The opioid crisis in the United States is a severe public health issue. In 2019, almost 50,000 lives were lost to opioid overdose, encompassing prescription pain relievers, heroin, and potent synthetic opioids like fentanyl. The economic impact of prescription opioid misuse is estimated to be a staggering $78.5 billion annually.¹ In this critical landscape, understanding tools like naloxone, commonly known by its brand name Narcan, becomes essential for everyone. Narcan is a life-saving medication capable of reversing opioid overdoses, offering a crucial window to save lives.
What is Narcan (Naloxone)?
Naloxone is classified as an opioid antagonist medication. This means it works specifically to counteract the effects of opioids in the body. Available in various forms, including an injectable solution and a more user-friendly nasal spray, Narcan is designed for rapid administration in emergency situations. It’s crucial to understand that Narcan is targeted at opioid overdoses and will not have any effect on overdoses caused by non-opioid drugs.²
The Mechanism of Action: How Narcan Reverses Opioid Overdose
To understand how Narcan works, it’s helpful to visualize opioid receptors in the brain. Opioids, when they enter the system, attach to these receptors, leading to effects like pain relief, euphoria, and unfortunately, in overdose situations, slowed or stopped breathing. Narcan’s effectiveness lies in its ability to compete with opioids at these very same receptor sites.
Think of brain cell receptors like uniquely shaped locks and opioid molecules as keys that fit into these locks. When an overdose occurs, too many “opioid keys” flood the brain, overwhelming the system and depressing vital functions like respiration. Narcan acts as a higher-affinity key. It has a stronger attraction to the opioid receptors than the opioid itself. When Narcan is administered, it essentially ‘kicks out’ the opioid molecules already attached to the receptors. By occupying these receptors, Narcan effectively blocks the opioids from further activating them.
This reversal is rapid, often occurring within minutes. The crucial point to remember is that Narcan’s effects are temporary. While it effectively blocks opioids and restores breathing, its action typically lasts for 30 to 90 minutes. Opioids, particularly long-acting ones, may remain in the body longer. As Narcan wears off, there’s a risk of the opioid effects returning, potentially leading to a relapse into overdose. This is why seeking immediate medical help after Narcan administration is absolutely vital.
Recognizing an Opioid Overdose: Key Signs to Watch For
Being able to recognize the signs of an opioid overdose is critical in an emergency situation. The signs can include:
- Slowed or shallow breathing, or even complete cessation of breathing.
- Pinpoint pupils – pupils that are very small and constricted.
- Loss of consciousness or unresponsiveness.
- Limp body.
- Choking or gurgling sounds, indicating airway obstruction.
- Pale, blue, and/or cold skin.
- Falling asleep or drowsiness.
If you observe these signs in someone and suspect an opioid overdose, immediate action is necessary.
What to Do in Case of an Opioid Overdose: Step-by-Step Guide
In the event of a suspected opioid overdose, follow these crucial steps:
- Administer Narcan: If Narcan is available, administer it immediately as directed by the product instructions. Nasal spray Narcan is designed for ease of use, even by individuals without medical training.
- Call 911: Even after administering Narcan and seeing improvement, it is imperative to call emergency services immediately. As mentioned earlier, the effects of Narcan are temporary, and the person is still at risk once it wears off. Medical professionals are equipped to provide ongoing support and monitoring.
- Keep the Person Awake and Talking: While waiting for emergency services, try to keep the person awake and responsive. Talking to them and encouraging them to stay alert can be helpful.
- Be Prepared for Additional Doses: Depending on the amount and type of opioid involved, and the individual’s response, multiple doses of Narcan might be necessary. Follow the instructions provided with the Narcan and relay information about doses given to emergency responders upon their arrival.
- Stay with the Person: Do not leave the person alone until professional medical help arrives and takes over.
Important Considerations and Safety Information
It’s important to reiterate that Narcan is only effective for opioid overdoses and will not reverse overdoses from other substances like benzodiazepines or alcohol. While Narcan is a remarkably safe medication, it can induce withdrawal symptoms in individuals who are opioid-dependent. These withdrawal symptoms, while uncomfortable, are not life-threatening. They may include symptoms such as nausea, vomiting, body aches, sweating, increased heart rate, and feelings of anxiety or agitation.
It’s also vital to address a common concern: fear of legal repercussions when calling for help during an overdose. Many areas have implemented Medical Amnesty or Good Samaritan laws. These laws are designed to encourage individuals to seek help in overdose situations without fear of legal consequences for drug possession or use, for either the person overdosing or the person seeking help. The priority is always saving a life.
Conclusion
Understanding how Narcan works and recognizing its importance is a critical step in combating the opioid crisis. Narcan is a powerful tool that can reverse opioid overdoses by temporarily blocking the effects of opioids in the brain. Its ease of use, particularly in nasal spray form, makes it accessible for individuals to use in emergency situations. However, it is crucial to remember that Narcan is a temporary measure, and calling 911 is an essential step to ensure the individual receives comprehensive medical care. By increasing awareness and access to Narcan, and understanding its mechanism, we can empower individuals to save lives within their communities.
¹ Opioid overdose crisis. National Institute on Drug Abuse. Updated March 11, 2021. Accessed May 23, 2021. https://www.drugabuse.gov/drug-topics/opioids/opioid-overdose-crisis
² Naloxone. National Institute on Drug Abuse. Updated September 2019. Accessed May 23, 2021. https://www.drugabuse.gov/publications/drugfacts/naloxone
