In 2018, there were 67,367 drug overdose deaths in the United States, a 4.1% decline from 2017 (70,237 deaths).1 Even with the decline from 2017 to 2018, drug overdose deaths are still an epidemic in our nation. So, what can be done to help alleviate the situation? One solution is the administering of NARCAN.

NARCAN is an FDA approved medication that is safe and effective for opioid/opiate overdose reversals. Narcan – also known as Naloxone – continues to be a huge benefit in harm reduction and saving lives in the ongoing opioid epidemic.  Naloxone is a drug that temporarily counteracts opioid overdose.  It takes between 2-5 minutes to work and, since the introduction of the nasal spray form, has been used with increased frequency by the public — not just professional first responders, nurses, and physicians. 

It comes in two other forms: an auto-injectable variety used intramuscularly through clothing, and intravenously, which has been used in used in emergency rooms for many years.  

Just giving Narcan is not a solution to overdose, though.  For the first responder who is a civilian, family member, friend, etc, 911 should be called immediately and rescue breathing should be initiated — if needed. In a recent study by the Center for Disease Control (CDC), 83% of all lives saved from opioid overdose involve responders on the scene and not 911 responders.

How does Narcan work? It occupies the opioid receptor sites in the brain previously occupied by the opioids which created the overdose.  By occupying those receptor sites, it stops the flow of dopamine that leads to continued respiratory depression and decreased level of consciousness.  With reversal of the overdose, respirations, which have slowed dramatically, return to normal as does level of consciousness and other vital signs (i.e. blood pressure and pulse).

With the passage of The Good Samaritan Law, which protects civilians who administer Naloxone to victims of opioid overdose from liability, more lives are being saved.  It is the policy of many medication assisted treatment clinics and detoxification units — such as those here at SMA Healthcare — to give Narcan to patients, where it is medically appropriate, whom we judge to be at increased risk for overdose. While Narcan saves lives, medication assisted treatment with medications like Suboxone, Subutex, and Vivitrol, combined with psychotherapy and community support groups working a daily structed program are the keys to recovery.

The two most common offending opioids in overdose deaths are fentanyl and heroin, respectively. In Fentanyl overdoses, and with the duration of Narcan only lasting 30-90 minutes, it can sometimes take 3-4 ampules of Naloxone to reverse a severe overdose in the emergency room. Unfortunately, the opioid addict often will receive Fentanyl, the strongest of illicit opioids, without knowing; it could pressed into “street drugs” or mixed with powder Heroin. 

If improvement in an overdose victim is not seen in 3 minutes, a second dose of Narcan should be administered. If the addict has other substances in their body such as alcohol or benzodiazepines, Narcan will have no effect on these substances making the situation more complicated.

After administering naloxone, the victim will be in a state of withdrawal. Some of the side effects include: fatigue, fever/sweating, upset stomach, vomiting; pain/aches; loss of bowel/bladder function; confusion, disorientation; increased heart rate/breathing.

Reducing and/or ending overdose deaths is not a one-size-fits-all approach. However, Narcan has proven to be a capable solution to saving lives of those who have overdosed. For questions or more information about Narcan, visit samhsa.gov.

 

 

  1. https://www.cdc.gov/nchs/products/databriefs/db356.htm