How Does Narcan Work?
Narcan, the brand name for the prescription, non-addictive drug Naloxone, is a powerful drug that can mean the difference between an opioid overdose survivor, and an opioid overdose death. Used by medical professionals for over a decade, it is now being prescribed and dispensed to people at risk of, or who have loved ones who are at risk of, an opioid overdose.
Narcan is a fast, effective, and invaluable tool for responding to an opioid overdose. It can be injected in liquid form, or given as a nasal spray. So how exactly does this miraculous drug work? And why has this drug that has saved lives elicited violent reactions from those whose lives have been saved? First, it helps to take a step back and understand what happens when somebody overdoses on opioids.
Opioid Overdose
The category of opioids include heroin, as well as prescription pain medication like oxycodone, methadone, vicodin, morphine and codeine. The rate of overdose from this category of drugs has reached epidemic proportions in the United States, and the number of fatalities continues to rise as their popularity skyrockets. According to the American Society of Addiction Medicine, in 2015 there were 20,101 overdose deaths related to prescription pain killers, and 12,990 overdose deaths related to heroin.1 When someone overdoses from an opioid, their breathing can slow down to the point of stopping, causing brain damage or death.
Narcan reverses the fatal effects of an overdose by blocking the effects of the opioid. Typically working within five minutes, the life-saving effects can be seen within 30 seconds to two minutes of being administered. If no signs of improvement are seen after five minutes, a second dose of Narcan needs to be given.
The Science behind the Miracle Drug
Narcan’s ability to seemingly raise the dead has made headlines across the country, hailed as a miraculous antidote to the opioid overdoses that have been plaguing the nation.
The key to success is to administer Narcan as soon as possible. Brain damage can occur within only a few minutes of an overdose, due to a lack of oxygen to the brain. After a dose of Narcan, heart rate and breathing will visibly increase, essentially resurrecting the victim from the brink of death. So what is the science behind it?
Opioids attach to ‘receptors’ in the body. When somebody overdoses from an opioid, it is because of the attachment of the opioids to these receptors. An overdose occurs when too much of an opioid fits in too many receptors, slowing and ultimately stopping the person from breathing.
Narcan works because it has a stronger affinity to the opioid receptors than opioids. It’s referred to as an antagonist because it quickly overtakes an opioid’s ability to bind to cell receptors, which are specialized proteins found on the cell’s surface. Narcon knocks the opioids off the receptors for around 30 to 90 minutes, allowing the person to breathe again, reversing the overdose.
For Benevolent Use only
Another positive attribute of Narcan is that it has no potential for abuse or addiction. It offers no euphoric qualities, so an individual cannot get ‘high’ from taking it. It has no potential for mis-use, other than reversing the effects of an opioid overdose. It is not harmful – if it is administered to somebody who has not taken opioid’s, there are no negative side-effects. It does nothing. It is not possible to overdose on Narcan.
Perceived Negative Effects for the Individual Overdosing
While Narcan is a life-saving drug with no potential for addiction or mis-use, it can be perceived negatively in the eyes of the opioid user. First responders have reported dealing with angry and even violent reactions from those they have saved from an overdose by administering Narcan. The reason is that Narcan can result in withdrawal symptoms for some users, which can be uncomfortable or painful. The lack of oxygen to the brain as a result of the overdose, in conjunction with the shock of quickly coming to, can result in agitation and confusion. It is also important to note that most people may not be aware how close they came to dying when they initially come to. All they will be aware of is that their high has been taken away.
What Comes Next
While Narcan has saved and will continue to save countless lives from fatally overdosing on opioids, it is important to remember that this solution is akin to putting a band-aid on a broken leg. While the person’s life is saved in that moment, the drug does not solve the larger problem at hand, which is addiction. Narcan offers individuals a second chance at life, to get the help they need. However, if steps are not taken to recover from their addiction to opioids, the person will likely find themselves in the same life-threatening position again.