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| Naloxone Stops Opioid Overdoses. How Do You Use It? | Naloxone Stops Opioid Overdoses. How Do You Use It? |
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| The United States surgeon general issued a rare national advisory on Thursday urging more Americans to carry naloxone, a drug used to revive people overdosing on opioids. | |
| The last time a s urgeon general issued such an urgent warning to the country was in 2005, when Richard H. Carmona advised women not to drink alcohol when pregnant. | |
| 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. | 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. |
| “Active drug users, people who live with or love drug users, and people on methadone or buprenorphine, who are often coming out of treatment and know people at high risk of overdose,” said Robert Childs, executive director of the North Carolina Harm Reduction Coalition in Wilmington, N.C. The surgeon general also listed patients who take high doses of prescribed opioids. | |
| People who are coming out of prison or detox programs should carry the drug, because detox lowers tolerance, Mr. Childs said. Those who work in places where there are public bathrooms or where drug users congregate, such as shopping center parking lots, should consider getting trained to use naloxone and keep it on hand. | |
| “It should be just like carrying a first aid kit,” Mr. Childs said. | |
| Experts at the American Addiction Centers say the signs of an overdose include pinpoint pupils, confusion, vomiting, trouble waking up, breathing problems, and cold or clammy skin. | Experts at the American Addiction Centers say the signs of an overdose include pinpoint pupils, confusion, vomiting, trouble waking up, breathing problems, and cold or clammy skin. |
| If you think someone is overdosing, call 9-1-1. If the person seems unresponsive, you first can shout, then shake them, then rap your knuckles on their chest. Check to see if they are breathing. If someone is awake, look at their eyes. “Mostly you see the iris, just a tiny black spot in the middle,” said Dr. Steven Daviss, senior medical adviser at the Substance Abuse and Mental Health Services Administration, which is part of the U.S. Department of Health and Human Services. “That’s a pretty good sign someone has overdosed on an opioid.” | If you think someone is overdosing, call 9-1-1. If the person seems unresponsive, you first can shout, then shake them, then rap your knuckles on their chest. Check to see if they are breathing. If someone is awake, look at their eyes. “Mostly you see the iris, just a tiny black spot in the middle,” said Dr. Steven Daviss, senior medical adviser at the Substance Abuse and Mental Health Services Administration, which is part of the U.S. Department of Health and Human Services. “That’s a pretty good sign someone has overdosed on an opioid.” |
| Naloxone comes in different forms. | Naloxone comes in different forms. |
| If you are using the nasal spray version, sold under the brand name Narcan, you tilt the patient’s head back and spray it into the patient’s nose. Another type of naloxone is injectable, and comes with vials of the drug and syringes or needles to fill and inject into the patient’s thigh. Sometimes the syringes are pre-filled. | If you are using the nasal spray version, sold under the brand name Narcan, you tilt the patient’s head back and spray it into the patient’s nose. Another type of naloxone is injectable, and comes with vials of the drug and syringes or needles to fill and inject into the patient’s thigh. Sometimes the syringes are pre-filled. |
| “It can take about a minute or so for it to work,” said Dr. Daviss. “If it hasn’t worked within two minutes, the recommendation is usually to take a second dose, which is why it is a two-pack.” | “It can take about a minute or so for it to work,” said Dr. Daviss. “If it hasn’t worked within two minutes, the recommendation is usually to take a second dose, which is why it is a two-pack.” |
| Some people who have overdosed on more powerful drugs like fentanyl need multiple doses. | Some people who have overdosed on more powerful drugs like fentanyl need multiple doses. |
| If the person is not breathing, or if their breathing is shallow, perform rescue breathing. If nothing has changed and there is no pulse, the person needs CPR from a trained bystander and emergency medical care. | If the person is not breathing, or if their breathing is shallow, perform rescue breathing. If nothing has changed and there is no pulse, the person needs CPR from a trained bystander and emergency medical care. |
| You can get naloxone at your local pharmacy. Some states allow you to purchase it over the counter at stores like CVS and Walgreens, but others require a prescription. And some community groups, local health departments and needle exchanges distribute low-cost or free naloxone kits, which come with gloves, face masks and instructions. | |
| Many emergency workers and medical personnel carry naloxone as well. | |
| Accessing Care| Treatment Locator | |
| It depends. The type of naloxone you can get often differs by state, pharmacy and what insurance you have. Many insurances cover naloxone, so you can ask to see what your share of the cost would be. Some public health programs also offer ways for people to get it for free or at a low cost, as do naloxone’s manufacturers in some cases. | It depends. The type of naloxone you can get often differs by state, pharmacy and what insurance you have. Many insurances cover naloxone, so you can ask to see what your share of the cost would be. Some public health programs also offer ways for people to get it for free or at a low cost, as do naloxone’s manufacturers in some cases. |
| “There is wide variation in the cost of naloxone,” said Kemp Chester, associate director at the Office of National Drug Control Policy at the White House. “It can be as cheap as $35 and as expensive as $100 plus.” | “There is wide variation in the cost of naloxone,” said Kemp Chester, associate director at the Office of National Drug Control Policy at the White House. “It can be as cheap as $35 and as expensive as $100 plus.” |
| No. Naloxone is not addictive. It does force people into opioid withdrawal, so the patient may be extremely uncomfortable and react aggressively. | No. Naloxone is not addictive. It does force people into opioid withdrawal, so the patient may be extremely uncomfortable and react aggressively. |
| But if you give it to someone and it turns out they are not overdosing, don’t worry. “It is not harmful to give it to someone who is not undergoing an overdose,” said Mr. Chester. | But if you give it to someone and it turns out they are not overdosing, don’t worry. “It is not harmful to give it to someone who is not undergoing an overdose,” said Mr. Chester. |
| Naloxone only works for overdoses from opioids, not overdoses from other types of drugs. | Naloxone only works for overdoses from opioids, not overdoses from other types of drugs. |
| Naloxone can save someone’s life during an overdose, but it is not a cure for opioid addiction. Dr. Daviss said that a number of people who go to an emergency room after an overdose will die from a second, third or fourth overdose within a year. “You’ve got to hook them up into treatment,” he said. “Medication-assisted treatment is the way to go.” | Naloxone can save someone’s life during an overdose, but it is not a cure for opioid addiction. Dr. Daviss said that a number of people who go to an emergency room after an overdose will die from a second, third or fourth overdose within a year. “You’ve got to hook them up into treatment,” he said. “Medication-assisted treatment is the way to go.” |