The Naloxone Guide

Each day, individuals save lives by administering Naloxone to those who have overdosed on opioids. Today, Naloxone is an essential tool in use by first responders in cities across the country. Some communities even offer free kits containing an easy-to-use naloxone spray called Narcan. Naloxone is the go-to drug for people on the frontlines of the opioid epidemic. It’s also an important contributor to medication-assisted treatment in drug rehab programs.

 

Why Use Naloxone?

Naloxone uses are primarily as an opioid antagonist. Being an antagonist means it protects against the impacts of opioids by blocking receptors in the brain. It’s used to reverse an opioid overdose. During an opioid overdose, individuals have stopped breathing. However, within minutes of receiving Naloxone, they can walk and talk normally.

Opioids are drugs that soothe discomfort and create relaxation. Morphine, oxycodone, and other opioids are generally prescribed to deal with severe discomfort after surgical procedures, during cancer therapy, or to accompany end-of-life treatment. Often, the medications are recommended to treat light or modest discomfort. These prescription drugs are considered risk-free when used as recommended for a couple of days or up to a week.

Unfortunately, people can abuse prescription opioids (or use the illegal narcotic opioid called heroin) to obtain a euphoric high. Opioids cause a rush of endorphins like dopamine throughout the brain, causing a feeling of happiness and relaxation. Too much can be fatal because overdosing on an opioid causes respiratory suppression. Translation: breathing stops.

In high enough doses, Naloxone and various other opioid antagonists can reverse the effects of an opioid. Some opioids, such as fentanyl and alfentanil, are so powerful that several naloxone sprays or shots are required to reverse the effects.

Drugs that Naloxone can reverse consist of:

 

• Buprenorphine
• Hydromorphone
• Codeine
• Demerol
• Hydrocodone
• Heroin
• Morphine
• Oxycodone
• Oxymorphone
• Methadone

Due to the increased availability of Naloxone, countless lives were saved in the 2010s. A 2015 study by the Harm Reduction Coalition found that 152,283 laypersons in 136 organizations obtained naloxone kits between 1996 and 2014. These organizations obtained records of 26,463 overdose reversals throughout this time.

 

Is Naloxone Safe? Is Naloxone Addiction a Thing?

The Food and Drug Administration accepted Naloxone in 1971. Despite being FDA-approved, the medication was only available in hospitals. Recently, states have passed regulations providing accessibility to the opioid remedy to first-responders and the general public.

Naloxone is a benign medication. There’s no possibility of abuse, and it’s very safe. Therefore, Naloxone side effects aren’t something people need to worry about.

 

Lexi Reed Holtum, executive director of the Steve Rummler Hope Network who has conducted hundreds of naloxone trainings says, “As far as side effects go, our doctors tell us that there’s a very small chance that you’re going to be allergic to naloxone. The reality is, if you overdose on an opioid, you have to have this antidote or you die.” To put it plainly, the benefits of Naloxone far outweigh any disadvantages.

Apart from misconceptions about the drug, Naloxone is safe for the majority of the population. Remember that it’s not a controlled substance. You don’t obtain a high, and it doesn’t damage people who don’t have opioids in their system.

Naloxone prevents the reception of opioids in the brain. For this reason, people dependent on opioids may go into withdrawal after receiving Naloxone. Opioid withdrawal creates unpleasant symptoms, but it’s seldom life-threatening.

 

What Are Evzio and Narcan?

Pharmaceutical businesses have developed brand-new ways to administer Naloxone, thus making the medicine easier for common use. The FDA approved a device called Evzio in April 2014. Evzio is a user-friendly tool that contains audio directions for administering a naloxone injection.

The FDA accepted another form of Naloxone called Narcan in November 2015. Narcan is a nasal spray that contains Naloxone. It was the first form of Naloxone that didn’t require injection.

Narcan was initially the brand of the naloxone injection. The injection type of Narcan is no longer available. Therefore, the nasal spray variation is the only Narcan product that you can buy today.

Some people utilize the term “Narcan” to describe all kinds of Naloxone. Nevertheless, Narcan is a brand name for a specific form of Naloxone. Evzio and generic naloxone injections contain the exact same active ingredient as Narcan.

 

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How Do You Administer Naloxone?

It can be difficult to determine if somebody is overdosing on opioids. It’s common for people to fall asleep after using, but they should respond if you try to wake them. They may be unconscious if they don’t respond. This loss of consciousness is one of the indications of an opioid overdose.

Various other warning signs of an opioid overdose include:

 

• Vomiting
• Pale or blue skin, lips, or nails
• Limp body
• Slow breathing or no breathing
• Sluggish heart price

If you believe someone else is going through an overdose, but they are still awake, find out what and how much they have used. In the event they do pass out, you can utilize the information to identify just how to respond. When they pass out, or you discover them less competent, you need to take steps to save their life.

Above all else, The first thing you should do if someone overdoses is to call 911. After calling 911, administer Naloxone, if available.

When calling 911, supply the dispatcher with as much detail as possible, including the type of opioid used, the time of use and just how it was administered. Next, carry out rescue breathing before administering Naloxone if the individual isn’t breathing.

 

How to Perform Rescue Breathing:

 

1. Lay the person on their back
2. Tilt their head back
3. Clear their mouth of vomit or foreign fragments
4. Squeeze their nose
5. Open their mouth
6. Take a breath one breath into their mouth every five seconds

The person’s upper body needs to raise with each breath. After giving two or three rescue breaths, carry out Naloxone.

 

How to Provide a Naloxone Injection:

 

1. Clean the skin with alcohol if possible
2. Get rid of the cap from the vial of Naloxone
3. Put the syringe right into the vial
4. Attract all of the Naloxone into the syringe
5. Insert the needle of the syringe right into the individual’s arm, upper thigh or butt
6. Press the plunger up until every one of the Naloxone is injected

 

How to Provide Narcan:

 

1. Remove the Narcan from the package
2. Place one finger on each side of the nozzle
3. Place the thumb on the plunger, however do not push the plunger
4. Insert the tip of the nozzle into a nostril up until your fingers touch the individual’s nose
5. Press the plunger securely with your thumb

 

How to Administer Evzio:

 

1. Remove Evzio from the external case, and don’t touch the black base
2. Remove the red safety and security guard from the device
3. Press the black base against the middle of the external thigh and hold for five seconds

If the person isn’t breathing, continue to do rescue breathing for two to three minutes or until initial-responders show up. If the individual does not awaken after two or three minutes, provide an additional dose of Naloxone.

It’s important to stay with the individual up until emergency situation-responders arrive. As soon as first-responders show up, provide them with as much information as possible.

 

What to Do After Reviving Someone with Naloxone

After restoring a person with Naloxone, encourage them to seek medical treatment. Because IV naloxone lasts around 45 minutes whereas opioids can last for several hours, it is possible for a person to overdose a second time once the Naloxone wears off.

Individuals who overdose on long-acting opioids, such as methadone or extended-release tablets are at an increased risk for experiencing a second overdose. Naloxone does not get rid of the opioids from the body. Instead, it briefly stops them from affecting the brain.

 

Referring Patients to Rehab

Individuals with an addiction to opioids normally go into withdrawal after receiving Naloxone. This happens because their brain craves opioids, and Naloxone prevents opioids from easing those cravings. Treatment from a health center can help people mitigate and cope with these withdrawal symptoms.

In addition to alleviating withdrawals and mitigating a second overdose, health care providers can counsel clients about the threats of misusing opioids. In doing this, they can likewise link them with drug rehab centers and various other healing solutions to help them find detox and treatment and live without the dependency on opioids.

If individuals reject drug addiction treatment, some medical facilities might offer naloxone sets. These kits generally include a dosage of Naloxone, details regarding the dangers of using opioids, locations that distribute Naloxone, psychological health hotlines and details regarding local rehabilitation centers.

 

Where Can You Find Naloxone?

Naloxone is more readily available today than ever before. Numerous big drug stores, including CVS and Walgreens, have actually boosted accessibility to Naloxone. As of July 1, 2017, according to the Prescription Drug Abuse Policy System, pharmacists in 49 states and the District of Columbia can sell Naloxone without a prescription from an additional health supplier.

In some areas, medical facilities, health and wellness divisions and crisis facilities are licensed to administer and dispense Naloxone. In addition to these facilities, some drug treatment centers and prevention groups are licensed to dispense Naloxone in some states. Social workers and other advocates might likewise be able to provide the drug, depending on neighborhood laws.

Many people first learn about Naloxone and how to use it at naloxone understanding or training events. These events are typically organized by advocates in the neighborhood who are dedicated to preventing deaths from opioid overdose.

 

The Rising Price

The expense and availability of the medication vary by state. For instance, in some states, health departments and not-for-profit companies, funded by federal grants, help boost accessibility to Naloxone. These organizations supply Naloxone at no charge to people taking opioids or to people who know someone that uses opioids frequently.

Many insurance coverage plans cover Naloxone when it is carried out in a medical setting, such as an emergency room. A select variety of insurance policy plans repay individuals who acquire the medication with a prescription or over-the-counter. Repayment differs relying on the state and type of insurance strategy.

According to research released in the New England Journal of Medicine, the price of Naloxone has actually increased over the last few years. The price of a single dosage of Naloxone normally varies between $20 and $150. The rate of a two-pack of Evzio auto-injectors can cost as much as $4,500.

 

 

Naloxone Use in Addiction Treatment

The main purpose of Naloxone is to reverse opioid overdoses. However, there are other functions for the drug, such as in utilizing it as a tool for recovery.

In fact, Naloxone is used in one of the most widely used medications used for opiate addictions: Suboxone. Most people have heard of Suboxone, but they may not be aware that Naloxone is a part of this drug. Naloxone and Buprenorphine combine together to make Suboxone.

Buprenorphine’s purpose in Suboxone is to alleviate the cravings and withdrawals associated with long-term opioid use. The proven benefits of Medication Assisted Treatment has been shown to improve retention rates in substance abuse rehabilitation. Studies have also shown the longer people remain in treatment, the greater their chances of success.

The only problem with buprenorphine is its susceptibility for abuse. Here is where Naloxone comes in. Naloxone blocks opioid receptors—which may sound counterintuitive when combined with buprenorphine—but Naloxone only works when injected intravenously. The only way to administer Suboxone is sublingually (by mouth). Therefore, if someone attempts to abuse suboxone by injecting it, they will not feel any high.

Thanks to Naloxone, addiction psychiatrists can now prescribe medication to people with opioid use disorders without the possibility of patients abusing it. This has made medication-assisted therapy for opioid use disorder a no-brainer.

 

What Do You Learn at Naloxone Training Events?

Many naloxone training events are open to the general public. However, you might need to sign up ahead of time. The program for each and every event varies, but naloxone trainings typically start with a short summary of opioid addiction. Event hosts might likewise speak about healthcare resources and neighborhood opioid trends.

After this intro, a presenter shows how to administer Naloxone. From here, participants typically practice administering Naloxone on a dummy or volunteer. The practice devices do not have needles or drugs.

For instance, at a 2017 Naloxone training event in Jacksonville, Florida, volunteers from Drug-Free Duval trained clinical trainees, registered nurses, community supporters and college professors to teach others how to use Naloxone.

“The event was about training people in the neighborhood to be instructors in [naloxone management] so we are able to canvass the neighborhood in a larger duty,” said Young People Director Melanie Bright at Drug Free Duval.

Education events like the ones held by Drug Free Duval occur each week in communities across the United States. For this reason, events can help highlight that Naloxone isn’t a medication used to treat opioid dependency. It’s a medicine that saves lives.

When more individuals have accessibility to Naloxone and know exactly how to make use of the drug, more lives can be saved. As a result, more individuals have a chance to think of the influence of opioids in our society. Additionally, more people have the opportunity to seek the abundance of resources for addiction recovery.