While the nation is still struggling to find the right strategy to climb out of the opioid crisis in U.S. it seems many are holding onto the idea that Big Pharma is going to save us from the destruction they helped create. While we can agree that evidence-based medical assistance in recovery is a useful tool, some seem to think that the only fix for a pill problem is more pills, or in this case, more needles.
Just recently, after President Trump declared the opioid crisis a “National Health Emergency”, the advisory committee to the U.S. Food and Drug Administration (FDA) voted 18-1 that a new injectable drug called RBP-6000 could benefit addicts and the lower of two doses studied had an “acceptable” safety profile.
So what does this mean for the opioid epidemic efforts? Is Indivior a miracle injection that is going to make the epidemic more manageable, or is it another kind of Methadone or Suboxone that is just keeping people hooked?
What is RBP-6000?
For a little background, RBP-6000 is an experimental drug designed to help fight America’s growing opioid addiction crisis. It is described as a sustained-release buprenorphine. It is designed to be delivered once a month as a subcutaneous injection. The compound solidified once in contact with bodily fluids and releases buprenorphine over time.
If approved, it will be the first monthly injectable buprenorphine treatment. When creating the drug the manufacturers studied two dosing regimens.
In one, 300 milligrams were given once a month for six months.
In the other, two doses of 300 milligrams were followed by four doses of 100 milligrams.
According to reports, there was only a minute difference in effectiveness between the two doses, and they drug company acknowledge that the higher dose of RBP-6000 caused more side effects. Looking closely into some of the reports from the research, some side-effects include:
Injection site pruritus
Upper respiratory tract infection
While these side effects were not noted in an extremely high percentage of those tested, they are still relevant to consider until there is more extensive data available. So far, the report says the safety profile is consistent with that of Suboxone.
So RBP-6000 is like Suboxone using the delivery of Vivitrol; another injectable drug used to try and block the effects of opioids.
Big Pharma Making Big Moves
This is one sign of how Big Pharma is stepping in to make a buck off of the opioid epidemic yet again.
Indivior is the company behind RBP-6000. It was originally part of Reckitt Benckiser as the Buprenorphine division but has since split off to be a specialty pharmaceutical company. Indivior already sells Suboxone Film, a product which combines buprenorphine and naloxone. Suboxone is a maintenance drug widely used in America to try and curb the effects of opioid addiction and withdrawal, but Suboxone is known to have its own side-effects and withdrawals. Some even attest that Suboxone is itself addictive and very difficult to get off of.
Two months ago the share prices for Indivior took a deep hit after a U.S. court ruling clearing the way for a generic rival to Suboxone Film. So, with new competition on the way in the Suboxone market, Indivior put a renewed focus on another maintenance drug to bring to market.
Some analysts already expect that RBP-6000 could capture around 30% of the broader buprenorphine market. Some believe this new form of injectable buprenorphine could generate annual sales of around $700 million by 2021.
Jefferies sees potential sales of $1.3 billion by 2025.
So now the push for this new drug is boosting its sales prospects as competitors threaten revenues from Suboxone sales.
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Waiting for FDA Final Ruling
This endorsement on behalf of RBP-6000 comes less than a week after FDA Commissioner Scott Gottlieb announced the agency’s plans to promote extensive use among opioid addicts of less harmful opioids such as methadone and buprenorphine, the active ingredient in RBP-6000.
However, some of the FDA panelists still would like to see more data about which patients should be given the higher dose. Other panelists say they would like to have it available, even though they lack of data supporting any additional benefit of higher doses. So even though the drug is shown to have side-effects in higher doses, and there is limited information on how these side-effects impact the individual, the FDA is considering to let this drug pass the grade.
The FDA’s decision is set to be made by November 30th, although typically the agency follows the recommendations of its advisory panels. So it may very well already be a done deal.
Why It Matters
Again, with respect to the importance of offering alternatives to particularly dangerous opioids like heroin or fentanyl. It is important to have resources for the purpose of preserving of life. Keeping people alive long enough to get help is crucial. But we also have to see that this is not a miracle cure.
Methadone, Suboxone, and Vivitrol may serve a purpose for some in a certain capacity. However, these drugs are not an adequate substitute for comprehensive addiction treatment. Each one of these methods should be accompanied by a holistic treatment plan that addresses all aspect of addiction, including emotional and mental health.
Drugs like RBP-6000 may help subdue the more serious symptoms from the physical side of addiction, but they can also present their own risks.
It is important to offer safe medical assistance, but we have to remember that these Big Pharma companies are not selling us instant cures to opioid addiction. This isn’t even the first time we have seen a new drug come out to try and treat the opioid problem from companies that are closely related or directly responsible for narcotic medications that helped fuel the issue.
Remember, there is not a quick fix for this problem. We cannot prescribe our way out of the problem. It is going to take better treatment resources beyond more medications.
Drugs like RBP-6000 from Indivior are not necessarily a bad thing, but they also may not be the kind of treatment people should focus on. Instead, there are safe medical treatment options that offer holistic resources and mental health services. A lasting recovery begins with effective treatment. If you or someone you love is struggling, please call toll-free now.
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Drug overdoses killed 64,000 Americans last year. That is an increase of more than 20% than the overdose deaths in 2015. Those numbers have nearly quadrupled since 2000. Now nearly two-thirds of overdose deaths are from by opioids. Some are from prescription opioids; others are from illicit heroin or synthetics like fentanyl.
However, some are concerned that the action we have seen thus far is too little too late. The president’s 2018 budget only increases addiction treatment funding by less than 2%. That already includes the $500 million appropriated by Congress in 2016 under the 21st Century Cures Act. So needless to say, many recovery advocates worry that the resources are just not going to be enough.
If we look at the recommendations of the president’s opioid commission, and at other initiatives that have started to gain some traction across the country, we can find patterns. There are some concepts that consistently show up, and perhaps if we focus on these similarities, we can see why so many minds are thinking alike.
So here are 5 big ways America can overcome the opioid epidemic.
Break the Stigma
In order to accomplish most of the things on this list, America first has to consistently fight to break the stigma of drug use and addiction. Misunderstanding what addiction is and how it happens only undermines progress to addressing it. If America hopes to overcome the opioid crisis, we have to be more willing to see it for what it is.
Right now the issue of addiction stigma is still a big deal. While we may have come a long way from how it was decades ago, there are still a lot of people who refuse to consider addiction as an illness. A lot of people still refuse to acknowledge the various factors that contribute to addiction, such as genetic predisposition and instead insist addiction is purely by choice.
If we can see how drug use affects people from all different walks of life, and for countless different reasons, we can then treat those suffering from more compassion. Finding more effective methods of treatment means having a better idea of what really causes addiction, and what feeds it.
Support PAARI, NOT Punishment
Speaking of compassion, supporting PAARI and not punishment is a perfect example of letting go of stigma to work toward saving lives.
It is about time that all of America realizes that the old ways of the failed War on Drugs do not work. Thankfully, it seems a lot more people across the country now understand that we cannot arrest our way out of this problem. Harsher punishments and severe sentences have not deterred addiction, they only support stigma.
Now in America, there are nearly 300 law enforcement agencies across 31 states that have Police Assisted Addiction and Recovery Initiative programs (PAARI). These PAARI programs offer treatment for drug users who come to authorities looking for a way out. Instead of fearing the threat of arrest, people struggling with substances are encouraged to reach out to law enforcement in order to be put in contact with treatment options or recovery networks.
This revolutionary new mindset was inspired by a department in Gloucester, Massachusetts not too long ago. So far these efforts appear to cost much less and with better results than efforts focused on punishing addicts.
Create Resources for Treatment
Today addiction medicine is an urgently needed specialty, but there is not much glory in it compared to other areas of medical work. One way the federal government could help create more resources for treatment is to provide tuition incentives for medical students to enter addiction-related specialties and work in underserved communities. By encouraging this kind of work, we further shed the stigma of addiction and shift the perspective to helping care for a vulnerable community.
But don’t just end with specialists.
By supporting things like Medicaid expansion, addiction and mental health treatment can be made available to more people who may not have access to healthcare under limited coverage. More state and federal funding can also be allocated by officials to help build or strengthen addiction treatment programs provided by the state.
Enforce Mental Health Parity
The Mental Health Parity and Addiction Equity Act of 2008 actually requires insurers provide equal benefits for mental health and addiction treatment that they do with other medical therapies or surgery. Thus, the law means to make discrimination against addicts by insurers illegal.
However, some insurers defy this law by imposing illogical treatment limits or tedious authorization requirements. In other words, insurance companies are finding ways to cheat the system in order to avoid paying for addiction and mental health treatment.
America and our government must to better to enforce mental health parity. If we want people to get the treatment they need, we have to protect their right to treatment and assure that insurance providers won’t be able to skip out on the bill.
According to John Renner, president of the American Academy of Addiction Psychiatry, between 50%- 70% of people with substance abuse problems also suffer from a mental health disorder such as:
- Post-traumatic stress disorder (PTSD)
With mental health and addiction so closely related, making sure those struggling with opioids and other substances receive care for mental health disorders or other co-occurring conditions it vital to lasting recovery.
First and foremost; preserve life! This should always be a priority when facing any kind of epidemic. Regardless of the circumstances, the preservation of life should always be paramount. This is a discussion that has become crucial in the fight against opioids considering the need for life-saving medications and harm reduction tactics.
At the moment, first responders and emergency rooms do not have adequate access to Naloxone or Narcan, the opioid overdose antidote, to save lives. Both federal and state health agencies can negotiate pricing for naloxone and expand access. They can also encourage pharmacies that offer prescription-free access in some areas.
Another aspect of saving lives involves harm reduction strategies, which tend to be a little more controversial. Not everyone likes to support programs like safe injection sites or needle exchange programs. However, whether you think these programs enable addiction or not, these programs are proven to help preserve life. Between preventing the spread of infectious disease and providing a supported environment in case of overdose, these harm reduction models can prevent a lot of needless loss of life.
One indisputable precedence in the effort to overcome opioids is keeping people suffering alive long enough to get them treatment. The more people we can help survive opioid addiction, the more people have a chance of recovering.
Drug abuse and addiction is a devastating and deadly disease, and providing effective and compassionate treatment makes a lifelong difference. Part of solving the problem is changing the way we look at it and changing how we treat each other. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now.
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As we have seen time and time again, the opioid epidemic all across America has not been confined to one substance. It takes the shape of prescription painkillers, illicit heroin and even the more potent synthetic opioids like fentanyl. With the gradual progression of this poisonous outbreak, we have seen the stakes get higher and higher. Prescription opioids contributed to a growing population of heroin users. Dealers lacing heroin with synthetics like fentanyl led to higher overdose rates. Then the highly dangerous, frequently lethal carfentanil was added to the mix and now just being around the drugs can almost kill you.
With the addition of fentanyl and carfentanil to the illicit drug world comes a very real and potentially lethal new threat- secondary exposure overdose.
What is Secondary Exposure?
Secondary exposure is also referred to as secondary contamination or second-hand exposure. It is a term usually used with things like asbestos poisoning or mesothelioma. Sometimes it is even used to describe the effects of radiation. It is when people come into contact with gasses or substances that can be absorbed into the body and do very real damage.
The most common comparison you could make is to second-hand smoke, which is when people smoking cigarettes expose others to the toxic gas they and the cigarette release into the air. Second-hand smoke can cause very real health problems, including some cancers. The most terrible aspect of it being that the individual who gets sick doesn’t even have to smoke themselves.
With drug use secondary exposure overdose has now become a real risk thanks to synthetic opioids. Law enforcement and other officials tell us that some of these dangerous substances must be handled with the utmost caution. The news coming out of Ohio this week is just another example of how hazardous these drugs have become.
Ohio Nurses Experience Secondary Exposure Overdose
At Affinity Medical Center, a hospital in Massilion, Ohio, three nurses helped treat an overdose patient. After cleaning the room where the individual was treated, the three nurses were overcome by secondary exposure. They got sick and shortly after lost consciousness.
Detective Shaun Dadisman states,
“They were cleaning up the room and started to feel sick. And then that left them waking up in a hospital bed,”
According to the investigators in this case, the three nurses were treated with Narcan. The opioid overdose antidote Narcan is the brand name for Naloxone, which is used to reverse the effects of opioids on the respiratory system. The local law enforcement believe the substance the nurses were exposed to was fentanyl. Thankfully, all three nurses are said to have recovered.
A union representing nurses at the hospital intends to meet with hospital officials to review protocols for environmental contamination. A spokeswoman from the hospital states that the institution does have effective policies, which isn’t out of the question.
Police Officer Needs Narcan after Secondary Exposure Overdose
Just this summer, a police officer in a very similar situation almost died from an accidental overdose due to secondary exposure. Officer Chris Green was responding to a drug call when the incident occurred. The drug he came in contact with at the time was so powerful that even though officer Green said he was wearing gloves and a mask as he searched a suspect’s car, he still ended up being severely impacted by the substance. Merely by ending up with a white substance on his shirt officer Green needed to be revived with not just one, but multiple doses of Narcan.
How Does Secondary Exposure Overdose Happen?
Detective Shaun Dadisman spoke more about the dangers of opioid overdose through secondary exposure. Dadisman states,
“It shuts down your breathing. It shuts down your system so you get to the point where you’re not breathing on your own. And you need that boost and that Narcan is what takes that away so it helps you to recover quickly,”
Fentanyl and other opioids like carfentanil present a whole new level of danger concerning secondary exposure. The drugs are so intoxicating that law enforcement and medical personnel are now forced to come up with new policies and protocols just to handle an individual who may be overdosing on these drugs to protect themselves and others. Dadisman stated,
“I was actually stuck by a needle from an individual on a heroin overdose, so I had to run through all of the testing myself,”
The opioid epidemic now doesn’t just present an elevate risk of death to those who are using these drugs. Opioid abuse now poses a very real and deadly danger to those who work to save the lives of users every day. The greatest danger some of these drugs prevent is that of the unknown. As Dadisman points out,
“I think there will be continued changes – gloves, masks. And the problem with our first responders, police officers and our nurses and stuff, is you don’t know immediately what you’re dealing with. After the fact, you may know, but it may be too late.”
So now every day these synthetic opioid drugs don’t just threaten the lives of people who consume them, whether knowingly or not, but also the people closest to them.
So what can be said about secondary exposure overdose? Well, it is safe to say that with some of the most powerful drugs that are out there simply getting some on your skin or breathing it in, even on accident, can cause life-threatening illness. While hopefully this concept does not start a panic, it is a reality that more people should probably be aware of. Whether people are leaving the drug around others, consuming the drug in public places or being revived by loved ones and first responders, the fact is the drugs are stronger and more life-threatening than ever. The fact that a dose of Narcan might not save someone on the first shot should be enough to push for more awareness and more focus on finding a way to fight back.
So, what more can be done about the possibility of secondary exposure overdose?
If you or someone you love is struggling with opioids do not hesitate to get help. The rates for overdoses and opioid-related deaths are far too high to keep gambling with your life. Protect your loved ones and your future. If you or someone you love is struggling, please call toll-free now. We want to help.
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President Donald Trump promised a “major briefing” via his favorite publication… twitter… this Tuesday morning. Many people were expecting something big related to the request from the national opioid commission to declare a state of emergency for the opioid epidemic. But alas, this was not the case. President Trump made no announcement on new policies in the fight against opioids. Instead, he made a comment that sounds a lot like Nancy Reagan telling everyone to ‘just say no’ in the 80s, and we all know how well that worked.
This is concerning to so many who put stock in President Trump when he said he would make fighting the opioid epidemic a priority. Yet, so many feel like he is absent on the subject when it comes to establishing any initiatives or taking proactive action.
President Trump vowed on Tuesday that the United States will “win” the battle against the heroin and opioid outbreak. But instead of presenting a plan to support and reinforce treatment initiatives and other programs, the focus on his comments were claims to-
“- protect innocent citizens from drug dealers that poison our communities.”
The closer we look at the administration’s latest actions, the more it seems like this administration prefers the failed ‘just say no’ and War on Drugs mentality than actually offering a progressive answer.
President Trump Says Drugs are Bad
Probably the one part people are most annoyed with is when President Trump stated:
“Maybe by talking to youth and telling them ‘no good, really bad for you in every way’, but if they don’t start it will never be a problem.”
I feel like most of us did a good old fashion face-palm on this one… because DUH! We know drugs are bad (thanks Mr. Mackey) and we know talking to kids about drugs matters. That is why programs like Drug Abuse Resistance Education (D.A.R.E.) have been around for decades. However, we also know from D.A.R.E.’s track record that this kind of program hasn’t been particularly successful at stopping drug use either!
While giving this latest briefing from his 17 day “working vacation” from his golf club in Bedminster, New Jersey, President Trump also stated:
“The best way to prevent drug addiction and overdose is to prevent people from abusing drugs in the first place,”
“I’m confident that by working with our health care and law enforcement experts, we will fight this deadly epidemic and the United States will win.”
Now while it is true that addiction can’t technically develop if someone never uses substances, this still sounds a lot like ‘just say no’, which we all know does not work as a drug policy. Prevention is key and maybe with more detail about Trump’s plan on how to prevent drug use we could see where this comment is going. But as it stands, these comments just sound like more of the same.
After all, Trump’s Attorney General Jeff Session does seem to agree with the old War on Drugs tactics. Why, we may never know.
It is incredibly frustrating to advocates and experts involved in the addiction recovery community, as well as for citizens all across the nation who are hoping for some real change. Why- because we know that ‘just say know’ failed. We tried to just tell kids that drugs are bad for them and not to do them, but the epidemic still happened! And needless to say, just saying no is not going to help us with the overwhelming rates of addiction, overdose and death that we are already dealing with.
Far beyond that, understanding and overcoming addiction is about a lot more than just knowing its bad for you.
Is President Trump Ignoring Suggestions?
The president himself appointed the opioid commission, chaired by Republican New Jersey Governor Chris Christie. Only a week ago the panel urged President Trump to “declare a national emergency”, citing the tragically high overdose and death rates across the country. In the report issued by the opioid commission there were numerous recommendations that many were hopeful would come to fruition as soon as possible. Among these recommendations there is:
- Expanding treatment facilities across the country
- Educating and equipping doctors about the proper way to prescribe pain medication
- Equipping all police officers with the anti-overdose remedy Naloxone
All of these suggestions seem like they would make a pretty big impact on the current predicament. Empowering treatment providers in more of the U.S. can help get more addicts off the streets and introduce them to the option of getting well. Putting more power in the hands of doctors to safely and effectively provide medications could help reduce the staggeringly high prescription drug abuse rates. Giving the overdose antidote to more first responders could save so many more lives.
And yet, President Trump did not address a single one of these recommendations, or event suggest that one of them was on his current to-do list.
Instead, he went back to his go-to argument for solving all of our problems… our borders. Again, President Trump doesn’t give any indication as to planning for expanding treatment or Naloxone access. Nope… he just promises to be-
“-very, very strong on our Southern border.”
Did he talk about training doctors in order to avoid issues with prescription drugs? Nope. Instead he claimed:
“We’re talking to China, where certain forms of man-made drug comes in and it is bad,”
Yes, again we understand… ‘drugs are bad… mmmkay.’ But seriously, this is not the first time that this administration has shifted the focus from helping treat those who have suffered from drug addiction to ‘tough on crime’ tactics and border security. But time and time again experts in law enforcement and drug policy insist that the answer is not in attacking the supply side, but in treating those who suffer now.
Health and Human Services Secretary Tom Price told reporters they haven’t taken anything off the table, but that they believe at this point the necessary resources and focus can be addressed without an official declaration. However, looking at what declaring the emergency would have done, why would doing it be a bad thing?
Why a National Emergency Matters
The reality is, we are all well aware of the severity of the opioid epidemic by now. However, declaring a national emergency does actually count for something.
If President Trump were to declare a national emergency it would speak volumes to the scope of the issue on a national platform. Also, coming from one of the highest authorities in the nation, it would have opened the door to making those other suggestions happen.
According to Juliet Sorensen, a professor at Northwestern University Pritzker School of Law, Trump’s declaration could have:
- Allowed the executive branch to direct federal funds to expand treatment facilities
- President Trump would have also been able to direct funds to equip police with Naloxone
- Allowed him to provide the FBI, the Drug Enforcement Agency and other law enforcement agencies with more money to focus on the manufacturers and smugglers of dangerous drugs like fentanyl
But maybe one of the biggest impacts it could have had would have been on the rest of the House and the Senate. Fighting the opioid epidemic is one of the very few topics in politics right now that has bipartisan congressional support. Declaring a national emergency could give President Trump the perfect opportunity to unite both sides of the aisle and create cooperation and momentum.
This is a vital issue that should absolutely be a priority. Therefore, the idea of returning to an archaic, outdated philosophy concerning drug use is annoying at the least and potentially terrifying for some. The epidemic shows no sign of stopping anytime soon. Maybe it is time to do more than just tell people drugs are bad. If we want to do some good, we need to support each other with compassion.
Palm Healthcare Company values compassionate, comprehensive and innovative holistic treatment opportunities to help save the lives of those that are suffering, and we encourage professionals, community leaders and family members to get involved in helping change lives for the better. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now.
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If you believe you or someone else is experiencing fentanyl overdose symptoms, please call 911 right away. Fentanyl is an extremely potent potentially fatal drug and should not be underestimated.
Fentanyl, also known as fentanil, is an incredibly potent synthetic opioid pain medication with a rapid onset and short duration of action. This drug is considered to be around 50 to 100 times more potent than morphine, while some fentanyl analogues such as carfentali, which are designed to mimic the pharmacological effects of the original drug, may be as much as 10,000 times more potent than morphine. Fentanyl brand names include:
Individuals who abuse opioids, particularly heroin, are more likely to ingest fentanyl, knowingly or unintentionally. This puts them at an even higher risk of overdose.
In 2015 alone, 33,091 people died due to overdose on opioids like fentanyl.
Learning how to recognize the indications of a fentanyl overdose and getting professional substance abuse treatment may save a life.
Fentanyl Overdose Symptoms: Side Effects of Fentanyl
As an extremely potent opioid drug, fentanyl is very carefully prescribed and dosed by medical professionals. Those who abuse fentanyl may use the drug outside of prescription guidelines or without a prescription altogether, which can drastically increase their risk of lethal overdose.
Fentanyl’s most common side effects of Fentanyl use include
- Dry mouth
Some of the less common side effects of Fentanyl use include:
- Abdominal pain
- Anorexia and weight loss
- Flu-like symptoms
- Dyspnea (shortness of breath)
- Urinary retention abuse
Fentanyl Overdose Symptoms: Risks of abuse
With a powerful drug like fentanyl the risk of abuse is exceedingly high, especially considering the drug’s medical use is so limited to treating extreme cases. So when people take fentanyl in higher doses or more frequently than prescribed it of course elevates their risk for serious side effects and experiencing fentanyl overdose symptoms.
As far as recreational use, fentanyl is extremely dangerous. Using this drug in any way other than intended, such as snorting or injecting it, is not only illicit abuse of the chemical, but potentially life-threatening. In recent years drug dealers have been mixing fentanyl powder with heroin to increase potency or compensate for low-quality heroin. This illegally manufactured, non-pharmaceutical fentanyl cut into other substances caused an outbreak of overdose deaths in the United States and Canada over the past several years.
Combining fentanyl with other drugs can have effects that either compound the already severe side effects of fentanyl or contradict the effect and cause more chaos in the body. Using fentanyl with other substances is very hazardous, especially with drugs such as:
- Antidepressant medication
The Center for Disease Control and Prevention (CDC) conducted a study recently that showed:
- 82% of fentanyl overdose deaths involved illegally manufactured fentanyl
- Only 4% were suspected to originate from a prescription
National Forensic Laboratory Information System reported:
- 942 fentanyl seizures in 2013
- 3,344 fentanyl seizures in 2014
Fentanyl Overdose Symptoms: Signs to Look For
Being able to address a possible overdose means being able to recognize and understand some of the possible fentanyl overdose symptoms. While one of these may not be a definite indication, noticing a combination of symptoms may be a more serious issue.
A person experiencing fentanyl overdose symptoms may present with the following overdose signs:
- Pinpoint pupils
- Pale skin
- Choking sounds or gurgling/snoring noises
- Weak muscles
- Extreme sleepiness
- Very low blood pressure
- Dangerously slowed or stopped breathing
- Blue skin tinge nails and lips
- Loss of consciousness
- Intensely slowed heart beat
The effects of fentanyl overdose symptoms on an individual’s respiratory system and heart rate are the most serious relating to risk of death or permanent damage. Not only can this lead to coma or death, but even after surviving the overdose there can still be complications.
If not treated immediately, the impact of fentanyl overdose symptoms on the heart and respiratory system may cause residual problems such as permanent brain damage.
Fentanyl Overdose Symptoms: How Much Is Too Much?
It is difficult to determine the exact dose it would take for someone to experience fentanyl overdose symptoms. According to some medical professionals, 250 micograms of fentanyl might represent a lethal dose of fentanyl. However, most individual’s using heroin and other drugs are unaware that they have ingested the drug at all, let alone know how much fentanyl is in the doses.
At the end of the day, fentanyl overdose symptoms can vary depending on the individual, and the amount it takes to overdose will vary to. Some elements that impact the odds of overdosing includes:
- Other drugs taken
- Physical condition
In the event of an overdose of fentanyl you should seek immediate emergency medical assistance. Some cases require several doses of Narcan (Naloxone), the opioid overdose antidote, to stabilize the individual suffering from an overdose. Even if you have access to Narcan or Naloxone yourself, always contact emergency medical services to get assistance, because when the antidote wears off the overdose could return, or there may be other severe complications.
Opiate medications and street drugs have done a great deal of damage these past few years. Synthetic opioids like fentanyl have raised the risks and increased the death rates in a big way. Far too many lives are ruined, or brought to an abrupt end, because of overdoses when there is real help out there. Don’t wait until after an overdose. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now.
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Narcan is a brand name for the opioid overdose antidote Naloxone hydrochloride. Technically speaking, the opioid antagonist is a synthetic congener of Oxymorphone that is structurally different in that the methyl group on the nitrogen atom is replaced by an allyl group. In the past couple years Narcan has gradually become a household name. With the opioid epidemic in America continuing to ravage many communities across the nation, Narcan has become one of the first lines of defense. For some people, while they know now what this powerful substance is, they are still unsure how to use Narcan to stop an opioid overdose.
NOTE: All instructions in this article come from the Harm Reduction Coalition website. You can also look for Narcan/Naloxone training in your area. Different brands may provide more specific instructions. Be sure to real labels and warnings on Narcan or Naloxone kits.
How to Use Narcan: More about Narcan
Narcan works by blocking the effects of opioids and can actually reverse an overdose in order to get medical attention to someone who is in need. The life-saving opiate antidote is used for the complete or partial reversal of opioid depression, including respiratory depression. An opioid overdose can cause breathing to slow down or stop completely, putting someone’s life in immediate danger. Some examples of opioid overdoses Narcan may be used to reverse include the drugs:
One major plus is that Narcan has no euphoric effects and cannot get someone “high” so abuse is not an issue. The overdose antidote is essentially harmless if there are no opiods present in someone’s system. If given to a person who has not taken opioids, there will be no effect. Narcan can still be effective when alcohol or other drugs are present with opiates. However, some of the incredibly potent synthetic drugs such as Fentanyl and carfentanil have shown to be somewhat resistant to Narcan treatment, meaning those overdosing due to carfentanil require extra doses to be stabilized.
Administration to opioid-dependent individuals may cause symptoms of opioid withdrawal, including:
- Fast heart rate
There are other measures that can be taken to help ease these symptoms as well.
How to Use Narcan: Intravenous Infusion
The most rapid onset of action is achieved by intravenous administration, which is recommended in emergency situations. Narcan may be diluted for intravenous infusion in either:
- Normal saline
- 5% dextrose solutions
2 mg of Narcan mixed in 500 mL of either solution provides a concentration of 0.004 mg/mL. Narcan should not be mixed with preparations containing:
- Long-chain or high molecular weight anions
- Any solution having an alkaline pH
No drug or chemical agent should be added to the mixture unless its effect on the chemical and physical stability of the solution has first been established. To use the injectable Narcan:
- If the person is not breathing perform rescue breathing for a few quick breaths.
- Use a long needle (called an IM or intramuscular needle) which about 1 – 1 ½ inch. NOTE: If there isn’t a big needle, a smaller needle is OK and inject under the skin, but big needles are better.
- Remove the pop off orange top from the vial
- Draw up 1cc (1cc=1mL=100u) of antidote into the syringe
- Inject into a muscle, the best being thighs, upper, outer quadrant of the butt, or shoulder. NOTE: Inject straight in to make sure to hit the muscle.
- After injection, continue rescue breathing 2-3 minutes.
- If there is no change in 2-3 minutes, administer another dose and continue to breathe for them.
NOTE: If the second dose of naloxone does not revive them, something else may be wrong— either it has been too long and the heart has already stopped, there are no opioids in their system, or the opioids are unusually strong and require more naloxone (such as Fentanyl or carfentanil).
For more information, you should be able to find instructions in the Narcan kit, or inquire when picking up a Narcan kit about any opportunities to receive more in-depth training.
How to Use Narcan: Nasal Spray
Another resource that has helped make huge progress in fighting opioid overdose death rates is the Narcan (or Naloxone) nasal spray kit. The variation has made training people to administer the overdose antidote much easier and much less dangerous. Without needles, the nasal spray system helps eliminate the issue of blood contamination.
According to instructions posted through the Harm Reduction Coalition, there are about 5 steps for how to use Narcan with nasal spray.
- If the individual is not breathing perform rescue breathing for a few quick breaths.
- Attach the nasal atomizer (applicator) to the needleless syringe and assemble the glass cartridge of naloxone.
- Tilt the head back and spray half of the naloxone up one side of the nose (1cc) and half up the other side of the nose (1cc).
- If there is no breathing or breathing continues to be shallow, continue to perform rescue breathing for them while waiting for the naloxone to take effect.
- If after about 3 to 5 minutes there is no change, administer another dose of naloxone and continue to breathe for them.
NOTE: If the second dose of naloxone does not revive them, something else is wrong—either it has been too long and the heart has already stopped, there are no opioids in their system, or the opioids are unusually strong and require more naloxone (such as Fentanyl or carfentanil).
Regardless of if you use an intravenous Narcan kit or a nasal spray kit, Narcan should never be used as substitute for emergency medical care. In the event of an opioid overdose one should always call 911 right away, even if the individual wakes up. Narcan can wear off between 30-90 minutes, while the effects of the opioids can last much longer. It is possible that after Narcan wears off the overdose can return.
Also look into Narcan training programs in your area.
How to Use Narcan: Get More Help
When someone has to be revived from an opioid overdose it can be a pretty clear cut indication that something needs to be done in order to help them stay safe.
Another difficult aspect of how to use Narcan is that naloxone can cause uncomfortable opioid withdrawals. Because Narcan blocks the action of opioids in the brain, people can wake up feeling withdrawals practically immediately and try to use again. Of course this could result in another overdose.
Beyond administering Narcan to save someone’s life, take this as an opportunity to seek resources and start a conversation about getting them the help they need. Preserving life is important, but saving a life by changing a life can make a world of difference. There are empowering and innovative addiction treatment programs that specialize in addressing this chronic, progressive and fatal substance use disorder. After surviving an overdose presenting someone with the opportunity to get treatment may be the best chance they get.
Holistic addiction treatment allows people who were once hopeless build the foundation of hope again. If you or someone you love is struggling with substance abuse or addiction, please call Palm Healthcare Company. We want to help.
CALL NOW 1-888-922-5398