Narcan: Reviving Hope for Patients with Opioid Use Disorders

Narcan: Reviving Hope for Patients with Opioid Use DisordersNarcan is the commercial trade name for the opioid reversal agent naloxone. It works to counteract effects of an opioid overdose. Opioids are pain medications and drugs that have effects similar to those of morphine on the body. Examples include oxycodone, fentanyl, methadone and heroin. Narcan’s most common usage is in reversing the effects of opioid overdose, which are sometimes fatal due to respiratory depression. Narcan is widely used in hospital emergency departments and is listed as an essential medication for any healthcare system by the World Health Organization1. It can be administered as a liquid injection through a vein or into a muscle. It can be absorbed into mucous membranes via an aerosol spray.

To help combat the growing epidemic of opioid use disorder and the 72,000 deaths it causes each year from opioid overdoses, the United States Food and Drug Administration approved a version of Narcan in 2015 that can be administered by people who do not have medical training2,3. The most common version of Narcan is administered into the nostril and absorbed into the body through mucous membranes in the nose. It is also now available in several other formulations and can be obtained through public programs. Narcan is available by prescription and, in an increasing number of places, over the counter4,5.

Narcan is not a Substitute for Addiction Treatment

If you are a regular user of opioids, or are close with someone who is, Narcan is a potentially life-saving medication. Its effects are immediate. And it can buy time for a person who has overdosed until they can receive medical care.

However, Narcan should not considered a substitute for addiction treatment or a cure. Before its approval for public use, one of the primary political arguments against Narcan was that it would lead to more opioid users maintaining an addiction without fear of overdose6. This does remain a risk, and if it describes your situation then it is important that you understand the consequences of addiction. Even more important that you know the possibilities for a healthier lifestyle that treatment can provide.

How Narcan Works Within Your Body

Narcan is, quite literally, a short-term solution. It is a liquid with opioid reversal effects that last for about 45 minutes. This is far less than the active time of most opioids within your body. Narcan achieves the reversal effect by binding itself tightly to your body’s opioid receptors. Thus, disallowing opioids from acting on them. Even though the opioids are still present in your system. As a result, Narcan will quickly (and sometimes alarmingly) precipitate the symptoms of opioid withdrawal if you have recently taken opioids and are physically dependent on them. Those flu-like symptoms include:

  • Agitation
  • Muscle aches
  • Nausea
  • Vomiting
  • Diarrhea
  • Runny nose
  • Anxiety
  • Increased heart rate
  • Dilated pupils
  • Sweating
  • Goosebumps

The body is subject to the effects of opioids still present after Narcan wears off. This can result in a person who was just revived from overdose returning to an unconscious state. And or re-experiencing shallow or slowed breathing. Further, some people may consume more opioids to stop the withdrawal symptoms. For those reasons, anyone who has experienced an opioid overdose must get proper medical care at an emergency department in a hospital.

Risk for Opioid Overdose

You are at high risk for opioid overdose if you are physically dependent on the drug. Especially if you’ve been abstinent for some time and then return to your previous level of intake. This is because you will have lost some of your opioid tolerance. Which would normally decrease the effect of a drug over time. Loss of tolerance occurs because your body will downgrade the amount and activity levels of its opioid receptors during regular opioid use (and thus you need to consume more of the drug for the same effect). However, it will upgrade the amount and activity of these receptors during abstinence (and thus it takes less of the drug to create the same effect).

Narcan is generally safe and reliable, and potentially life-saving, but it has its limits. In addition to the above considerations, it does not reverse the effects of any other drug overdose besides opioids. except for clonidine when Narcan is administered in high doses7. It is not a treatment for physical dependence on opioids, nor is it a treatment for addiction.

An Opportunity for Treatment

The widespread availability of Narcan does represent a significant shift in how society thinks about opioid use disorder and addiction. More resources than ever are now available for treatment. At Transformations Treatment Center, our certified professionals can support you in a multitude of ways, as you strive toward a balanced and substance-free life. The following are some of the steps in treatment that you can expect if you have an opioid use disorder:

First, it will be important to establish that your body has become physically dependent on opioids. Because of this, treatment begins with medical detoxification. Our team and colleagues at Summit Detox Center will monitor for signs of opioid withdrawal. Additionally, our medical staff will provide interventions accordingly.

Treatment Options

Psychotherapy will become an important part of your recovery process. The psychotherapy of choice for opioid use disorders is cognitive behavioral therapy, or CBT. CBT works by helping you identify, monitor and change unhealthy behavior patterns. Primarily,  by closely studying and challenging the relationships between your thoughts, feelings and actions. This approach has more evidence for its usefulness in treating addiction than any other form of talk therapy.

Other psychotherapy approaches may also be useful as you learn how to become emotionally sober. They include mindfulness training exercises and motivational interviewing.

Finally, participating in a 12-step-based program can help you develop accountability, self-awareness and a reservoir of support. These steps are critical to being able to live the healthy and substance-free life that you deserve.

Our team at Transformations Treatment Center is ready to support you as you work toward a return to dignity, balance and freedom from active addiction. Contact us today to begin the next phase of your life.

  1. “WHO Model List of Essential Medicines (19th List)” (PDF). World Health Organization. April 2015. Archived (PDF) from the original on 13 December 2016. Retrieved 21 Aug 2018
  2. NIDA. “FDA approves naloxone nasal spray to reverse opioid overdose.” National Institute on Drug Abuse, 18 Nov. 2015, Accessed 22 Aug. 2018.
  3. NIDA. “Overdose death rates” National Institute on Drug Abuse Accessed 22 Aug. 2018.
  4. National Public Radio. “Narcan Opioid Overdose Spray Is Now Stocked By All Walgreens Pharmacies” Accessed 22 Aug 2018
  5. CVS Health Press Release. “CVS Health Expands Efforts to Educate Patients About Naloxone” Accessed 22 Aug 2018
  6. Winstanley, Erin L. et al. “Barriers to Implementation of Opioid Overdose Prevention Programs in Ohio.” Substance Abuse 37.1 (2016): 42–46. PMC. Web. 23 Aug. 2018.
  7. Seger, Donna L. and Loden, Justin K. “Naloxone reversal of clonidine toxicity: dose, dose, dose.” Clinical Toxicology (2018): 16 Mar 1-7.. Web. 23 Aug. 2018.
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