Naloxone, Narcan Saves Lives from Opioid Overdose
Naloxone (brand name Narcan) saves lives from opioid overdose by reversing the effects of an opioid overdose. America's problem--some say epidemic-- with heroin and prescription opioids is big news, so why is naloxone, which saves lives from opioid overdose, controversial?
How Naloxone Saves Lives from Opioid Overdose
Opiates, such as heroin, codeine, oxycodone (OxyContin), hydrocodone (Vicodin), hydromorphone (Dilaudid), morphine and fentanyl (Duragesic) attach to proteins in the brain, with multiple effects. They reduce the perception of pain, and therefore, their most common prescription use is for pain relief. They also affect the reward and pleasure centers of the brain, and therefore, can produce a euphoric effect. Simultaneously, opiates depress the central nervous and respiratory systems, which can lead to minor side effects like constipation, but also respiratory or circulatory failure and death.
Naloxone works by physically pushing the opiate off the receptor and attaching itself there instead. Within seconds, the person to whom naloxone has been administered is thrown into withdrawal. While opioid withdrawal is extremely unpleasant, it is not, by itself, lethal.
The Opioid Overdose and Withdrawal Cycle
Opioid withdrawal is not, in and of itself, lethal. There is some concern, however, that naloxone could increase the likelihood of a second overdose. The reasoning behind this is as follows: Naloxone's effects wear off more quickly than the opiate's effects. So even though the person is technically in withdrawal, they may still have significant quantities of opiates floating around, waiting for an opportunity to re-attach. Then, if the person goes out and seeks opiates in order to relieve the withdrawal symptoms, they are more likely to overdose because they still have the previous round of opiates in their system.
Right now, very little data has been gathered about the opioid overdose drug--it is just too new. We do know, however, that naloxone has so far been effective in reducing death from drug overdoses in areas where it is in use. In December 2014, The Atlantic ran a feature on the drug, in which the author discussed naloxone use in Quincy, Massachusetts. In 2010, Quincy became the first town in America to equip its police force with the drug. Over the following year, fatal overdoses decreased by by two-thirds.
Overdose Death Deterrent as Argument Against Naloxone
The more common argument against naloxone is that it encourages reckless drug use. The debate here retreads familiar ground: zero-tolerance-versus-harm-reduction territory. One school of thought says if people know they can be saved by a drug like naloxone, they are more likely to engage in excessive drug use. The other school says that in fact, millions of Americans are already engaging in excessive drug and they are better served by making a life-saving drug available (Treating Addiction to Prescription Opioids).
I would wager to guess that if you asked opiate users and the people who provide services for opiate users, the vast majority would say that addicted people are not thinking about whether or not their city has naloxone available before they shoot, smoke, or ingest an opiate. Personally, I have not been addicted to opiates, but I have struggled with (and nearly succumbed to) alcoholism. The deeper a person falls into addiction, they less they are able to care about anything other than feeding it. In other words, the idea that naloxone availability will increase drug use rests on the assumption that drug abuser are acting rationally when they are not. With or without naloxone, people will continue to overdose. I would rather live in a society where they can get this life-saving drug when they do.
Lesley, K. (2016, March 21). Naloxone, Narcan Saves Lives from Opioid Overdose, HealthyPlace. Retrieved on 2019, August 17 from https://www.healthyplace.com/blogs/debunkingaddiction/2016/03/naloxone-saves-lives-from-opioid-overdose
Author: Kira Lesley
My article Emergency Medicine News Dec. 2015
Dr. Aaron Orkin co-author Can. J. Public Health 2013;104(3):e200-4 http://journal.cpha.ca/index.php/cjph/article/view/3788 My response
'Development and implementation of an opioid overdose prevention and response program in Toronto, Ontario.' http://static.smallworldlabs.com/hsf/user_content/files/000/000/169/355cc02324a166bb8abf31174c141f69-cjph-20131043200-4.pdf
Two case reports Naloxone ineffective in children, thousands more like this in the literature. Marcia L. Buck "Naloxone for the Reversal of Opioid Adverse Effects" Pediatric Pharmacotherapy. 2002;8(8)1-5 Read my moderated comment Medscape if you don't have access see next hyperlink http://www.medscape.com/viewarticle/441915_4
Kept alive five days respiratory assist. Crazy doctors pumping massive doses Naloxone into children with no affect.
Dr. Gordon Awy the world expert on chest compression's only. Dr. Awy phoned me "Gary don't stop what you are doing"
Quote "Some doctors worry that bystanders can get confused and do only chest compressions in drug-overdose and drowning cases [any asphixia or poisoning etc]."
One of my articles in the 2015 AHA & ILCOR CPR guidelines
Such an honour to receive a like on the above post from Dr. Richard Wilmot who spent years doing street outreach in disenfranchised neighbourhoods. Treating physical and mental health issues. 'American Euphoria: Saying 'Know' to Drugs' By Dr. Richard Wilmot
Dr. Aaron Orkin's Power Point Canadian Emergency Care Conference Feb 22, 2016 'Overdose Training and Naloxone Distribution' Dr. Orkin is co-author 2015 AHA CPR guidelines Part 10:3 opioid OD See Slide page 16a next hyperlink??
All 70+ references from 2015 CPR guidelines on opioid overdose and comments ALL SAY RESCUE BREATHING NO MENTION ANYWHERE CHEST COMPRESSIONS ONLY
Deputation Toronto Board of Health https://youtu.be/QhsDjmI9H9c read hyperlinks under 'show more'
Heart & Stroke Foundation Official site read my moderated comments box and click AliasCPR for my video's https://youtu.be/Wy3eEES511E
Spreading deadly misinformation chest compressions only has and continues to backfire in a thousand ways you could never dream up, nature of the creature. There is no medical evidence for the Public Health protocol, it's contraindicated.
Don't suffer any of the hundreds of causes respiratory emergency you may get tortured to death.
Signs of OD and proper treatment, rescue breathing any respiratory emergency
Ontario's Naloxone Training Video https://vimeo.com/68067103 Listen 9:20 secs signs of respiratory emergency
Public Health Ontario training video http://www.youtube.com/watch?v=zlbkU5IK5Do
Training Power Point Slide 23 https://www.cpso.on.ca/uploadedFiles/members/Meth-conf-POINT-PP.pdf
Best Wishes @GaryCPR
Chest compressions still being taught!! Read comment box YouTube https://youtu.be/CycS5GeylbM
Quotes Mayor above press conference at 37 minutes "When you have a CRISIS...one thing that often stands in the way...different protocols people have...that they have protocols that are well agreed upon...this person didn't tell me that...we have a different system here...this is what causes people to lose their lives quite literally." Drug OD can mimic any breathing emergency rescue breaths ASAP your life depends on this.
My deputation BOH March 20, 2017 https://youtu.be/uz7GBCZrRek
Information package given to all board of health members https://aliascpr.wordpress.com/2017/03/22/board-of-health-200317/
My letter ‘Flaws in Toronto’s Opioid Overdose Prevention Program’ EMN 2015; 37(12):31 With hyperlinks to Public Health Ontario’s training literature, and also the proper protocol.
Correct protocol Dr. Nicholas Etches Medical Officer of Health for Calgary district http://www.cbc.ca/player/play/895066691568/
Your pet eats a poison or drug Veterinarian will give respiratory assist and any antidote, not torture them with chest compression's only. Why would we allow this to our women and children?
It's a mental illness called Anosognosia a severe form of denial. Anosognosia is quite different than simple or temporary denial. It is not simply denial of a problem, but the genuine inability to recognize that the problem exists. Usually this is caused by brain damage and/or FEAR!
Agnotology is the study of culturally induced ignorance or doubt, particularly the publication of inaccurate or misleading scientific [medical] data. Agnotology focuses on the deliberate fomenting of ignorance or doubt in society. Google @GaryCPR for more info