The Importance of Narcan in Overdose Prevention

Medical professionals generally administer Narcan through injection. (Mr.Nikon/Shutterstock)

Amethyst Recovery has been offering Vivitrol treatment for some time, but some have expressed concerns about the way it works. Vivitrol blocks the receptors that allow people to feel the effects caused by alcohol and opioid drugs. This is obviously useful in relapse prevention, but what of those who must receive such medications for surgical purposes or other medical emergencies? Those who are worried about such instances due to chronic pain or other issues may find the perfect solution in a medication called Narcan.

Many appreciate Narcan for its ability to reverse overdose deaths. With the rate of overdose having tripled between 2000 and 2014, the threat of drug overdose in the United States is a growing concern. We previously noted in our assessment of addiction statistics and demographics that the use of heroin and prescription drugs has been on the rise among both the upper and lower classes, which means that more people are putting themselves at risk of overdose every day. But while Narcan may be effective in treating possible overdoses, it can also play a pretty major role in addiction treatment and relapse prevention.

Its use in relapse prevention is generally relegated to certain circumstances, but Narcan is definitely an important drug in treating addiction. And while the circumstances in which Narcan can be used are relatively specific, it is still useful for more than just medical emergencies. Below, we will talk a bit about how Narcan works and why recovering addicts should know about it. We should also note that this medication is now available at Amethyst Recovery, so those who are interested in its use should definitely consider the following information and whether or not Narcan might be something that they need.

What Is Narcan?

Narcan is available not only as a shot, but also as a nasal spray. (FabrikaSimf/Shutterstock)

Narcan is one of the more common brand names of naloxone, a medication that is similar to naltrexone in that it blocks the effects of opioid drugs. Such drugs include heroin, methadone, oxycodone, fentanyl, morphine, codeine, hydrocodone, hydromorphone and buprenorphine. Naloxone is a fast-acting medication and generally works within minutes, five when injected into a muscle and as few as two when administered intravenously. Once administered, it will generally last for anywhere between thirty and sixty minutes. This may sound like a short amount of time, but it is more than long enough to save someone who is at risk of an overdose.

Since Narcan reverses the effects of opiates, it can also be used to prevent drug abuse. Obviously, since naloxone wears off after just an hour, it cannot act as a pragmatic substitute for medications like Vivitrol. But if a person must receive painkillers or other medications for emergency purposes, naloxone can be used in a very interesting way. It cannot be absorbed by the gastrointestinal tract, so those who must take pills will find that they still work. But if a person tries to inject opiates intravenously, Narcan will block the effects and keep the person from getting high.

Unfortunately, treatment centers must sometimes use Narcan for emergency purposes. This use may be seen in the case of patients who enter treatment while under the influence of drugs. In our article on fentanyl, we mentioned the case of a patient at another treatment center. The patient had chewed a handful of fentanyl patches before entering treatment. Shortly after being admitted, he began turning purplish and showing signs of a possible overdose. The worst-case scenario was averted, but it gave the treatment center and the patient’s family quite a scare. Had they had Narcan on hand, the overdose could have been reversed much faster.

Narcan is generally administered either through a shot or in the form of a nasal spray. An injectable kit called Evzio is portable and easy to use without training, so even family members of opiate users can carry naloxone on hand in the case of a fatal relapse. And while this is not generally its primary purpose, Narcan may even jumpstart the detoxification process by reversing the effects of drugs soon after they are used. But the issue of making Narcan publicly available is a highly controversial one, and it is generally best that decisions regarding its use be left to medical professionals.

Are There Side Effects?

Many of Narcan’s side effects are those associated with opiate withdrawal, such as sweating, nausea and chest pains. (Sopotnicki/Shutterstock)

The reason we note above that Narcan may jumpstart the detoxification process is because this actually leads to some of its potential side effects. These side effects are the same as those seen in opiate withdrawal, such as pain and possible seizures. It is not uncommon for patients receiving Narcan to shake, sweat, and experience nausea. Some may also experience discomfort in their hands and feet, or in the general area around the spot of the injection site. Patients receiving Narcan may also experience symptoms similar to those of an allergic reaction, such as hives, swelling, and trouble breathing.

This is why it is best to leave Narcan to the professionals. While the drug may cause some highly uncomfortable withdrawal symptoms, any treatment center worth its salt will be staffed with physicians who are well-versed in treating withdrawal. Allergic reactions may also require immediate medical attention. Just because naloxone can prevent overdose deaths does not mean a person will not still need medical treatment after such a close call. It is highly important that Narcan be administered under medical supervision, and that patients be monitored to assess further medical needs.

Some believe that allowing Narcan to be accessed by the public has the potential to spur more drug abuse. There is a theory that drug users will abuse heroin and other substances with greater frequency if they are able to carry a potentially life-saving medication in the event of an emergency. So far, studies have been unable to corroborate that there is any such risk. The risks associated with naloxone use by non-professionals are generally related to the issues described above. But when administered by a medical professional who understands the potential side effects and how to deal with them, Narcan is generally considered to be a safe and acceptable medication.

Those who take Narcan without opioids in their system will likely experience no side effects of any kind. Since Narcan is relatively inexpensive, and there is a generic form available, some may be tempted to use it as a Vivitrol substitute by injecting every hour to prevent the effects of opioids should they be ingested. Note, however, that naloxone and naltrexone are fairly different animals. Naloxone, a pure opioid antagonist, reverses the effects of opioids by blocking opioid depression in the respiratory system and central nervous system. It removes the opiate from the opiate receptor, but does not necessarily block opiates in the same way as Vivitrol.

Narcan in Addiction Treatment

It’s always best to let professionals decide when Narcan is most important. (Pressmaster/ShutterStock)

With Narcan being used primarily to reverse the effects of drug overdose, some may believe its only role in addiction treatment is not relapse prevention but rather damage control in the event that a relapse occurs. And while it may serve this purpose, we have explored some of its other potential uses as well. One of the primary things we mentioned was that it can be used to keep people from abusing necessary medications when issued for surgery or other emergency purposes.

Of course, this brings up a rather complicated subject. After all, there are non-addictive substitutes for most addictive medications, so it is hard to imagine a circumstance in which Narcan would technically be needed for such a purpose. But not all medications work for all people, and some may find they have very specific allergies. In the case that a person cannot take a non-addictive substitute, or in the case that a substitute simply does not work for whatever reason, Narcan will allow the patient to manage their pain without putting themselves at risk of a major relapse. Care must be taken before making such a decision, but there is little denying that it must sometimes be made. No patient who experiences pain, from surgery or from other causes, should be forced to suffer simply because they are afflicted with the disease of addiction.

At Amethyst Recovery, we have begun carrying Narcan for any purpose that might necessitate its use. Whether a patient attempts to enter care under the influence of drugs and nearly suffers an overdose or if special circumstances require that they take medication for pain management, we will be ready to administer it. Even if a patient has only been in our care for a few minutes, we do not want their actions prior to walking through our doors to cause them to die of an overdose while on our watch. Addiction treatment is about saving lives, and our dedication to each patient begins from the very moment we first make contact.

Amethyst is a treatment center that patients can comfortably attend when they and their families are concerned about safety. We are prepared to deal with withdrawal symptoms, whether caused by Narcan or not. We are stocked with high-quality treatment medications such as naloxone and naltrexone, and we understand which patients are most likely to require their use. If you or someone you know has been struggling with opioid addiction, contact us today.