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What is Narcan and how can it help?

Posted by mwvaddictionresource on January 31, 2016 at 12:40 AM

 

Submitted: Janice Spinney, RPhm

Narcan is the antidote to an overdose caused by opiates (narcotic prescription pain killers, opium or heroin).


Opiates like oxycodone, morphine, methadone ,fentanyl, hydrocodone, codeine and heroin can cause deceased respiratory rates or slow breathing.


When an increased dosage or unknown potency of these substances in ingested or injected it can cause someone to stop breathing, leading to cardiac arrest and death if breathing is not restored.


Without getting into to much detail, we can think about opiate drugs as an agonist — and Narcan as an antagonist.


When one takes opiates there is a direct effect on nerve cells in the brain, spinal cord and elsewhere in the body. The drug causes an action or acts as an agonist. Along with the drug's wanted effects, like pain relief and euphoria, opiates also have the unwanted side effect of depressing the nerves centers in the brain that control breathing. The greater the dose the larger the depressing effect on respiration.


Many things can influence whether or not a person will have a live-threatening overdose including: tolerance, dosage increase, smoking history, respiratory infections, mixing opiates and high purity of heroin and cutting of heroin with fentanyl.


Narcan or Naloxone (its generic or chemical name) is an opiate antagonist. It has an even stronger affinity or attraction to the same nerve cell sites or receptors that opiate drugs bind to. Narcan is so strong that it bumps the drug off the cell or receptor site and blocks the narcotic drug from its action. Breathing can return to normal after Narcan has had time to work and a person who may have been unconscious or passed out will eventually awaken. The effects are Narcan are very short acting so a person may pass out again and need another dose. It is imperative that someone call 911 at the first sign of an overdose to ensure that rescuers are in transit and can take over the care of a person who is unconscious.


There is some discussion that the widespread availability of Narcan is an enabler and that some will continue to use opiates because they know there is a safety net. At a press conference earlier this fall to roll out the state's "Any One Any Time" campaign Gov. Maggie Hassan said: "I understand that some health-care providers have expressed concern that making naloxone more widely available could send the wrong message to individuals misusing heroin and other opiates by giving them a false sense of security that they could be revived with the use of the drug. But with 326 confirmed drug overdose deaths in the state last year and with these numbers significantly rising again this year, naloxone will save lives and allow affected individuals an opportunity to get the help they need on their road to recovery. This is just one step of a comprehensive set of actions that we need to take to begin to reverse this terrible crisis."


There is a very important window of opportunity to offer help to someone who has recently overdosed and almost died. During the first 24 to 48 hours after an overdose, an individual is more likely to be open to discussing recovery options. This is a time of opportunity for family and treatment professionals to offer recovery options to an overdose survivor.


Narcan is now or will soon be available in communities through a number of access points or venues. Regional hospitals and community health centers are points of distribution for Narcan or Naloxone Nasal Kits though the New Hampshire "Any One Any Time" program (designed and implemented by the DHHS and Public Health Network). Community pharmacies may have Evzio, an auto injection currently available for sale by prescription, though it is very expensive and insurance coverage is spotty. Nasal Narcan Kits may or may not be available through your community pharmacy for sale as corporate chain drug outlets institute policies and training for pharmacist to dispense it. Kits will be less expensive than Evzio, and again, coverage under affordable care plans, commercial plans, Medicare or Medicaid is not certain.


Narcan kits can be obtained by attending a community training session where one is given training on how to recognize and respond to an overdose, give rescue breathing and administer nasal naloxone. People who complete the training and can show the trainer they are competent in the life saving steps and administration of nasal narcan/naloxone will be given kits to take home.


For more information or to find a training session close to you go to drugfreeNH.org/anyone-anytime.

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