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Naloxone—A Potential Lifesaver

March 04, 2014

Combating the epidemic of opioid abuse—including prescription painkillers and, increasingly, heroin—requires a multi-pronged approach that involves reducing drug diversion, expanding delivery of existing treatments (including medication-assisted treatments), and development of new medications for pain that can augment our existing treatment arsenal. But another crucial component we must not forget is that people who abuse or are addicted to opioids need to be kept alive long enough that they can be treated successfully. In this, the drug naloxone has a large potential role to play.

Naloxone as packaged in a box for distribution© M intropin

Naloxone is an opioid antagonist—meaning that it binds to opioid receptors and can reverse or block the effects of other opioids. It can very quickly restore normal respiration to a person whose breathing has slowed or stopped as a result of abusing heroin or prescription opioids, or accidentally ingesting too much pain medication.  Naloxone is widely used by emergency medical personnel and other first responders for this purpose. Unfortunately, by the time a person having an overdose is reached and treated, it is often too late. To solve this problem,  several experimental overdose education and naloxone distribution (OEND) programs have issued naloxone directly to opioid users and their friends or loved ones, or other potential bystanders, along with brief training in how to use these emergency kits. Such programs have been shown to be an effective, as well as cost-effective, way of saving lives.

For example, a Massachusetts OEND program that began in 2006, during a growing overdose epidemic in that state, significantly reduced overdose deaths in the 19 communities that implemented it. As of 2010, the CDC reported that lay-distributed naloxone had prevented more than 10,000 overdose deaths nationwide since 1996. So far, 17 states have passed laws allowing for wider prescription of naloxone to those in a position to help prevent overdose fatalities. These laws help put the life-saving drug not only in the hands of family members and friends of opioid-addicted persons but also a wider array of emergency personnel, such as police and firefighters.

Naloxone is currently only FDA approved in an injectable formulation. To facilitate ease of use, many OEND programs use syringes fitted with an atomizer to enable the drug to be sprayed into the nose. NIDA and other agencies are working with the FDA and drug manufacturers to support the development of an intranasal formulation that would match the pharmacokinetics (i.e., how much and how rapidly the drug gets into the body) of the injectable version.

Over 15,500 Americans died from an overdose involving prescription painkillers in 2009—more than from all other drugs combined--and we are now seeing indicators of a rise in heroin overdose deaths as well. If we are to reverse these terrible trends, we need to do all we can to ensure that emergency personnel as well as at-risk opioid users and their loved ones have access to tools like naloxone that may save people’s lives in the event of overdose.

This page was last updated March 2014

Comments

Naloxone

My son would not be alive today if not for the 3rd party prescription of Naloxone. But we didn't learn about Naloxone during one of his several rehab attempts, even as other patients left rehab and immediately died from overdose. Instead, we discovered it much later through a harm reduction center. Naloxone needs to be readily available in treatment centers and jails and in the medicine cabinet of anyone who uses opiates of any kind.

More Research?

Is there more research coming with regard to naloxone? Why can't this drug be administered in time release form so addicts can't experience a high at all. This sounds like it could be another research path to follow for a true treatment...

There is actually another

There is actually another drug called naltrexone, which is also an opioid antagonist (i.e., blocks other opioids from attaching to receptors), and it is used as an addiction treatment in precisely the way you suggest. Originally it was only available as a pill that had to be taken daily, and patient noncompliance with the treatment was an issue. But in 2010 the FDA approved a long-lasting injectable form, called Vivitrol, which prevents an opioid high for weeks. It is one of the main medication-assisted treatments used to treat opioid addiction.

Recovery NO ONE EVER SAID IT WOULD BE EASY !

I am in a very miserable state of mind trying to battle my problems with on and off again addiction. I take full responsability for my actions and my addictions. As a young man I wanted to experince everything first hand no matter what the statictics say and behind the backs of my christian upbringing I became an functioning addict. Or so I thought I was functioning. Soon I found my life was in a terrible downward spiral. I have been to rehabs without feeling as if I really gained anything positive at all and very upset because I thought I was going to actually relate to people and learn how to function in society without my addiction cravings out weighing any other thoughts first. After rehab I went a step further and moved states away for any thing or any one from my past. There I was joined with other men battling there own addictions and actions. I was actually functioning and enjoying the support from my peers and family all of which was to be short lived. Once leaving the treatment facility I felt as if I deserved a new begining so I packed up moved to Florida to gain some quality time with my only sibling my sister which was not what I ever dreamed it would be. Soon I was once again bored with life and feeling pretty miserable that I had beat this addiction thing for not myself but my families positive attention. I was never truly happy I only found that feeling by pleasing and no longer did I have the support system so I did the only thing I knew to find comfort. So once again I was on the road to self destruction with what ever drugs were available 'my drug of choice being prescription medications'. This is a sum of how I found your web site today. Now in my early thirties I found comfort in a suboxone program which was what I felt saved my life. Now I am twelve thousand dollars in debt to the clinic and no money due to the outrageous cost of the perscripton. Today I am out of medication can not afford to see a doctor and I am feeling pretty lost with my research for help ending in point less time calling doctors offices only to be told what I already knew MONEY over recovery every time NO HELP for me who needs medical help to be a positive functioning man. I lived in Virginia and I would greatly appreciate any and all advice out there. I have no options left because my body is not strong enough to battle this alone and I DO NOT want to turn to street drugs. I actually felt alive again with suboxone but I never knew it would be at such a cost. HELP!!!

This web page has answers to

This web page has answers to frequently asked questions about availability of and coverage for Suboxone (buprenorphine) treatment, which varies from state to state, as well as links you to a locator that can help you find a licensed physician able to prescribe buprenorphine in your area. Depending on where you live, some clinics may provide buprenorphine treatment to people without insurance coverage.

Dan B. I hope I can help.

Dan. I went through a similar situation as you. Not sure if you tried inpatient rehab, which helped me most. Also getting yourself a sponsor and regularly attending meetings. Please email me if you need, coachrich40@yahoo.com I hope you can get help cause I know what it's like to call for help when it seems there is no one to hear you.

Trying to quit Suboxone

I'm currently on Suboxone for my back pain and trying to withdraw. The withdrawals are not pleasant. Suboxone helps my back pain but when I don't have it I'm in pain, I have low energy, and feeling nausea. I also feel pain in joints, my gums and teeth are very sensitive. I've been trying to quit for maybe 2 or 3 months. Recently I had a chance to quit when my lung doctor prescribed medicine for my COPD. But the ER won't even prescribe cough medicine to a Suboxone patient. I tried get off cold turkey, now I'm tapering down the dose. I'm finding a lot of people in the same boat like me and a lot of inspirational stories on how to get off Suboxone. I hope I'll manage to quit because it did more harm than good to me. God bless!

Grateful for Naloxone but Remember This

I'm an intractable pain patient (primary cause of pain is Artificial Disc Replacement Surgery that implanted two discs on a curvature of my spine). I have a great doctor, and over the years have been able to cut my medications way back, so that I'm taking only one - compounded liquid Fentanyl. However, my doctor also prescribes many needed hormones, to balance the hormonal/endocrine system, because doing so dramatically reduces pain too. The problem -- I can't read fine print without my reading glasses and the pharmacy put my liquid compounded Oxytocin (a liquid hormone) in the exact same container as the liquid Fentanyl. Also, the regular dose of Oxytocin is much, much higher than the dose of Fentanyl. I went to the refrigerator, saw the bottle of what I thought was the hormone, remembered I had missed my hormone doses for two days, and slammed a big gulp. I swallowed, and instantly realized I had just swallowed a lethal dose of Fentanyl. I called my family, who during the winter lives a block away. My sister-in-law came over immediately. The next thing I knew, I opened my eyes. I was in the back of an ambulance and looked into the sweetest face I've ever seen. As soon as I began talking, and the paramedic realized I wasn't going to have an aggressive or psychotic response to having the opiates slammed out of my system by the two doses of Naloxone he had administered to me, he undid my restraints. All I could do was thank him, over and over. I thanked him that he was so close when the 911 call came in; I thanked him that he carried Naloxone in his vehicle. I thanked him for saving my life. My doctor now supplies me with a readied dose of Naloxone but there is no reason that every family shouldn't have one or two doses ready to administer -- and the training to do that -- in the medicine cabinet in their home. But -- and this is critical to know -- if the person who overdosed ingested an usually large dose of a particular narcotic, or if the narcotic itself is particularly strong, the Naloxone can wear off before the drugs the person overdosed on wear off. Luckily, they kept me in the hospital for 12 hours. I was laying on a gurney, in the emergency room hallway. Almost four hours to the second from the last (successful) dose of Naloxone administered, I overdosed again (from the original ingestion of Fentanyl, not another one). I was talking, watching the clock, feeling fine but the second the Naloxone "wore off," the previously-ingested Fentanyl came back, full force. So, even if you have a "home remedy" for overdose, please seek proper medical care and if your life has been saved by Naloxone, watch that clock and be ready. You may well need a second dose in four hours, and possibly a third, another four hours after that. Life is so worth living. Take care of yourselves (and I never, ever deal with medications now without wearing my reading glasses).

Find Help Near You

The following website can help you find substance abuse or other mental health services in your area: www.samhsa.gov/Treatment. If you are in an emergency situation, people at this toll-free, 24-hour hotline can help you get through this difficult time: 1-800-273-TALK. Or click on: www.suicidepreventionlifeline.orgExternal link, please review our disclaimer.. We also have step by step guides on what to do to help yourself, a friend or a family member on our Treatment page.

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