Using NARCAN (Naloxone) to Save a Loved One from an Opioid Overdose

What is NARCAN & how do you use it?

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What is NARCAN®?

NARCAN® (naloxone) is a prescription drug that reverses the potentially lethal effects of an Opioid overdose. In many cases, the overwhelming effects on the heart rate and breathing are behind the high mortality rates for Opiate abusers.

When a large amount of an Opiate enters the bloodstream, breathing and heart rate slow significantly, creating a coma-like state that can be nearly impossible to reverse without medical attention or Narcan. Individuals in this state are not easily aroused, leading to an eventual cessation of breathing or heartbeat and potential death.

Narcan immediately counteracts the consequences of an Opiate overdose by displacing the molecules attached to the Opioid receptors in the brain to instantly ameliorate symptoms. By the time Narcan wears off, most user will have processed enough of the Opiate in their system that they no longer are at risk.

Narcan is generally available in one of two forms: an intramuscular injection or a nasal spray. Availability may be limited to one variety or the other based on state laws, source, and more. If Narcan Nasal Spray is not available, a Narcan intramuscular injection shot is an alternative. Albeit the Narcan shot is more challenging to administer but it can be handled by a non-medical professional if necessary.

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Narcan Nasal Spray & Narcan Injection

How Do You Administer Narcan?

If you are in the presence of a Heroin addict and you feel that they are experiencing with what appears to be a Heroin overdose, immediate action is imperative. However, many people do not know how to properly administer a Narcan dose. In order to increase the odds of survival, understanding how to prepare and administer a dose of Narcan to the Heroin addict is critically important.

The NARCAN® (naloxone HCl) Nasal Spray is fast and easy, providing an application that virtually anyone can master in a matter of seconds. By pushing up on the applicator, a concentrated dose of Narcan can be sprayed directly into either nostril, quickly entering the brain. If Narcan Nasal Spray is not available, a Narcan shot is an alternative. An intramuscular injection is more challenging than spraying a substance into the nostrils but can be handled by non-medical professionals if necessary.

As for administering a Narcan injection, you’ll  first need a syringe and an intramuscular needle, sometimes available within the Narcan package, otherwise available at most pharmacies over the counter. Remove the orange top of the Narcan vial and draw up approximately 1 cc of Narcan. Proceed by attaching the needle to the syringe and insert the needle with force, straight down into a muscle area on the body, like the thigh, buttock, or shoulder. Do not be afraid to cause pain; saving someone from a Heroin overdose is more important than post-injection tenderness.

Quick Stats:

The CDC reported that from 2014 to 2015 Heroin overdoses increased by 20.6 %

Does Narcan Only Work for Opioid Overdoses?

Narcan does not reverse the effect of any other types of drugs, it only counteracts the effects of Opioids such as Heroin, Methadone, Morphine, Opium, Codeine, or Hydrocodone. However, if the addict has stopped breathing, it wouldn’t harm them to give them a dose of Narcan. Some overdoses occur when addicts mix Opiates with other drugs.

Despite the pleasurable side effects of Opiates, continued abuse can take a serious toll on overall health. As tolerance builds with chronic, prolonged use, many Opioid abusers compensate by ingesting larger doses increasing the likelihood of an overdose.

Is Narcan used only for Opioid overdoses?

Historically, there has been no easy way to treat an Opiate overdose. In some cases, a hastily-placed call to 9-1-1 can provide medical attention in enough time to reverse the effects of an excessive dose of Opiates, but this is often impossible for users who are alone or among others who do not realize the gravity of the situation.

The release of Narcan in the midst of an overdose, however, has changed the face of an Opiate overdose by stopping an overdose in its tracks, significantly reducing the risk of fatality.

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How Do You Know When to Give Narcan?

Differentiating between extreme intoxication and an Opioid overdose can be challenging even for seasoned drug users, putting addicted people and heavy substance abusers at serious risk. If the distinction is not immediately clear, it’s best to treat a situation like an overdose; with drug abuse & addiction, it’s always better to be safe than sorry.

The main differentiating feature between intoxication and overdose is a response to a stimulus. A seriously intoxicated individual will still respond to light, noise, or touch, but someone experiencing an overdose will not be able to respond in any way.

Signs of an Opioid Overdose

  • Loss of consciousness
  • An inability to respond to outside stimulus
  • An inability to talk or communicate
  • Slow, shallow, or erratic breathing
  • Bluish purple or gray and ashen skin tone
  • Choking or gurgling sounds
  • Limpness and an inability to move
  • Blue, purple, or black lips and fingernails
  • Slow, erratic, or nonexistent pulse

Heroin Overdose - When do I administer Narcan?

It is important to note that death from an Opiate overdose is typically not instant, providing an opportunity to save a life if action is taken in time. With access to Narcan injections and Narcan nasal spray, it is possible to reverse the effects of an Opioid overdose.

Quick Stats:

According to the CDC, 13,000 people died from Heroin overdose in 2015.

Selecting Narcan Doses

Calculating Narcan dosage amounts is generally not a requirement when administering it and there are no specific dosage guidelines for each individual Opiate, like Heroin. Instead, Narcan is sold in standard amounts to make providing the right amount quick and simple, even for those without medical training.

Each Narcan Nasal Spray provides approximately one single concentrated dose of 1cc or .4 mg, the suggested amount for initial application. This is approximately the same amount that should be drawn up with a syringe when providing an injection.

Upon providing a dose of Narcan, people must be monitored for pulse and breathing. If symptoms do not improve, or improve and then worsen again, it is okay to continue to provide as many dosages as necessary to ensure a stabilized state. Closely observe condition and if there is no improvement within two to three minutes, proceed with subsequent doses.

In general, Narcan only lasts 30 to 90 minutes. For most users, this amount of time is adequate to secure medical attention or for effects of Opiates to wear off, but this may not be true for everyone. If symptoms wear off and overdose signs worsen again, additional doses can be provided.

Evaluating Narcan Usage

If you believe someone is experiencing an Opiate overdose, it is always better to administer Narcan than to watch and wait. Due to the chemical composition of Narcan, it will have no negative consequences on those not overdosing; in fact, sober individuals, if given Narcan, will have no response whatsoever.

As such, if you believe an acquaintance, friend, or loved one is suffering from an overdose or is dangerously high to the point that an overdose may be forthcoming, provide access to Narcan as soon as possible. A single dose can be the difference between life and death.

Using Narcan for Heroin Overdose

It is very important for users to understand that Narcan is not a substitute for medical care. Upon providing Narcan, be sure to call 9-1-1 immediately.

Can You Overdose on Narcan?

Simply put, it is not possible to overdose on Narcan. In fact, Narcan has absolutely no effect on users who are not experiencing an Opiate overdose as there are no changes to Opioid receptors in the brain to overcome. Narcan is completely safe for use and can only help an individual experiencing overdose. Narcan will also provide no intoxicating side effects, protecting against a risk of exacerbated symptoms.

What are the Common Side Effects of Narcan?

There are few side effects of Narcan if taken outside of the drug’s intended use. The most common side effects of Narcan are Opioid withdrawal, as Narcan essentially negates the pleasurable sensations most users crave. These side effects can include sweating, irritability, nausea and vomiting, and a runny nose.

There is no way to build a tolerance to Narcan, and multiple doses cannot make this Opioid antidote any less effective.

How Do I Get Narcan?

As a partially-regulated substance, Narcan may require a doctor’s script to obtain. This is true for both nasal spray and injectable varieties. However, due to the minimal risks and ease of use, many doctors have pushed to see Narcan sold behind the counter or over the counter in order to provide lifesaving access for those in need. In response to this, many states are now deregulating Narcan.

Starting in early 2016, pharmacy giant Walgreens launched a pilot program to dispense Narcan without a prescription in 35 states and Washington, DC. In states with participating stores, users can purchase Narcan without a prescription over the counter in any quantity.

Naloxone/Narcan for Opioid Overdose

Rival pharmacy CVS adopted this policy in 2016 as well, working to provide Narcan to as many individuals as possible. In an effort to expand these policies, many legislators are working to reduce regulation on Narcan in the 15 non-participating states.

Opiate overdose is no joking matter. With a rise in overdose rates from coast to coast, more drug users than ever before are at an ongoing risk of loss of life. However, Narcan is changing the status quo, providing a new and highly effective way to halt the dangerous consequences of an overdose before it’s too late. If your friends or loved ones are trapped in an addiction to heroin or prescription painkillers, Narcan may quite literally be the difference between life and death, providing hope to millions nationwide.

Quick Stats:

In 2014, about 2 million Americans abused or were addicted to prescription opioids.

What Are Opiates?

In pharmacological vernacular, the term Opiate refers to any substance derived from Opium. With a history dating back thousands of years, these potent drugs have contributed addiction, abuse, and overdose across virtually every country in the world.

Opiates are popular for numerous reasons, most notably for their influence on the body and the brain. When consumed, Opiates activate and attach to Opioid receptor proteins, inhibiting the brain’s pain signals and eliminating the consequences of painful stimuli. Opioid receptors are found on nerve cells throughout the brain, gastrointestinal tract, and spinal cord.

What are Opiates?

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Opiates work quickly once ingested, reducing pain and providing a light, blissful feeling that users describe as highly pleasurable. This feeling is due to a rapid release of dopamine, a neurotransmitter associated with the reward center of the brain. Many users find this sensation so pleasing that they continue taking Opiates to perpetuate the enjoyable effects.

However, this euphoria isn’t purely psychological. Due to the flood of dopamine triggered by taking Opiates, natural levels of dopamine fail to register appropriately within the brain, causing feelings of apathy, lethargy, depression, and anxiety. To overcome this, users continue to use Opiates in larger and larger doses. Over time, tolerance begins to build as well, forcing users to take more drugs to achieve the same results and there you have it, an Opiate addiction that requires rehabilitation.

Opiates in the United States

Despite the propensity for addiction, Opiate painkillers are among the most commonly prescribed drugs on the market. In fact, one in five clients in an office setting not seen for cancer-related pain or pain-related diagnoses is given a script for pain meds, creating a booming market that puts millions at risk.

As such, Opiates are extremely popular and very easy to acquire. Unlike many dangerous drugs, like Cocaine and Methamphetamine, many Opiates come directly from a doctor and are thus perceived as safe and normal. Drugs like Codeine, Fentanyl, Hydrocodone, Methadone, and Hydromorphone, for example, are commonly prescribed both in the hospital and in outpatient settings.

For habitual Opioid drug users, the threat of an overdose is always looming. The potential for seizures, coma or death is certainly frightening, but most Opiate users are in too deep to realize or even care about the true risks they face. Tragically, over 30,000 Opiate drug abusers in the U.S. die of an overdose each year, creating a devastating reality for friends, family members, and loved ones.

With an estimated 2.1 million Americans facing an addiction that requires rehabilitation for Prescription Painkillers and an additional 500,000 addicted to Heroin, the Opiate epidemic in the United States is destroying lives, one overdose at a time. The increase in Heroin overdoses in states like Ohio, Kentucky, West Virginia, and more is startling – in fact, Heroin-related deaths have quadrupled since 2010, according to the CDC – but the reality is indisputable: Opiates are killing more people at a faster rate than ever before.

But what if there was a way to make a difference? With Narcan, there is now a system in place to control Opiate overdose before it turns fatal, giving those fighting addictions a second chance at life.