What is Narcan?

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Narcan may be something you’ve heard of, particularly recently, but do you know what it is? It’s a key part of the opioid epidemic, and the use of Narcan is helping save lives when people overdose on opioids.

Narcan is the brand name of the generic naloxone, and it’s described as an opiate antidote. Narcan or naloxone is administered to people in order to reverse the effects of an overdose of heroin or other opioid painkillers. It isn’t necessarily new, as it’s been used in emergency rooms and by first responders for a number of years. What is new, however, is the rising number of people who are overdosing on opioids as we’re in the midst of a very serious opioid epidemic.

As a result, in some states across the country, if you have a loved one who is addicted to heroin or a narcotic prescription painkiller, you can carry naloxone. There is an injection, but typically individuals who carry Narcan use the nasal spray version of it, which fits in a pocket and is easily transportable.

Narcan Generic Name
The term opioids is one that refers to a class of drugs that includes both prescription painkillers as well as illicit drugs like heroin.

Heroin is an example of an opioid that’s always illegal, while drugs like fentanyl, oxycodone, hydrocodone, morphine and many others are available by prescription. What’s frequently happening right now is that people begin taking prescription drugs and then move to heroin, continuing their cycle of addiction and abuse.

Opioid prescription pain relievers are intended for use during a short period of time, and they’re also meant to be taken exactly as instructed by a doctor, but taking them for a longer period or using them outside of the instructions of a doctor can lead to dependence and addiction.

Opioids are drugs that interact with opioid receptors found throughout the brain and the body. Opioids depress the central nervous system as part of how they relieve pain and change how people perceive pain, but that’s also a big part of the risk of these drugs.

Along with depressing the central nervous system, opioids, particularly when they’re taken in higher doses can create euphoria.

Opioids include:

  • Heroin
  • Fentanyl
  • Codeine
  • Opium
  • Hydrocodone
  • Hydromorphone
  • Methadone
  • Morphine
  • Oxycodone
  • Oxymorphone
  • Sufentanil
  • Tramadol
Opioid abuse and addiction have reached a crisis point in the U.S., which is why the topic of Narcan is so widely discussed as well. Opioids reduce the number of pain signals sent from your body to your brain, and they change the response of your brain to pain. They’re prescribed for a variety of scenarios including dental procedures, injuries, surgery and chronic pain from conditions like cancer. There are also some prescription cough medicines that contain opioid components.

Addiction is a disease that manifests itself in your behaviors, and while you may initially have the control to decide whether or not to use a substance, the impacts it has on your brain’s reward center ultimately makes it a compulsion. With opioids, your brain changes so that you are constantly feeling cravings to continue using the drugs.

Some of the signs someone is abusing opioids include:

  • Coordination problems
  • Drowsiness
  • Shallow or slow breathing
  • Nausea
  • Vomiting
  • Constipation
  • Agitation
  • Bad decision making
  • Forgoing responsibilities
  • Slurred speech
  • Excessive sleep or sleeping too little
  • Euphoria
  • Mood swings
  • Irritability
  • Depression
  • Anxiety
  • Lack of motivation

When someone takes opioids, whether they’re prescribed or not, it creates artificial endorphins in their brain, which essentially means it makes them feel good. As this happens, your brain not only wants to continue seeking out the stimulus that triggered a pleasurable reward response, but your brain also stops being able to produce its own feel-good chemicals. As this happens, your brain chemistry is altered in a way that creates addiction.

If you can no longer feel good on your own from natural brain chemicals, it stands to reason that you would want to keep taking drugs to feel good. Drugs like opioids become your new normal as far as your brain and body are concerned.

Opioid addiction is something that’s particularly hard to overcome because of how these drugs impact the brain. The more someone uses opioids, the more opioid receptors the brain creates as it becomes used to the presence of the drugs. That means there are more receptors that need to be filled in order to achieve a high or even just feel good, and there can be a lot of pain that accompanies unfilled opioid receptors.

It’s a very difficult addiction and situation for everyone involved, and it’s not that people aren’t motivated to stop using opioids, but science and the chemistry of the brain make it an incredibly difficult challenge.

Important to understand what Narcan is used for is understanding what happens during an opioid overdose.

First, there is the concept of tolerance. A tolerance to substances develops as someone uses them for a period of time and then they ultimately need more and more of the drug to achieve the same effect. An opioid tolerance can happen relatively quickly, or it can take time to develop, depending on the person. When someone has a tolerance to opioids, it can put them at a greater risk of an overdose because they are taking such large doses of the drug in order to achieve a high.

With opioids, it’s estimated that 69,000 worldwide die each year from an overdose, and according to the World Health Organization, around 15 million people have an opioid dependence in the world.

Opioids have an effect on the area of the brain that regulates breathing, so if you take high doses what can happen is that you experience respiratory depression and it can become so severe that you simply stop breathing altogether and die.

There are three signs and symptoms of opioid evidence that are described. The first is respiratory depression, and the other two are having pinpoint pupils and unconsciousness. The risk of an opioid overdose is higher if you combine these drugs with other substances such as combining multiple opioids or using them with sedatives or alcohol.

The number of overdoses from opioids happening around the world has increased dramatically in recent years, and it’s expected to continue going up. These overdose deaths are the result of both heroin and prescription painkillers.

There are certain risk factors that can put someone at a higher risk of an opioid overdose. The group at the greatest risk are the people who are physically dependent on them. People who were dependent on opioids and stop using them, maybe because of going to treatment or prison, often relapse and are at a much higher risk of overdose. This is because they think their tolerance is still high to these drugs, and they take much larger doses than their body can handle following a period without them.

People who inject opioids, people who use opioids in combination with other substances and people who have certain medical conditions like depression are also more likely to overdose.

The people who are most likely to witness an overdose according to Who include the loved ones of people who are addicted to opioids, as well as first-line responders including healthcare workers, police, emergency services providers, and people who provide treatment to addicts.

Because of the risk in opioid overdoses, legislators and policymakers around the world are looking at possible solutions including reducing inappropriate prescribing of these drugs, and close monitoring of opioids when they are prescribed and dispensed.

There is also work being done to make the availability of treatment programs more accessible for people. Some of the recommended treatment options for people dependent on opioid according to WHO include psychosocial support, opioid maintenance programs, supported detox and treatment, and the use of opioid antagonists which include naltrexone.

What is Narcan?
Narcan or naloxone is an opioid antagonist that can be used to partially or completely reverse an opioid overdose. The use of Narcan can reverse even the respiratory depression that people experience with an opioid overdose, and it can in some cases be used to diagnose an opioid overdose or to help with blood pressure support if someone is in septic shock.

Narcan is a narcotic drug that can also be used to reverse the effects of narcotic that were administered to treat pain or during surgery.

Essentially when someone takes this opioid antidote, and they have overdosed, Narcan can be administered to block the effects of the drug. Narcan can’t be used to get high, and it has no use when given to someone who didn’t take opioids.

When someone takes opioids, and an overdose is suspected, the Narcan dosage they’re given essentially pushes those opioids out of the opioid receptors in the brain. Even if someone has taken opioids with other substances such as alcohol, using Narcan will work at least on reversing the effects of the opioids.

Once someone takes Narcan, they should be able to wake up and start breathing normally again, but it’s essential that people are given Narcan right away once an overdose starts. Otherwise, they may experience brain damage.

The objective of giving Narcan to people instead of having it used exclusively by first responders and medical professionals is that it can be administered to provide more time to save someone’s life until help arrives.

There are two primary ways that Narcan can be administered. The first is as an intramuscular injection that can be given someone such as the thigh or arm. The other way Narcan can be used is as a nasal spray.

While Narcan is used to reverse the effects of an opioid overdose, it’s important for people to realize that it’s not a substitute for emergency care. Instead it’s used as a way to buy some more time between when someone overdoses and when help arrives.

If you suspect someone is overdosing on opioids, there are steps that are outlined to take as a bystander. First, it’s important to check for responsiveness. This can include shaking the person gently or shouting at them. You should then check and see if they’re breathing.

If you think someone is overdosing you should call 911 immediately and let them know if the person isn’t breathing.

If you have naloxone available, you should administer it. Even after an initial dose, a person may need more Narcan or naloxone if they start vomiting or making gurgling sounds, their lips or fingernails appear blue, their breathing or heartbeat is slow or stopped, they’re not able to speak, or they can’t be roused from sleep.

While you’re on the phone with 911, they will often provide instructions for how to perform rescue breathing, and then you will wait until help arrives. There is a recovery position that emergency responders can tell you about to make sure the person doesn’t choke.

When you use Narcan Nasal Spray, it should be given right away, and medical help should be sought immediately as well.

The following are signs Narcan should be used:

  • A person can’t be woken up or seems unusually sleepy
  • They are experiencing breathing problems
  • If someone has pinpoint pupils or very small pupils, Narcan may need to be used

There may be certain people who shouldn’t use Narcan if they have allergies to ingredients that include benzalkonium chloride, sodium chloride or hydrochloric acid.

There doesn’t have to be evidence someone is breathing to use Narcan, and it can usually reverse the effects of an overdose in two to three minutes.

Narcan works by competing with the opioid that is in the person’s brain to bind to the same receptors.

Narcan obviously can’t be administered by the person who has overdosed on opioids, because an overdose renders you unconscious. It has to instead be given by someone who is near the person who’s overdosed. It’s important for someone who is opioid-dependent to give Narcan to someone close to them and make sure they know how to use it.

The following are instructions that go along with the Narcan dosage guide:

  • A Narcan dose needs to give as soon as possible. The longer someone is experiencing depression of the respiratory system, the more likely they are to suffer damage to their central nervous system including their brain or to die.
  • If you suspect someone has overdosed on opioids, you should immediately contact emergency services.
  • In some cases, a person may give an initial Narcan dose and then have to give additional doses of the Narcan nasal spray while they wait for emergency help to arrive.
  • According to the Narcan dosage guide, each Narcan Nasal Spray has one dose of naloxone that can’t be reused, so a person should use a new nasal spray every two to three minutes if there is no response. The Narcan Nasal Spray should also be readministered if the person seems to respond from the opioid overdose and then goes back into a period of respiratory depression.
  • The Narcan dose should be given in an alternating nostril each time it’s administered, and the person doing it should follow the instructions that come with it.
The initial Narcan dose that’s recommended for both adults and pediatric patients is one spray that’s given in one nostril.

Then, repeat Narcan dosages can be given. With each Narcan dose, it should be given in an alternating nostril. The patient initially responds to the first Narcan dose and then goes back into respiratory depression, additional doses of Narcan can be given.

Also according to the Narcan dosage, if someone doesn’t respond within two or three minutes another dose can be given. Every two or three minutes an additional Narcan dose can be given while waiting for emergency assistance.

There may be different Narcan dose instructions if someone takes a partial opioid agonist like buprenorphine. This may require a higher dose of Narcan or repeated use of the treatment using a new nasal spray each time.

Every single Narcan dose spray contains 2 mg or 4 mg of naloxone hydrochloride.

One of the most important things to realize when discussing the Narcan dosage guide is the fact that the nasal spay drive is only intended for use one time. It has to be sprayed once in the nostril, then discarded. You can’t, as an example, use half of it one time and then use it again. You would have to use a new Narcan dose.

According to the Narcan dosage guide, this drug can be used in children, but the child has to continue to be monitored because there is the risk of a relapse as the naloxone is metabolized.
Narcan is metabolized by the liver, and studies have shown the half-life of Narcan ranges in adults from around 30 to 80 minutes. The half-life of Narcan is generally shorter than other opioids.

In terms of how long Narcan works, it’s been shown to stay in the body about two hours.

Along with the Narcan half-life, people often wonder what happens after Narcan is administered. Many local governments and hospitals are working on programs that will provide people who overdose with opportunities to receive support and treatment following the use of Narcan. For example, some hospitals are providing recovery coaches who can help guide people toward the next steps once they’ve been given Narcan to save their life.

While Narcan has been highly beneficial for people who are struggling with opioid addictions, and it’s responsible for saving countless lives, does it have side effects? The following are some of the effects of Narcan, some of which can be negative.

First and foremost, Narcan is not addictive, and there is no potential for abuse or overdose, but what about other Narcan side effects?

The primary side effect of Narcan is the fact that when it’s used it may precipitate the onset of acute opioid withdrawal syndrome. This is the case when it’s used on people who are dependent on opioids, and some of the symptoms of acute opioid withdrawal can include:

  • Body aches
  • Fever
  • Sweating
  • Runny nose
  • Yawning
  • Diarrhea
  • Increased heart rate
  • Goose bumps
  • Nausea
  • Vomiting
  • Nervousness
  • Restlessness
  • Abdominal cramping
  • Increased blood pressure
  • Weakness

If Narcan is used in an opioid-dependent infant, the side effects of acute withdrawal syndrome can be very serious or fatal.

There is also some evidence to show that a 2 mg dosage of Narcan might help prevent the onset of severe opioid withdrawal in people who are opioid dependent, but there is the concern that a 2 mg dosage of the drug might not provide enough of an opioid reversal in someone who’s taken very potent opioids or has taken a very high dose.

As was touched on above, Narcan can sometimes be used following surgery to reverse opioid respiratory depression, and the side effects of Narcan in these situations can be similar to the ones named above but can also include very severe side effects like tachycardia, hypotension, hypertension, seizures, and cardiac arrest. These Narcan side effects are most likely to occur in patients who have pre-existing cardiac conditions.

Some other potential effects of Narcan Nasal spray can include headache, nasal dryness or edema, nasal congestion, and nasal inflammation.

Narcan is a prescription product, but there are a number of states where there is work being done to allow for the purchase of it without a prescription. For example, many states currently have an entity specific standing order, which means that a physician with prescribing authority can write an order allowing Narcan Nasal Spray to give by certain trained employees.

There are also states where there is currently a standing order that allows the State Physician General to allow Narcan to be distributed by certain people including pharmacists.

So, to sum up the information about Narcan.

Narcan is a prescription medication that’s used to treat an opioid emergency situation including an overdose when the person who took the opioids seem to be having breathing problems, is nonresponsive or isn’t breathing at all. Narcan is to be given right away, but Narcan use doesn’t negate the need for emergency help.
Narcan Nasal Spray is given in the form of a nasal spray in a measurement of 2 or 4 mg in most cases. Each nasal spray dispenser is a single Narcan dosage, and it can only be given one time. If repeated dosages of Narcan are given, it has to be a from a new nasal dispenser each time. If you are waiting with someone who has overdosed on opioids, you can administer the initial Narcan dose, and if they still seem to be unresponsive, you can continue to give them a new Narcan dose every three minutes.

If someone comes to from an opioid overdose and then seems to relapse and again become non-responsive, they can continue to given Narcan doses as well.

The primary side effect of Narcan is the fact that it can lead to acute withdrawal syndrome in people who are opioid-dependent, so this needs to be considered as part of the treatment of a person who overdoses. These symptoms can be severe and need to be treated.
What is Narcan Used For?
The generic name of Narcan is naloxone hydrochloride. Narcan is just one brand name for naloxone, and when naloxone is injected it works within two minutes, and it works similarly quickly when it’s sprayed in the nose with Narcan Nasal Spray.

The effects of the generic naloxone will usually last for around thirty minutes to an hour, but this is one of the reasons why people might need additional doses. The effects of most opioids can outlast naloxone.

Naloxone was originally patented in 1961 as a pure opioid antagonist that works on people who have overdosed by reversing central nervous system and respiratory depression.

The Narcan generic name naloxone is cited on the World Health Organization’s Lists of Essential Medicines because it’s one of the safest and effective medicines available in a healthcare system.

Naloxone can be purchased as a generic drug, and it can also be purchased as the brand name Narcan, although it is still naloxone. Another brand name for naloxone is Evzio.

People may also wonder in addition to the Narcan generic name, is a Narcan overdose possible? The answer is no. It’s not possible to overdose on Narcan, and if you were to take it and no opioids are present in your system, there would be no effect.

Regarding routes of administration, in a healthcare setting, naloxone is most commonly given by an intravenous injection because it acts so quickly and the effects will last up to 45 minutes, however, when individuals use it, it’s often as a pre-packaged nasal spray.

The nasal Narcan spray doesn’t require any assembly, and it allows for consistency in the Narcan dose that’s given.

Narcan Nasal Spray (naloxone HCI) is the only FDA-approved nasal version for the treatment of an opioid overdose.

Narcan and generic naloxone continue to be life-saving ways to reverse the effects of opioid overdoses, but at the same time more needs to be done to reduce the root causes of these overdoses. Unfortunately even after being administered Narcan or naloxone people will continue to use opioids. Some people will even use them right after an overdose, which is why the opioid epidemic is front and center for policymakers and ordinary people who are seeing their loved ones suffer as a result.

Narcan Addiction & Abuse
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Narcan Addiction & Abuse was last modified: April 4th, 2018 by The Recovery Village