Naloxone Hydrochloride, sold as Naloxone or Narcan, is the most popular opioid inhibitor drug in the world. Today, the United States is in the midst of an opioid epidemic, with an estimated 70,000 opioid-related deaths each year. Some 10.3 million people abuse opioids including prescription pain pills and illicit street drugs like heroin, and Naloxone is the medication used at the front line to prevent overdose, reduce addiction, and help people to return to their normal lives.
Naloxone was first patented in 1961 and is now available freely or at low cost via brands like Narcan. If you or a loved one is struggling with an opioid use disorder, acquiring and learning how to use Naloxone in an emergency could save a life. Most clinics and pharmacies will offer the drug for a relatively low cost, making it accessible to nearly everyone.
What is Naloxone?
Naloxone is a pure opioid antagonist. The drug binds with the opioid receptors in the brain, preventing opioids from binding to them. This is useful in preventing or reducing an opioid overdose or an alcohol-opioid overdose because it can reduce respiratory depression and mental depression. The drug is also used in maintenance therapy during drug addiction treatment.
Drug Overdose Prevention – Naloxone binds with opioids and opioid receptors, preventing their binding together. An individual suffering from an overdose has taken too much of an opioid drug. Naloxone can force some or all of the drug to un-bind, pulling the individual out of overdose. This means that when someone takes naloxone during an overdose, the drugs in the brain cease to work. In most cases, this is sufficient to successfully stop the overdose within 2-5 minutes. If individuals do not pull out of the overdose after 5 minutes, the official advice is to administer a second dose. The CDC reports that Naloxone reversed over 10,000 overdoses between 1996 and 2010, with both professional and amateur administration.
Medication-Assisted Treatment – Naloxone is also used as a preventive measure during drug addiction treatment. Individuals in drug addiction treatment are sometimes given Naloxone as part of maintenance therapy, typically in combination with Methadone. Here, Naloxone simply prevents any opioids from affecting the body, although it can cause intense discomfort and withdrawal effects for individuals who use opioids while on the maintenance therapy. These withdrawal effects can include cold and flu symptoms, seizures, and spasms. For this reason, most medication assisted treatment is started after the individual has undergone significant rehab treatment including psychotherapy such as cognitive behavioral therapy or dialectical behavioral therapy.
The drug is approved by the FDA in all its forms (injection, nasal spray, tablet, patch), and is typically available without a prescription.
Is Naloxone Safe?
Most medications used to treat drug addictions are considered controversial. With phrases like, “Treating a drug addiction with a drug”, many people get the wrong idea about what drugs like Naloxone are and do. Most of the people who claim that using a drug to get off another drug would not complain if given a crutch or pain medication after breaking a leg. But, Naloxone frequently functions like that crutch, offering individuals the support needed to survive long enough to build up the tools to actually recover.
The World Health Organization lists Naloxone as the safest and most effective drug for treating opioid overdose.
Naloxone Side Effects
Naloxone is a drug, and like any drug, will have side effects. These typically include:
- Pain or burning at injection site
- Hot flashes
- Heart irregularities
- Sudden onset withdrawal
- Slight chance of allergies
Is Naloxone Addictive – No. However, long-term users will build up a slight chemical tolerance to the drug. This means that more is needed to achieve the same results. With no addiction profile, Naloxone is a safe drug to be administered long-term as part of a maintenance program.
Overdose Risk – You cannot overdose on Naloxone. However, you may overdose on buprenorphine, a Naloxone and Methadone mixture sold for maintenance therapy.
What is Narcan?
Narcan is a popular brand offering Naloxone. The brand was first approved by the FDA in 2015 and has since become one of the leading providers of Naloxone in the country. Their products include an intramuscular injection, which works after 20-30 minutes, a patch for maintenance therapy, and a nasal spray. Narcan often works to make their products available for free or for a low cost via their website.
Naloxone in Buprenorphine
Naloxone is incredibly popular for maintenance therapy, because it works to actively block the effects of opioids when added to another drug. Suboxone, a combination of Buprenorphine and Naloxone, is one of the most widely used MAT drugs. Buprenorphine is the partial opioid agonist that binds to opioid receptor sites and provides relief from withdrawal. The Buprenorphine reduces cravings and removes withdrawal symptoms, while the Naloxone element ensures that the individual cannot abuse opioids.
In some cases, Naloxone is administered as maintenance therapy on its own. However, this is rare, because Naloxone does not reduce withdrawal symptoms or cravings. However, it does cause massive withdrawal symptoms in individuals who use despite being on Naloxone, which can be dangerous for the patient. For this reason, most Naloxone maintenance therapy includes Suboxone or Methadone treatment.
Naloxone is most readily available as Narcan or EVZIO. Both of these drugs are distributed widely at pharmacies, doctor’s offices, shelters, and organizations established to prevent and assist with substance use disorders.
Administration heavily depends on the option:
Intramuscular Injection – Read the package instructions for the brand. Inject into the fleshy part of the arm or hip, being sure to inject into a large muscle. Naloxone takes effect after 5-30 minutes.
Nasal Spray – Read package instructions for the brand. Insert spray nozzle into nostril and hold down. Naloxone takes effect after 2-5 minutes.
Naloxone is safe, affordable, and often available to individuals who are concerned that a friend or loved one may suffer an overdose. Talk to your doctor or pharmacist for more information. Maintenance therapy is only available via a prescription.
If you or a loved one is struggling with opioid use disorder, it’s important to seek help. Naloxone can reverse an overdose, but only real therapy and assistance can help an individual overcome the mental and behavioral aspects of addiction to truly recover and get their life back.