Experts advocate for expanded use of life-saving overdose medication naloxone
The Surgeon General has issued a public health advisory urging more Americans to carry naloxone, a drug that can reverse an opioid overdose. It is not the only solution to the opioid epidemic, but experts say keeping people alive is the first step.
To save the life of someone overdosing on an opioid—anything from heroin to fentanyl and oxycodone—all it takes is a quick, hard push of a plunger on a white plastic tube. Life-saving naloxone streams into an individual’s nostril, and if that does not revive an overdose victim, it is repeated in the other nostril.
The four milligrams of naloxone delivered by the plunger will almost immediately block the receptors in the brain from processing an opioid that is stopping a victim’s heart.
Kevin Donovan, an overdose prevention educator for a health agency in Syracuse, said naloxone—also known by its brand name, Narcan—saves people’s lives. Donovan said there is no downside, either.
“There’s no harm in administering Narcan to somebody,” Donovan said. “If it’s given by mistake, it’s not going to hurt somebody.”
Creating easier access to the drug is a no-brainer for drug abuse treatment experts, and that means getting it into the hands of everyday citizens, according to Donovan. He conducts training in Central New York for local business people, librarians, public park employees and anyone else who could come across someone overdosing. For him, the more people who carry the small naloxone kit, the better.
“The target population would be anybody who is at risk or knows somebody at risk, and outside of that, it could be anybody and anybody who is frequently around public places,” Donovan said. “Overdoses happen in public places, especially if there are public rest rooms and public places to sit down and relax. It can happen anywhere.”
Currently, naloxone is covered by most insurance plans. Depending on the state, it is available for free or at a reduced cost through public health agencies or programs, or through discounts by retailers or manufacturers. Anyone can get it without a prescription in 41 states, and all 50 states have some kind of naloxone access law.
"You're trapped in a cycle of misery, so I think a close scare with an overdose death can be a determining factor into giving someone that extra needed incentive to get into treatment and recovery," Donovan said.
This practice is nothing new, said Lon Fricano, a paramedic who used naloxone in New York City years ago and now runs an ambulance company in upstate New York. He said the difference these days is the potency of the drugs.
The introduction of fentanyl into batches of heroin a few years ago coincided with the explosion in the number of overdoses nationwide, according to Fricano. The notoriety of the overdose antidote has grown to meet this increase, with more police and emergency medical personnel keeping it on hand. Those in the addiction community also carry it.
“We know that people suffering from addiction get together, and someone will not use and have Narcan, while everybody else uses, to sort of watch over them in case somebody does overdose,” Fricano said.
Critics of naloxone suggest it encourages repeated drug use, but nothing could be further from the truth, according to Jeanna Murraffa of the Upstate New York Poison Center.
“When you get naloxone after you use heroin or whatever other opioid you’re using, that’s going to put you into withdrawal,” Murraffa said. “Withdrawal is uncomfortable and can be really painful for users.”
Murraffa emphasized the key to naloxone is that it can be a life-saver in an emergency.
“Community naloxone, though I think it will have a very important role, it should never, ever, ever, be used as an alternative to 911 and health care,” Murraffa said.
Once in an emergency room or other medical setting, that is when the real work of attacking the opioid crisis begins.
“Once they get brought to the hospital, we can manage some of their opioid withdrawal with some other things, as well as begin those discussions of their willingness and acceptance of perhaps rehab and recovery and things of those natures,” Murraffa said.
Donovan is a recovering addict, and he said sometimes it can take more than one overdose to spur an individual into rehab. However, he said the use of naloxone keeps hope alive for anyone fighting an insidious addiction.
“Your life is a roller coaster of misery and panic,” Donovan said. “It’s not about feeling high and partying and this sort of lifestyle. You’re trapped in a cycle of misery, so I think a close scare with an overdose death can be a determining factor into giving someone that extra needed incentive to get into treatment and recovery.”