Narcan and You: First Aid in the Opioid Years

Narcan and You: First Aid in the Opioid Years

It’s the 21st century, and we have lost the War on Drugs. In 2021, over 80,000 people in the United States died as a result of an opioid-related overdose, almost twice as many as the year 2016. At this point, most of us know someone who struggles with a substance use disorder; it may not even be someone you know, but you yourself. The entire crisis is too big to fight alone, but there is now a way to look out for your health and the people around you: It’s called Narcan, and in 2020 it reversed nearly three thousand overdoses in New Mexico.

What is an opioid? What about an opiate?

(image via stopoverdose.org)

Opioids are a class of drugs that work by numbing the body against pain. They do this by interfering with your brain’s ability to receive pain signals. This can be very helpful when you’re recovering from surgery and you need those signals dulled while your body heals, which is when many people are prescribed opioid medications like morphine or oxycodone. However, this means they can also suppress other operations of your central nervous system, like breathing. When a person overdoses on opioids, their nervous system is so depressed that those necessary functions slow and stop; if they pass out and can’t wake up, if their heart rate drops, if they’re cold and clammy, or if their lips turn blue, they are in the danger zone and need help immediately.

(You might have heard “opioid” and “opiate” used together. They differ in that opiates (heroin, morphine, codeine) are naturally derived from plants and opioids (fentanyl, Oxy) are synthetic, but they’re both part of this conversation. They operate in the brain in the same way, which means naloxone is effective against both of them.)

What is naloxone?

Your brain is outfitted with opioid receptors, which is what opioids attach to when they’re disrupting your nervous system. Naloxone, sometimes sold under the brand name Narcan, is a medicine that also fits into these receptors. In fact, naloxone is drawn to them so strongly that it will knock away opioid particles to take their place. Although it’s now attached to the receptors, the naloxone doesn’t impede them the way the opioids were doing, allowing bodily functions to restore themselves.

There are other classes of drug that it’s possible to overdose on, including stimulants like meth and benzodiazepines like klonopin. Because these work in the body using different mechanisms than opioids do, naloxone is not effective against them. However, it also does not combine with them to make overdose symptoms worse. This means if you’re not sure what a person has taken, it’s safe to give them naloxone while you try to find out.

How do you use it?

(image via University of Washington Addictions, Drug, & Alcohol Institute)

A spray bottle of naloxone, like pictured, is a single dose. If your person is passed out and showing signs of overdose, insert the long tube of the bottle into one nostril, deep enough that the knuckles of your hand touch their nose. Press the button on the bottle with your thumb. It may take 2-3 minutes to take effect; while you wait, roll them on their side and call 911. Keep checking their breathing; if they stop, you may need to perform emergency breathing on them.

After 2-3 minutes, if your person doesn’t start to wake up, you can give them a second dose of naloxone if you have it. Double-dosing naloxone isn’t dangerous. When you do, insert the tube into the nostril opposite the one you tried first. If multiple doses of naloxone are having no effect, they may be overdosing on may not be opioids.

If your person comes to, they still need help! Naloxone will last 20-90 minutes, not forever; if it wears off before the opioids do, they may begin to overdose again. Seek medical help as soon as possible.

Where do you get it?

As of 2019, if you are prescribed an opioid medication in New Mexico, in many cases your doctor should co-prescribe naloxone. Ask them for it!

However, a prescription isn’t necessary to get naloxone on its own. In every state in the U.S., pharmacies like Walgreens and CVS carry it over the counter.

If you are so inclined after reading this, you can, right this moment, google “narcan training near me” and find a free class that will teach you how to administer it. Most of these classes will typically provide you at least one dose to take home.

Online health resources like Harmreduction.org and Open Aid Alliance offer naloxone kits for order, often free of charge. Organizations in your community, like Alianza of New Mexico, can do the same in person.

Once you obtain your Narcan, you can keep it in your purse, backpack, home, wherever you may need it. Just remember to keep it somewhere that the temperature is moderate; if you stash it in a hot car, it will expire!

What is harm reduction?

Illicit or unsupervised drug use carries a number of risks with it. While the worst case scenario is a fatal overdose, it can also lead to injury. In the case of injectable drugs, reusing needles can spread communicable disease. Harm reduction policies allow healthcare providers and public health operatives to focus on keeping people safe, without abstinence being the barrier of entry. These policies might look like providing clean needles so that a drug problem doesn’t become a drug problem plus hepatitis; it might look like providing a safe place to use with supervision so that a person experiencing an overdose can be revived, when using alone can be hazardous. For a long time, from many people, this fact has inspired an attitude of oh well - “if you don’t want the consequences, just quit!” But reality just isn’t that simple. Substance use disorder is a fight with many battles. When we choose to take care of people who struggle, if we are able to lessen their load, we can reduce the number of obstacles standing between them and recovery.