fbpx

Naloxone: Back from The Dead

David Epstein, MD, explains what naloxone is and why it is important in the battle for lives during the opioid epidemic.

We’ve been hearing about the opioid epidemic for a while and, most recently, the surge in fentanyl overdoses. Fentanyl has been particularly deadly because it is mixed with other drugs without the user’s knowledge. The opioid drug class consists of a number of medications, including morphine, oxycodone, hydrocodone, methadone, heroin, fentanyl, and others. They all have similar side effects that make them deadly, but fentanyl is approximately 100 times more potent than morphine. So, a very small amount of fentanyl can have a very large effect on someone.

Opioids are primarily used for pain control. However, they also have several side effects that need to be considered. Aside from minimizing or eliminating pain, opioids can cause drowsiness, confusion, nausea, constipation, euphoria, and slowed breathing. The side effects on the brain (drowsiness, confusion, and slowed breathing) can also be potentiated when mixed with other drugs that cause similar effects, like alcohol and benzodiazepines. Death from opioids usually occurs when the breathing slows or stops, as the user becomes more sedated and slips into unconsciousness. The resulting respiratory depression causes a lack of oxygen to enter the body and there is subsequent organ damage and death, if not reversed quickly.

So, can this process be reversed? Thankfully, the answer is “yes”. The medication, naloxone or Narcan, is the antidote to opioids and blocks their effects. But, the antidote for an opioid overdose must be administered quickly before the body suffers the irreversible effects of a lack of oxygen. Once given, however, naloxone works instantly. The opioid effects are immediately reversed. While someone can be barely breathing and unconscious, the individual awakens suddenly and starts breathing immediately after the naloxone is given. It is like rising from the dead. One moment, an individual is completely unconscious and the next, they are awake and alert. It is surreal to watch.

 

On administering naloxone: one moment, an individual is completely unconscious and the next, they are awake and alert. It is surreal to watch. Click To Tweet

 

However, the duration of the effect of naloxone is often shorter than the opioid that caused the deadly side effects. Naloxone will last about 30-90 minutes, but the opioid that is circulating in the body may last longer because of the type and amount used. It is not unusual for a person who had the effects of an opioid overdose reversed by naloxone to slip back into somnolence and unconsciousness when naloxone wears off before the opioid does. As the naloxone stops working in the body, the person can develop respiratory depression again. So, a repeat dose of naloxone needs to be given.

 

Some naloxone facts:

Naloxone is Narcan (Narcan is the brand name and naloxone is the generic name).

Naloxone can be given by nasal spray or by injection.

Naloxone is the antidote for opioids (i.e., morphine, fentanyl, heroin, etc.) and their side effects.

Naloxone is NOT the antidote for alcohol, benzodiazepines (i.e., Valium, Ativan, etc.), or other illicit drugs.

If someone uses opioids chronically and has physiologic dependence on them, naloxone can trigger acute opioid withdrawal symptoms which can include a fast heart rate, elevated blood pressure, fever, sweating, agitation, and other symptoms.

Naloxone’s duration of effect can be shorter than the opioid involved in the overdose, so naloxone may need to be given multiple times until the opioid effects wear off on their own.

Naloxone is a life-saving medication if someone is suffering from an opioid overdose and develops respiratory depression. Opioid overdose has become a problem for some kids because they may be exposed to fentanyl without their knowledge when it is mixed with other illicit drugs that have been taken.

 

Opioid overdose has become a problem for some kids because they may be exposed to fentanyl without their knowledge when it is mixed with other illicit drugs that have been taken. Click To Tweet

 

Because of the concern for opioid overdoses in children at school, the Los Angeles Unified School District (LAUSD) is providing naloxone to its schools to combat the problem. Also, the medication has been made readily available and free to those who may be at risk for opioid overdose in many US states. While we may not have all of the tools to successfully prevent opioid drug abuse and overdose, we do have the tool to prevent the deadly side effects of opioid abuse and overdose…naloxone.

Have you ever seen naloxone used?

Share

Tweet this:

Earn CME credit:

This learning experience is powered by CMEfy - a platform that brings relevant CMEs to busy clinicians, at the right place and right time. Using short learning nudges, clinicians can reflect and unlock AMA PRA Category 1 Credit.

Leave a Reply

Your email address will not be published. Required fields are marked *

Subscribe To Our Newsletter

Get updates and learn from the best

What if Twitter Went Kaput?

Dana Corriel, MD explains how professionals should ideally regard EVERY social media platform, and use it to their benefit.

Startups, Stop Hoarding Experts

Startups, Stop Hoarding Experts

Dana Corriel, MD explains why businesses try to “hoard” experts like physicians, and why disruption is needed – STAT – in this field.

Susan J. Baumgaertel, MD FACP

Navigating Your Health (with Dr. Susan Baumgaertel)

Dr. Baumgaertel draws upon her 30 years of experience as a physician in primary care internal medicine, and uses her personal story-telling style to communicate with you as if you are sitting right across from her. Pull up a chair and enjoy.

My DPC Story

Their DPC Stories

Physicians are increasingly looking to different practice models, as burnout rates continue to climb. This series explores the DPC model.

Support A Platform that Celebrates Real Doctors

For just $10 a month, you can help keep this openly accessible site available to all & help us sposnor in more doctors.

I acknowledge that this site is not to be used for medical advice.

Play Video
Our Founder Answers Your BURNING Question

SoMeDocs

“Why should I become a member of SoMeDocs if I already have my own space online?”