Naloxone, Narcan Saves Lives from Opioid Overdose
Monday, March 21 2016 Kira Lesley
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.