The opioid epidemic has been a growing problem in the United States for over a decade, with the death toll setting new records each year. The problem is so significant that it has negatively affected U.S. life expectancy for the second year in a row, dropping from 78.7 years old to 78.6 in 2016. However, one way to fight the rising overdose rates is a drug called Narcan that can stop and even reverse the effects of an overdose that could otherwise be fatal.
Learn how this drug works to reverse an opioid overdose and how it can help. Is it the key to turning the tide in the fight against opioids or is it a temporary fix?
How Opioids Work
Before understanding how Narcan can stop an overdose in its tracks, it’s important to understand how opioids work in the brain and body. Opioids are analgesics, which are useful for suppressing and managing pain. But they aren’t just helpful, they are excellent at stopping pain every step of the way.
The Science of Pain
The message your body sends your brain when you experience something that can damage you, like touching a hot stove, is what we know as pain. Pain travels through the nervous system via neurotransmission, or the release of chemical messages from nerve-to-nerve across synapses. When you experience something that triggers pain like falling on your roller skates and scraping your knee, a message is sent from its origin to the spine and into the brain, specifically the thalamus. Then the thalamus relays that message to the hypothalamus and limbic system, which helps you learn to be more careful on roller skates. When the pain message is particularly strong, the response from the hypothalamus and limbic system might cause you to develop an intense fear or phobia, causing you never to put on roller skates again.
How Opioids Intervene
Opioids don’t just stop pain in the brain, they work all along the nervous system’s pain highway, even in the spine and pain origin areas. In the spine and pain areas, opioids can modify and inhibit pain signals that are being sent to the brain. And in the brain, opioids alter mood, having calming or euphoric effects. They can also soften your brain’s response to pain, helping you avoid long-lasting psychological repercussions of an accident like a fear of roller skates.
Opioids do this by binding to opioid receptors in the presynaptic and postsynaptic neurons. In other words, they attach to particular points designed for them in both the neuron that’s sending the signal and the one that’s receiving the signal. These opioid receptors exist for naturally occurring opioid-like chemicals called endorphins.
The Problem with Opioids
The problems with opioids are their dangerous side effects, ability to cause tolerance, and chemical addiction. The level of tolerance is increased the longer opioids are used, making them less effective at the same dose over time. As tolerance grows, many users increase the dose, which puts them at greater risk of developing dependence and addiction. The limbic system, the same system that causes you to learn from pain, teaches you that opioids not only kill pain but also leave you feeling pleasurable euphoric effects. A similar instinctive or irrational compulsion that can make you fear your roller skates after an accident can make you crave and seek opioids. Once addiction takes hold, your likelihood of experiencing dangerous and fatal side effects or overdose increases.
What Is Narcan?
Narcan is the brand name for a drug called naloxone that block the effects of an opioid. It’s primarily used to treat patients during overdose but is also sometimes combined with opioid prescriptions, in the same pill, to decrease the risk of abuse. During opioid overdose, users can experience respiratory depression, mental confusion, and heart-related complications. Narcan is effective in reversing respiratory depression during overdose, but there is very little evidence to suggest that it can help with heart-related complications, like cardiac arrest. Still, Narcan, where it has been implemented, has saved countless lives that would otherwise be lost to overdose.
Opioids like heroin bind to opioid receptors to relax you and essentially slow you down. In high doses, opioids can slow down breathing and heart rate to the point of oxygen deprivation. Narcan binds to the same receptors that opioids do, which means that Narcan blocks the binding of opioids and stops their effects. Narcan is a competitive antagonist and binds to active binding sites on receptors that are taken up by opioids. As an antagonist, it does not activate the receptor it binds to, as an opioid would.
How Is it Used?
Narcan can be administered intravenously, injected into the muscle, or in the form of a nasal spray. The speed at which it begins to take effect depends on the method of administration, but it works within minutes. Naloxone can reverse and prevent overdose for a half hour to an hour after it’s administered. However, many opioids, including heroin have a much longer duration of action than one hour. To prevent an overdose from occurring after Narcan wears off, additional doses are administered until the opioid stops being effective.
Paramedics, emergency medical technicians, and firefighters often carry naloxone like they would carry other life saving, fast-acting medications including epinephrine or insulin. In some counties, police officers carry it in the event they are the first on the scene during an overdose. It is legal to prescribe Narcan in every state in the U.S., but its administration is still restricted. Individuals are able to purchase Narcan at a pharmacy as an over-the-counter medicine, without the need for a prescription. However, only 36 states allow over the counter sale of naloxon.
Why Narcan Isn’t a Cure
There is no question that Narcan has saved lives, and the more its availability increases, the more lives it will save. However, as Narcan has become more available, with more states making it legal to buy over the counter, opioid overdose death rates continue to grow every year.
The problem is growing faster than Narcan can stop it.
One reason for this is that Narcan isn’t a cure. While it stops the effects of overdose, it does not stop addiction. In fact, Narcan can cause withdrawal symptoms to occur in people who are chemically dependent on opioids. This means that someone administered Narcan in the morning might be using heroin again in the afternoon.
What You Can Do To Beat Opioid Addiction
If you are struggling with addiction and would like to avoid adding to the overdose statistics, there is treatment available. Addiction is a chronic disease, but it is one that can be treated. Through personalized addiction treatment, you can enter into lasting recovery. Call Pathway to Hope today at 844-557-8575 to find out more about your treatment options. Addiction is chronic, but overdose death isn’t inevitable.