, an illicit derivative of fentanyl; carfentanil, a sedative used to tranquilize large exotic animals; and acryl fentanyl, a drug that might be impervious to naloxone.
Acryl fentanyl use typically results in death, as this particular strain can withstand multiple consecutive Naloxone injections before any sign of overdose reversal.
What is the future of Naloxone?
The cost of Naloxone is increasing with demand in response to a surplus of opiate and fentanyl deaths. Accessibility of the opioid antagonist is becoming limited, consequently restricting lifesaving efforts.
Thousands have died in the United States because of substance abuse. Naloxone creates a sizeable dent in the drug epidemic as the light at the end of the tunnel.