What do firefighters, librarians, baristas and bartenders have in common? Not only do they all serve the public in their own way, they might also be carrying naloxone, an opiate overdose antidote drug also known as the nasal spray Narcan®.
Naloxone is a medication designed to immediately reverse an opioid overdose. It blocks the brain’s opioid receptors and restores normal breathing in people who have overdosed on fentanyl, heroin or prescription painkillers. Its effects last for 30 to 90 minutes, which ideally buys enough time to get medical attention.
According to the U.S. Centers for Disease Control and Prevention (CDC), deaths caused by opioid overdose rose by 80 percent between 2012 and 2016. While the rate of naloxone administration by emergency medical providers increased more than 75 percent during the same period, not everyone who experiences an overdose reaches a medical provider in time.
Those who spend time with opioid users — whether patients using opioids for pain management, or friends or family members, or people in areas frequented by people who use injectable opioids — may find themselves in a position to save a life.
Who should carry naloxone?
While the drug that counteracts the life-threatening effects of an opioid overdose was originally developed for first responders, those with no medical training can also administer it when needed.
“Carrying naloxone is recommended for all individuals exposed to opioids,” says Rashida Taqui, a pharmacist with Sharp Rees-Stealy. “It can help save the life of your loved one or just a life in general.”
Taqui says the list of who should carry the drug includes, but is certainly not limited to, the following:
- Patients on high doses of opioids for chronic pain
- Individuals misusing prescription opioids
- Illicit opioid users
- Those on methadone or buprenorphine for opioid use disorder
- Those with concurrent alcohol or benzodiazepine use
- Individuals living in remote areas
- Firefighters, EMTs, health care professionals, community members, friends and family in a position to help someone at risk of overdose
Naloxone is a prescription medication. Californians can purchase naloxone directly from a participating local pharmacist who has completed certified training. Sharp Rees-Stealy Pharmacies are certified to dispense naloxone. Those purchasing naloxone must also complete a screening questionnaire and receive brief in-store training on its use before it is dispensed.
In California, a law signed by Governor Jerry Brown permits individuals to possess and administer naloxone in an emergency. It also protects them from civil or criminal prosecution for administering naloxone to save a life.
Side effects of naloxone
Serious adverse effects are rare with the use of naloxone. However, some common side effects related to its use include the following:
- Acute opioid withdrawal
- Body aches and weakness
- Agitation and irritability
- Abdominal cramping and diarrhea
- Hypertension and increased heart rate
- Sweating and fever
- Nausea and vomiting
“The benefits of administering naloxone greatly outweigh any potential complications associated with opioid overdose, including death,” Taqui says. “However, it is crucial that a bystander or the person administering the drug calls 911 after the first dose.”
Taqui goes on to recommend the following additional steps to take after administering naloxone:
- Give a second dose after two to three minutes if the patient is unresponsive or has relapsed into slow and ineffective breathing.
- Watch for common withdrawal symptoms, such as shivering, sweating, hypertension, palpitation, nervousness, muscle pain and abdominal cramping.
- Continue to monitor breathing until the individual breathes independently or an EMT arrives.
- Position patient on their side to prevent aspiration.
- Refill the naloxone prescription as soon as possible after use.
If you, a loved one or the people you come into contact with on a daily basis are opioid users, talk to your primary care provider or pharmacist about the benefits of carrying naloxone.
Learn more about individually tailored approaches to treating drug and alcohol abuse for children, teens, adults and seniors offered by Sharp McDonald Center, the only medically supervised chemical dependency hospital in San Diego.