Naloxone = Narcan
Naloxone, or Narcan, is an antidote for opioid overdoses. Naloxone reverses an overdose by kicking opioids off their receptors and deactivating them, allowing the brain to initiate breathing again.
Naloxone works against any type of opioid*, prescription or illicit. It does not work on other types of drugs, such as alcohol, cocaine, or benzodiazepines (Klonopin, Valium, Xanax, etc.). However, if someone has ingested an illicit substance laced with fentanyl, or if a person has taken other drugs in addition to opioids, naloxone will still act to reverse the effects of the opioids, allowing an overdose victim to resume breathing.
Naloxone is a very safe medication to give. If you have naloxone available and suspect that someone has overdosed on opioids, call 911 immediately and then administer the naloxone. It is extremely unlikely that you will cause any harm, and you may very well save that person’s life. In Rhode Island, you do not need a certification, medical license, or any other special permission to give naloxone to an overdose victim.
*Examples of opioids are: Heroin, Fentanyl, Morphine, Oxycodone, Hydrocodone, Codeine, Tramadol (Ultram), Methadone, Dextropropyxyphene (Darvocet), Meperidine (Demerol), Oxymorphone (Opana), and Hydromorphone (Dilaudid).
Types of Naloxone
Intramuscular Naloxone
All forms of naloxone are equally effective in reversing an overdose. PONI supplies two doses (1cc each) of intramuscular naloxone in the kits, free of charge.
Intramuscular naloxone is available at any pharmacy without a prescription. In Rhode Island, this type of naloxone is covered by all insurances, minus a copay, and is covered completely under Medicaid. Not all states have the same laws.
Narcan Nasal Spray
Another common type of naloxone is the one-step Narcan Nasal Spray. The administration device requires no assembly and is easy to use. Each Narcan kit comes with two (4 mg) doses of naloxone.
Narcan Nasal Spray kits are available at any pharmacy without a prescription. In Rhode Island, this type of naloxone is covered by most insurances minus a copay and is covered completely under Medicaid.
How to Administer Naloxone
0:15 How to administer Narcan Nasal Spray
2:02 How to administer Intramuscular Naloxone
Good Samaritan Law
In Rhode Island, the Good Samaritan Overdose Prevention Act of 2016 provides several legal protections for people who call 911 for suspected overdoses:
If a person reasonably believes someone is overdosing and administers naloxone to them, they will not be subject to any civil or criminal liability for that action.
If someone calls 911 for a suspected overdose victim, the law protects the caller from being prosecuted for drug possession or having their probation or parole violated as a result of drug possession.
The overdose victim themselves will also not be prosecuted or suffer probation or parole consequences for drug possession.
The Good Samaritan Law does not provide protection from all possible legal consequences—if someone has an active warrant, for example, they may still be arrested— but it addresses the most common reasons that people hesitate to seek and provide medical attention during an overdose emergency.
How Naloxone Works
TRANSCRIPT
People are dying every day from opioid overdose -- parents and children, friends and neighbors -- but naloxone can help. Naloxone is a safe and effective rescue medication that reverses the effects of opioids and saves lives. To understand how naloxone can stop and reverse the effects of an opioid overdose, it's helpful to see how opioids work in the body. Opioids are agonists. This means they bind to and activate specific receptors in the body including the brain, brainstem, and spinal cord. When these receptors are activated, people experience the effects produced by opioids such as pain relief, euphoria, calmness, relaxation, and slowed breathing.
Taking too many opioids causes so many receptors to fill and activate that breathing may become dangerously slow and even stop. This is how an opioid overdose happens and this is where naloxone can help. Naloxone has a strong affinity to opioid receptors -- more so than most prescription opioids and heroin, but, unlike opioids, naloxone is an antagonist. This means it attaches to opioid receptors without activating them, so when naloxone is administered during an overdose, it knocks the opioids responsible out of the way and allows breathing to normalize naloxone can be administered through an injection or a nasal spray. It usually starts working within a few minutes and lasts from 30 to 90 minutes. While one dose of naloxone can reverse an overdose sometimes, multiple doses are needed -- especially in cases involving extremely potent opioids like fentanyl or opioids that stay in the body longer than naloxone.
Naloxone is very safe. In single or multiple doses, it may produce withdrawal symptoms in people with opioid dependence, but it has no abuse potential and cannot cause an overdose. It's important to remember that naloxone is opioid specific it has no effect on an overdose caused solely by non-opioid substances like benzodiazepines or alcohol. At the same time, people shouldn't be afraid to use naloxone when the cause of an overdose is unknown. If opioids were not involved in an overdose, it won't cause any harm. If opioids were involved naloxone can save a life.