Naloxone: Emergency Treatment for Opioid Overdose

The Opioid Crisis

You’ve probably heard the term “opioid crisis” on the news, but what does that mean exactly? In short, it means that a large number of individuals are addicted to these substances and that opioid abuse is leading to increasing numbers of overdoses and deaths.

Consider these statistics:

• On average, more than 130 Americans die every day after experiencing an opioid-related overdose.
• Opioid-related overdoses have increased in recent years, with a 30% rise from 2016 to 2017 alone in regions throughout 45 of the 50 states.
• Opioids are a leading cause of overdose deaths — they were a factor in 68% of such cases in 2017.
• Only around 10% of individuals who are struggling with opioid addiction receive the treatment they need, even though treatment options do exist and can be effective.
• Opioid overdoses aren’t limited to individuals who use illicit drugs, such as heroin; up to 29% of individuals with a valid prescription for an opioid pain reliever ultimately abuse their prescription drugs. Additionally, as many as 12% of individuals develop an addiction that could lead to overdose.

How Naloxone Helps

Naloxone is a medication that blocks an opioid from interacting with critical areas of the brain and body to the degree that it helps to reverse a potential overdose.

The medication is available in several forms and is carried by emergency responders and some law enforcement personnel. It is also stocked by most hospitals and emergency clinics that treat opioid overdose patients. Physicians may also prescribe naloxone as an emergency backup medication for addicts who are at risk of overdosing during rehabilitation or other treatment programs.

In medical terminology, the category of medication under which naloxone falls is “opioid antagonist.” This term quite literally means that naloxone antagonizes – or disrupts – the effect of opioids on the brain and body of an individual who has overdosed.

Here’s how it works:

• Opioids act on certain areas in the brain that lead to the euphoric high associated with illicit substances, such as heroin, and the pain relief offered by prescription opioids.
• Changes that opioids create in the brain also lead to alterations in bodily functions, including critical activities such as breathing.
• An increase in opioid use creates more intense negative effects on the brain and body, placing an individual at grave risk for an overdose.
• Naloxone reverses an in-progress overdose by blocking the opioid’s detrimental effects on the brain and body.

Naloxone is a defensive measure, meaning that it is administered when an individual appears to be suffering from an opioid overdose. Medical professionals and addiction specialists consider it a safety net that can be used to halt the serious and often fatal impact of an opioid overdose. However, in some cases, it is used as a preventative measure.

The FDA approves of three methods for naloxone administration.

• Injections of generic forms of this medication can be administered by clinical professionals, including physicians, nurses, EMTs, and other specialists who are state-licensed to administer injections.
• Injections of Evzio, a branded form of naloxone, can be administered by non-clinical professionals, as well as the loved ones of an individual experiencing an opioid overdose. The auto-injection device is prefilled with the appropriate dosage, and the medication is injected into the thigh similar to other rescue injectors, such as EpiPens. These devices provide audio instructions for use.
• Naloxone can also be administered as a nasal spray under the brand name of Narcan. This medication is also prepackaged, making it easy for non-clinical professionals or loved ones to administer.

Typically, patients receive naloxone in one of two ways. First, they can be administered the medication by medical professionals or first responders as emergency treatment during a potential opioid overdose. This scenario usually occurs when a concerned loved one calls 911 because of a possible overdose, or the patient enters an emergency room or urgent care facility with symptoms of an overdose.

In some cases, however, patients may be prescribed naloxone as a proactive measure. Common reasons a medical professional might prescribe naloxone include:

• An individual is in rehabilitation for opioid addiction, and treatment professionals believe he or she is at risk of relapse, which could lead to an overdose
• A patient is taking high doses of prescription opioids, creating the risk of an overdose
• An individual is being released after emergency treatment for opioid poisoning

Every state legislates the administration of medications and who can handle them differently, so the exact details about naloxone provision are unique to each location.

The most common side effects of naloxone treatment are opioid withdrawal symptoms. These symptoms occur because naloxone blocks the effects of opioids, which makes the addict’s body react from essentially being starved of a substance it is used to having and can include body aches, fever, chills, weakness, dizziness, nervousness, and irritability.

In some cases, patients can have an allergic reaction to naloxone. Signs of an allergic reaction include hives or swelling, especially in the face or throat. If an individual experiences these symptoms and is not already under the care of a medical professional, contact medical help immediately.

Even if an allergic reaction doesn’t occur, it is critical to seek medical assistance after administering or receiving naloxone treatment. While the timely administration of naloxone can save someone’s life, the individual may need additional medical assistance, including repeated doses of naloxone. A repeat dose is so common that most prescriptions and opioid overdose kits are equipped with at least two doses of naloxone.

Learn more by reading our guide on heroin addiction, including how to find help for an opioid addiction before an overdose occurs. Additionally, visit one of these resources for information on opioid addiction and naloxone treatment:

• NIH’s Principles of Drug Addiction Treatment: A Research-Based Guide
• NIH’s Opioid Guide
• CDC’s Real Stories Opioid Addiction and Overdose Series
• HHS Naloxone Guide

• https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis
• https://ncric.ca.gov/files/D2DF00000/049.pdf
• https://www.cdc.gov/drugoverdose/epidemic/index.html
• https://www.who.int/substance_abuse/information-sheet/en/
• https://www.ncbi.nlm.nih.gov/pubmed/25785523
• https://www.fda.gov/media/138208/download
• https://www.drugabuse.gov/related-topics/opioid-overdose-reversal-naloxone-narcan-evzio
• https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/evzio-naloxone-auto-injector-approved-reverse-opioid-overdose
• https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/narcan-naloxone-nasal-spray-approved-reverse-opioid-overdose
• https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/pharmacotherapies
• https://www.drugabuse.gov/drugs-abuse/opioids
• https://www.cdc.gov/rxawareness/stories/index.html
• https://www.hhs.gov/opioids/sites/default/files/2018-12/naloxone-coprescribing-guidance.pdf