Naloxone – A Potential Lifesaver For Heroin Addicts
Heroin use has exploded, a national survey on drug use reveals, growing from 373,000 yearly users in 2007 to an estimated 669,000 in 2012. This alarming substance abuse trend highlights the need for drug rehab and for strategies that reduce heroin’s harmful impact. One of those strategies is the distribution of a medication called naloxone, which reverses the effects of heroin overdose.
Naloxone, also known by the brand name Narcan, is a non-narcotic drug that works by binding certain opioid receptors in the brain. Approved by the FDA in 1971, naloxone reverses sedation and respiratory suppression, heroin’s primary life-threatening effects. It can be administered via an injection, usually given in the upper arm or thigh, or as a nasal spray. After it’s been administered, the medication takes effect as quickly as five minutes or less. Naloxone is considered safe and nontoxic, and it doesn’t produce a pleasurable high when used. This medication treats overdoses from heroin and other narcotic drugs, including codeine and oxycodone.
Administering naloxone is a harm-reduction technique, which means it’s not necessarily intended to stop heroin use. Instead, its purpose is to reduce the harmful and potentially lethal impact of a heroin overdose. While death is, of course, the most serious consequence of overdosing on opioids, brain injury from oxygen deprivation is a very serious concern as well.
Heroin users who overdose are at risk for long-term health issues, ranging from coordination problems to communication difficulties. In severe overdose cases, the result can be a vegetative state. Brain injury damages both the physical and emotional well-being of the addict, but it also negatively impacts the well-being of his or her loved ones. Treatment of an overdose-related brain injury is expensive as well. If the addict is unable to pay for needed medical care, the community will end up bearing the burden.
Who Can Give Naloxone?
Naloxone has been available for years to emergency medical technicians, ambulance crews and emergency room personnel. However, in recent years, perhaps fueled by the increase in heroin use, public health officials have pushed to make it more widely available to other first responders. For example, naloxone is now carried by police officers in several communities, including one in New Mexico and five in Massachusetts.
The challenge, however, is that heroin overdoses sometimes result in injury or death before first responders arrive or before the drug user reaches an emergency room. This has spurred some public health officials to advocate putting naloxone directly into the hands of addicts, their loved ones and concerned friends. In fact, in 2012, the American Medical Association (AMA) announced its support of offering naloxone through community-based programs. This would allow the bystanders of an overdose to administer the potentially life-saving medication. Some states have already moved to make naloxone more widely accessible. For example, Washington State allows drug users, family members and concerned friends to carry the medication.
What Are The Benefits Of Naloxone?
The potential benefits of naloxone are significant, and include the following:
The drug saves lives. Research shows that using this medication reduces the number of deaths from opioid overdoses. A published study, which examined Massachusetts communities where first responders carried naloxone, reported 327 rescues from 2006 to 2009. The communities that had higher levels of training for naloxone use reported a nearly 50 percent reduction in opioid overdose fatalities. Those with lower levels of training had an approximate 30 percent lower death rate.
Naloxone is relatively inexpensive. A nasal spray naloxone kit costs in the ballpark of $25. This is extremely inexpensive when compared to the potential cost of brain damage or death due to a heroin-induced overdose.
It can be administered with minimal training. Naloxone, whether it is in injectable or nasal spray form, is easy to administer to someone who has overdosed on heroin or other narcotic drugs. Instructions are typically provided with the medication to help someone at the scene know when it’s time to give it and how to prepare the dose. For those who want to learn more about how to give naloxone properly, training is available through many community-based programs or from physicians familiar with the drug.
What Are The Downsides Of Naloxone?
Although the benefits of using Naloxone for opioid overdoses are impressive, use of the medication is not without its downsides. Negative aspects include the following:
The medication usually must be administered by someone else. By the time a heroin user needs naloxone, he or she is already likely unconscious. Naloxone is most effective when there’s a sober bystander able to watch for signs of overdose and administer the medication as quickly as possible. Unfortunately, many addicts use when they’re alone or with others who are also using. A sober bystander often isn’t anywhere in the vicinity. By the time someone does come onto the scene, it may be too late.
It doesn’t counteract the effect of other drugs. Naloxone only works for opioid overdoses, which means it has no impact when a person has ingested alcohol or substances like cocaine, benzodiazepines (such as Xanax or Valium), or methamphetamines.
Naloxone triggers withdrawal. Because the medication quickly reverses heroin’s effects, the user experiences withdrawal symptoms. These feelings are intense and uncomfortable; however, they’re not life-threatening. Perhaps the most dangerous aspect of withdrawal is that the heroin user will have a compelling urge to get high again.
The medication’s effects are temporary. Naloxone begins to wear off after 30 minutes, and most of it is gone after 90 minutes. However, a heroin high lasts from two hours in addicted users and up to six hours in new users. When the naloxone dose wears off, there may still be enough heroin in the body to reinitiate the high. If the original dose of heroin was large enough, respiratory suppression and sedation could start again. This would make an additional dose of naloxone necessary.
Bystanders may not call for help because they fear trouble with law enforcement. Loved ones or drug-using friends are sometimes highly reluctant to reach out to responders, even when those responders are armed with the potentially life-saving naloxone. This is often because they don’t want the person who’s using to get into legal trouble.
Some oppose its use. As with other harm-reduction strategies, such as needle exchange programs, there are always those who oppose its use. Critics charge that naloxone makes heroin users less likely to seek drug rehab because they no longer fear the consequences of an overdose.
Heroin abuse and addiction are serious community concerns. An overdose can lead to tragic and permanent consequences. While drug rehab treatment and abstinence are always the ultimate goals, it’s also important to address and reduce the harm done by drug abuse. Although it has its downsides, naloxone is a safe way to decrease the physical, emotional and financial impact of heroin overdose.
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