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Naloxone: The Drug to Have in Case of an Opioid Overdose

Naloxone is easier to get now, due to the opioid addiction epidemic


The opioid crisis has reached epidemic proportions in the U.S. More than 130 people die every day from overdose, according to the National Institute on Drug Abuse.

Older adults who hear these statistics, especially if they consider themselves to have “good” families, may think they are invulnerable to it. They might think opioid abuse is mostly caused by heroin addicts living on the street. Yet, many of those dying are, or will be, your neighbors, friends, co-workers, adult children or others you truly care about.

Many older adults don’t realize that the common pain medications they’ve been prescribed can put them at risk for addiction. Also, their kids and grandkids could be in the highest risk age range for overdose: 27 to 54.

It’s been common practice for two decades for physicians to prescribe strong opioids for pain due to injury, surgery, illness or other conditions. Patients and families often assumed opioids were harmless, so the drugs became ubiquitous, with many homes storing unused pills for potential future use.

In other words, every generation, including boomers and those who are older, needs to understand opioids and addiction as well as how to protect those in their family who take prescription pain medications, especially for chronic pain.

The downward slide of addiction is very difficult to stop, and it knows no age, gender or socio-economic boundaries.

One tool now available to people who have loved ones with an opioid addiction is naloxone, a medication that quickly reverses the effects of an overdose, allowing the person to breathe again.

This drug, available as brand names Narcan and Evzio, has saved many lives: At least 26,500 opioid overdoses in the U.S. were reversed by laypeople using naloxone from 1996 to 2014, according to MedlinePlus, a service of the National Library of Medicine, which is part of the National Institutes of Health.

Before learning more about naloxone, it’s important to understand opioid addiction and how it can happen to anyone.

How Opioid Addiction Happens

Half of opioid addicts and 80% of heroin addicts begin using opioids quite innocently, as prescriptions for pain from surgery, injury, arthritis, back or joint issues or other conditions.

These prescription medications include such common brand names as Demerol, Percocet, Oxycontin, Vicodin and Dilaudid. They are generally safe for short-term use, allowing patients to make it through post-surgery pain or a temporary condition. Problems occur with long-term use, even if prescribed by a doctor, because the drugs begin to “rewire” the brain.

This rewiring starts because opioids block the transmission of pain signals in the brain and attach to its reward centers, releasing large amounts of dopamine throughout the body.

So, in addition to pain reduction, the person taking an opioid medication feels a “high,” and that pleasurable feeling handles any unrelieved residual pain.

As with many substances, however, the brain develops increasing levels of tolerance the longer the person takes it. So, stronger pain killers or higher doses are required to get the same effect.

Also, the brain starts to interpret the “high” feeling as normal. Anything less than that gets interpreted as pain. This can easily lead to dependency and eventual addiction, with intense cravings and a singular focus on getting more of the drug or a stronger drug — like heroin, a dangerous and powerful illegal opioid that is immediately addicting.

The downward slide of addiction is very difficult to stop, and it knows no age, gender or socio-economic boundaries.

Getting “sober” is extremely difficult, and families often spend thousands of dollars and endless hours of worry and effort trying to help their loved ones. The withdrawal symptoms are intensely painful and, in general, impossible to get through without professional supervision and treatment.

An opioid overdose is basically suffocation. The person stops breathing and the usual efforts to restart breathing will not work.

Even for those who succeed, relapse rates are high, especially if they go back to the same environment, friends and triggers that enabled addiction in the first place. As with alcoholism, it takes concerted determination and a support network to overcome the cravings. Unfortunately, sometimes even that is not enough.

Why People Overdose

Opioid overdose is most often accidental, and can happen in a number of ways. For instance:

  • The person developed tolerance and tried a higher dose, not realizing the new dose was too high.
  • The person took an opioid while also using a benzodiazepine medication, such as Xanax, Valium or Ativan. These drugs, taken for anxiety, alcohol withdrawal, seizures and other conditions, also affect the central nervous system and when used with an opioid create a multiplying effect. Even taking a normal dose of opioid pain medication while taking benzodiazepines can be catastrophic.
  • The person took opioids laced with other drugs, such as fentanyl — a legally prescribed synthetic opioid for extreme pain, but which is also sold on the street and is 50 to 100 times stronger than morphine.
  • The person went through rehab and got sober but later succumbed to cravings and took the same amount of opioid as in the past. Because his or her brain no longer had the tolerance built up, that amount causes an overdose.

Regardless of how it happens, an opioid overdose is basically suffocation. The person stops breathing and the usual efforts to restart breathing will not work. What does work is naloxone.

How Naloxone Works

Naloxone is a drug that literally removes the opioids from brain receptors and allows the person to breathe in order to be transported to a hospital. There are several forms. The injectable form is used by paramedics and medical personnel. Evzio is an auto-inject form also commonly used by first-responders and emergency room doctors. Narcan is a nasal spray designed for easy use by laypeople.

In 2018, the U.S. Surgeon General issued the first national advisory since 2005, telling family and friends of people dependent on, or addicted to, opioids to carry Narcan in case of an overdose.

How to Get Naloxone, and Its Cost

In many states, you can get Narcan from a pharmacy without a doctor’s prescription. In others, it must be prescribed by a doctor. Some states have “standing order” laws that let doctors write a non-patient-specific prescription to facilitate wider availability of naloxone to families.

To learn about laws regarding naloxone in your state, go to the Prescription Drug Abuse Policy System or the National Association of State Alcohol and Drug Abuse Directors (NASADAD) website.

The NASADAD website also includes information on which states passed Good Samaritan laws, protecting people from lawsuits if they assist a person who has overdosed. Another good resource for information about naloxone is the Prevent & Protect website.

The cost of naloxone varies, depending on insurance plans and whether you’re buying the generic drug or the brand. Medicare Part D covers Narcan, according to Medicare.org.

Depending on the pharmacy, Narcan costs about $130 for a kit with two doses. The Food and Drug Administration approved a generic form of the nasal spray in April 2019, but it isn’t clear when it will be on the market.

By Amy Florian
Amy Florian is an educator, author, public speaker, and Founder/CEO of Corgenius, the first professional training firm to focus on life transition support. With a style that combines grace, good-natured humor and rock solid science, Amy travels the country teaching financial advisors and other business professionals how to better serve clients experiencing loss, grief, and transition. She also educates clergy, hospice staff and volunteers, social workers and others who work with the grieving. Amy serves on the advisory board of Soaring Spirits International, a nonprofit organization that provides support for widowed people around the globe.

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