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
Ever since Methadone was introduced to combat opioid dependence, it has been leaned on by countless people over several decades to treat opioid abuse. For a long time methadone clinics have been looked to as a source of relief from an addiction to opioids, but are they as effective as people seem to think? Over time more people who have used methadone to try overcoming serious addictions have realized methadone maintenance also comes with a great deal of damaging side effects.
What is a methadone clinic?
A methadone clinic is a clinic for the dispensing of methadone. Because this is a schedule II opioid analgesic drug, access must be restricted. Methadone clinics are a way to provide people with this medication. But before you rush out to find the one closest to you, there are a lot of things to consider.
What is a Methadone Clinic: History of Methadone
Firstly, let us not that methadone is an opioid drug. It is used to treat pain, like most opioid medications, but most people know it as a maintenance drug for detoxing from dependence on other opioids, such as heroin. Methadone, sold under many brand names, including:
Different countries have different brands as well. A few footnotes of the history of methadone include:
Methadone was developed in Germany by Gustav Ehrhart and Max Bockmühl.
The United States approved the use of Methadone.
About 41.400 kilograms of methadone were manufactured globally
What is a Methadone Clinic: Methadone Detox
Methadone is available in various forms, including:
- Sublingual tablet
- Two different formulations designed for the patient to drink
Drinkable forms include:
- Methadose- the ready-to-dispense liquid form found in theUnited States.
- Diskets- tablets designed to work like Alka-Seltzer, dispersing rapidly in water for oral administration.
The most common method of administration is the liquid form, because it allows for small dose changes. Methadone is almost as effective when administered orally as by injection.
Detoxification using methadone is intended to be a way for people addicted to opioids such as heroin or powerful prescription drugs to taper off, but at the same time detoxification using methadone has been met with a great deal of controversy.
Many who oppose methadone clinics refer to this strategy as methadone substitution. As a treatment of opioid addiction methadone is heavily criticized for its role in what some call “social control of addicts.” Many who oppose methadone suggested that the drug does not function as much to curb addiction as to redirect it and maintain dependency. In other words, some insist methadone is essentially keeping people addicted, but making sure the money goes to drug manufactures and methadone clinics instead of street dealers.
What is a Methadone Clinic: Methadone Side-Effects
There are so many adverse effects of methadone, which may vary in range and severity depending on the individual. There include, but are not limited to:
- Diarrhea or constipation
- Heat intolerance
- Chronic fatigue
- Sleep problems
- Memory Loss
- Weight gain
- Stomach pains
- Mood changes
- Decreased libido or impotence
- Urinary difficulty
- Blurred vision
- Skin rash
- Low blood pressure
- Heart problems
- Respiratory problems
Some of these adverse effects of methadone use are much more serious than others.
What is a Methadone Clinic: Withdrawal Symptoms
There is also a massive list of possible withdrawal symptoms from using methadone. This is one of the primary issues many people have with methadone treatment.
Physical withdrawals include:
- Runny nose and sneezing
- Aches and pains (especially in joints)
- Sensitivity to pain
- High blood pressure that may cause strokes
Others are more concerned with the mental aspect of the withdrawals experienced from methadone.
Cognitive withdrawals include:
- Suicidal ideation
- Drug cravings
- Hallucinations (auditory and visual)
- Panic disorder
The irony is that methadone withdrawal symptoms are even reported to last significantly longer than withdrawals from some other opioids. In some cases, people may even try to treat an opioid addiction with this drug not knowing that it is actually a much worse opioid to withdrawal from.
What is a Methadone Clinic: Methadone Overdose
As mentioned before, there are some very real dangers when it comes to using methadone.
- Between 1999 and 2004, deaths in the U.S. linked to methadone quadrupled.
- In 2004 reports credit methadone as contributing to 3,849 deaths, 82% of which were reported as accidental.
- In 2011, there were 4,418 deaths in the United States involving methadone. At the time that made up 26% of total deaths fromopioid poisoning.
Respiratory depression is probably the most common overdose risk related to opioid drugs. Other symptoms of a methadone overdose include:
- Hypoventilation (slow/shallow breathing)
- Cool, clammy skin
- Limp muscles
- Excessive vomiting
- Risks are greater with higher doses, as well as mixing methadone with any other drugs.
The risks of methadone are very, very real. In fact, U.S. Food and Drug Administration (FDA) issued a Public Health Advisory back in 2006 about methadone titled “Methadone Use for Pain Control May Result in Death and Life-Threatening Changes in Breathing and Heart Beat”. In the report, the FDA stated that they received reports of death and life-threatening side effects with patients who were newly starting methadone.
Both individuals who were starting methadone for pain, or who were trying to switch to it from another powerful narcotic pain reliever were included to be at an elevated risk, according to the FDA.
What is a Methadone Clinic: Another Way
Getting off of powerful opioid drugs, whether they are prescription narcotics or illicit street drugs, is possible without the use of methadone. While maintenance drugs can be useful to some extent as a means of harm reduction, these should not be considered as sustainable means of addiction recovery. Maintenance drugs are typically only ever effective if utilized in combination with therapy and other forms of addiction treatment.
Luckily there are other ways to get help. It is possible to be safely and effectively removed from a methadone taper through a safe medical detox. Understanding methadone can also be fatal is of vital significance. Methadone detox can be deadly if not supported by a medical staff with the right medications to help ease the pain and discomfort of the detox. Medical detox combined with a holistic treatment program is a proven strategy for saving lives.
If you or someone you love is struggling, do not wait. Please call toll-free now. We want to help. You are not alone.
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