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Posts Tagged ‘Narcan’

Narcan Will Soon Be Over-the-Counter. Here is What You Need to Know. By Our Student Pharmacist, Jadelyn Cheng.

In the upcoming weeks, Narcan (naloxone 4 mg) nasal spray will hit the shelves of many grocery stores, pharmacies, and gas stations for purchase directly over-the-counter without needing a prescription.

To help you understand this rescue drug better, we’ve compiled some frequently asked questions and their answers.

Graphic 1

What is Narcan? Is it different from naloxone?

Narcan is a brand name for a nasal spray that contains naloxone as its active ingredient. It is a lifesaving medication used to reverse the effects of an opioid overdose. It is an opioid antagonist, which means it binds to the same receptors opioids bind to in the brain, blocking the opioids and reversing their effects. It can rapidly restore consciousness in someone who has overdosed on an opioid.

Currently, Narcan is the only version of the naloxone nasal spray that is over-the-counter. However, the Food and Drug Administration (FDA) has recently approved a second over-the-counter naloxone nasal spray called ReVive. People can expect this alternative to be more broadly available at a lower cost in 2024.

Why should I carry Narcan?

Opioid overdoses can happen anywhere, anytime, and to anyone. Keeping Narcan in your emergency kit or carrying it on the go can save lives. 

Can Narcan be used for all types of opioids?

Yes! Narcan is effective for reversing prescription painkillers prescribed for chronic pain, injuries, and surgeries, as well as opioids commonly found in illicit or street drug use.

Common opioids include:

  • morphine
  • codeine
  • OxyContin (oxycodone)
  • Vicodin (hydrocodone)
  • tramadol
  • buprenorphine
  • heroin
  • fentanyl

Who can be given Narcan?

Narcan is safe to be administered to anyone of all ages, from infants to teens to older adults. This can be especially useful for children and teens who unintentionally ingest a prescription opioid.

What are the signs and symptoms of an overdose?

Here are the signs and symptoms to look out for: Graphic 2

Act fast! If someone displays symptoms or you suspect an overdose, use Narcan.

How do I use Narcan? What do I do after?

If you suspect an overdose, act quickly. Look for signs like difficulty breathing or unresponsiveness. If the person does not respond to gentle shaking, follow the steps: LAY – SPRAY – STAY.


Graphic 3
You cannot overdose on Narcan, so it is safe to continue administering new doses every 2-3 minutes until emergency services arrive.

Can I give myself Narcan?

You cannot administer Narcan to yourself. This is why your friends and family must know that you carry Narcan, where you store it, and how to use it.

Can I use Narcan if I’m unsure someone is experiencing an overdose?

Narcan has no effect if opioids are absent in a person’s body. If it is given to someone who is not overdosing on an opioid, it will not harm them.

Are there any side effects or risks associated with Narcan?

After using Narcan, some people may experience side effects such as shaking, sweating, nausea, or irritability. This is commonly referred to as acute withdrawal syndrome.

Where can I buy Narcan?

The current retail price of Narcan is approximately $44.99. The manufacturer of Narcan currently has a search tool to find Narcan online or at a store near you: https://narcan.com/buy 

Can I get Narcan for free or at a reduced cost?

NaloxoneOhio is an initiative to provide Ohioans with a database of providers and sites that offer free Narcan. Access that here: https://naloxone.ohio.gov/get-naloxone/individual

For More Information, Visit:

CDC. (2020). Save a Life from Prescription Opioid Overdose. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. https://www.cdc.gov/rxawareness/prevent/index.html

References:

Bennett, A. S., Freeman, R., Des Jarlais, D. C., & Aronson, I. D. (2020). Reasons People Who Use Opioids Do Not Accept or Carry No-Cost Naloxone: Qualitative Interview Study. JMIR formative research, 4(12), e22411.https://doi.org/10.2196/22411

Carpenter, J., Murray, B. P., Atti, S., Moran, T. P., Yancey, A., & Morgan, B. (2020). Naloxone Dosing After Opioid Overdose in the Era of Illicitly Manufactured Fentanyl. Journal of medical toxicology : official journal of the American College of Medical Toxicology, 16(1), 41–48. https://doi.org/10.1007/s13181-019-00735-w

Images:

  1. https://narcan.com/
  2. https://narcan.com/opioid-education
  3. https://narcan.com/resources

Using Opioid Narcotics: Safety Tips and Using Narcan ® (Naloxone). By Our Student Pharmacist, Madeline VanLoon.

Opioids are a class of medication that include heroin, as well as prescriptions medications such as:

  • morphine
  • codeine
  • methadone
  • oxycodone (Oxycontin, Percocet)
  • hydrocodone (Vicodin, Norco)
  • fentanyl (Duragesic), hydromorphone (Dilaudid)
  • buprenorphine (Subutex, Suboxone).

Opioids are extremely effective in controlling pain; however, they also carry risks such as significant constipation, physical dependence, and respiratory depression. Respiratory depression is also known as an “opioid overdose,” and occurs when breathing slows or stops, leading to death. This is why it is important to be careful when using these medications.

image 1 jpeg

What are the risks of an opioid overdose?

You are more likely to experience an opioid overdose if you:

  • Take 50 morphine milligram equivalents (MME) or more of prescribed opioids every day

  • Take opioid medications together with other sedating drugs, such as benzodiazepines and muscle relaxers

  • Have conditions such as lung disease, kidney dysfunction, liver dysfunction, or if you are HIV-positive

  • Have a decreased tolerance due to recent abstinence or break in therapy

  • Have a history of illicit substance use disorder

  • Have a history of overdose from opioids

  • Use any illicit drugs or have an opioid use disorder

How can an opioid overdose be prevented/stopped?

Avoid the risk factors listed above at all costs. If you are prescribed opioid medications by a physician, it is important to take them as sparingly as possible, and no more than prescribed. If you have a substance use disorder, talk to your doctor about seeking treatment.

In an overdose, Narcan ® (naloxone) is a medication that rapidly reverses the effects of opioids long enough to call an ambulance. The Centers for Disease Control and Prevention (CDC) recommends that naloxone be provided to all patients who have or know someone with risk factors for opioid overdose. Extensive administration education is provided to all who receive the medication.

image 2

Overview of naloxone:

Naloxone (nal-OKS-one) blocks the effects of opioids on the brain and restores breathing. It is safe to give to anyone who is experiencing a known or suspected overdose caused by opioids. It has very few side effects and drug interactions. It will produce withdrawal symptoms. In situations where an overdose was caused by non-opioid drugs, naloxone will not be effective.

Naloxone only lasts 30-60 minutes in the body, but opioid medications typically last much longer. That is why it is so important that if someone receives naloxone, emergency medicine services (9-1-1) are called and that they go to the hospital. As soon as naloxone wears off, the risk of overdosing returns.

Keep naloxone on hand if you or someone you know has risk factors for opioid-related overdose. It’s like having a fire extinguisher – hopefully you will not need to use it, but it can be the difference between life and death.

If you are at risk for opioid overdose, educate your family and others around you on how and when to use naloxone.

How do I get naloxone?

Naloxone can be accessed at many pharmacies and public health agencies. If you believe you or someone you know has risk factors for an opioid overdose, ask your pharmacist or health department about accessing naloxone.

How do I use naloxone and recognize an overdose?

  1. The signs of an overdose include:

    1. Slow breathing (less than 1 breath every 5 seconds) or no breathing

    2. Vomiting

    3. Pale and clammy face

    4. Blue lips or nails

    5. Slow heartbeat

    6. Snoring or gurgling noises

    7. Unresponsive

  2. Try to wake the person

  3. Call 9-1-1

  4. Make sure nothing is in the person’s mouth

  5. Give rescue breathing

  6. Use naloxone and continue rescue breathing

image 3 jpeg

  1. Turn the person on their side if the person begins breathing on their own. This is to avoid choking.

  2. Stay with the person until EMS arrives

Visit the State of Ohio Board of Pharmacy website for more information on administering naloxone.   https://www.pharmacy.ohio.gov/Pubs/NaloxoneResources.aspx

References:

NARCAN nasal spray. ADAPT Pharma. https://www.narcan.com/. Accessed June 10, 2020.

Naloxone resources: pharmacist dispensing of naloxone. State of Ohio Board of Pharmacy.https://www.pharmacy.ohio.gov/Pubs/NaloxoneResources.aspx. Accessed June 10, 2020.

Prevention of lethal opioid overdose in the community. UpToDate. Wolters Kluwer. Available athttps://www.uptodate.com. Accessed June 9, 2020.

Streamline processes for providing naloxone. Pharmacist’s Letter. 2018.https://pharmacist.therapeuticresearch.com. Accessed June 9, 2020.

Images:

  1. https://www.drugabuse.gov/drug-topics/opioids/opioid-summaries-by-state/ohio-opioid-involved-deaths-related-harms

  2. https://www.narcan.com/

  3. https://www.narcan.com/

 

The Epidemic That Hurts Us All. By Our Student Pharmacist, Doug Gugel-Bryant.

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There’s an elephant in the room. This elephant is killing humans and eliciting fear on a massive scale. The only way to get rid of this elephant is to talk about it.

The “elephant” I’m referring to is the opioid and heroin abuse problem. This abuse situation is plaguing every part of America, especially here in Ohio.

I’ll give you a fact: heroin kills at least twenty-three Ohioans every week. That number translates to one out of every five Ohio residents knowing someone who is struggling with heroin.

We have a huge problem on our hands.

It would help to understand how this problem happened with a bit of a heroin history lesson. It’s fair to say that heroin has always been an issue, but it has grown over the past decade. Heroin is derived from the opium that is extracted from the poppy plant (papiver somniferum). Heroin was first manufactured in 1898 by Bayer for treatment of tuberculosis and morphine addiction. It was discovered that using heroin to fix addiction problems created a new problem that hasn’t stopped for over one hundred years.

The reason heroin was thought to be used for morphine addiction is that heroin is chemically similar to other opiates used for pain. That means heroin has the same overall action as opioids, but a different intensity of the action, also called potency. Heroin is about 4-5 times more potent than morphine, which is why people use it to get high. The feeling of the high from heroin creates a euphoric state that eliminates sensations, such as pain. The more heroin you consume, the stronger the high and the less pain you feel.

The concerning issue of using too much heroin comes from the other effects heroin can have on the body. Remember how I said heroin reduces sensations? Another sensation your body loses is the “sense” to breathe when you are low on oxygen. This is where overdose causes death.

Heroin1

We’ve seen an increase in overdoses over the past few years. In 2015, there were just under 14,000 deaths from heroin overdose. That’s twice as many deaths compared to cocaine. This is a growing problem and hasn’t shown any signs of slowing down. This is where you can step in. Law makers have been combatting the issue along with first responders and officers trying to keep people safe. But waiting for a paramedic or other first responder to arrive on the scene takes time–and in overdose situations, we don’t have the liberty of letting time slip by.

There are two things you, with little or no background in medicine, can do right now to save a life.

  1. Recognize the signs and symptoms of an overdose: I hope you never have to come across someone who has overdosed on heroin. But if you do, I want you to act appropriately to save someone’s life. The first step is knowing if someone could have overdosed. Since opioids and heroin are related, they share the same signs and symptoms of an overdose. You can follow the rules below if you suspect someone has overdosed on heroin or any opioid.

Heroin2

  1. Use the antidote, naloxone: There is a medication that can correct an overdose to heroin. That medication is called naloxone (brand name Narcan). Naloxone is an opioid antagoinist, meaning it tries to kick heroin off of the receptors in the brain where it binds and reverse the overdose. While this is great, it is a short lived action. The heroin can come back in and re-bind to the receptors and cause symptoms of the overdose again. The purpose of naloxone is to buy time for the paramedics to reach the scene and take over. Any time spared can save a life.

Heroin3

I stated you should use the antidote, because naloxone can be purchased without a prescription from a pharmacy. This was recently allowed by new laws in the hopes that lives could be saved. An entire list of every pharmacy that sells naloxone can be found at this link.

http://pharmacy.ohio.gov/Licensing/NaloxonePharmacy.aspx

Likewise, to find information about overdoses and how to use naloxone, please refer to Project DAWN (Deaths Avoided With Naloxone) for various resources.

http://www.odh.ohio.gov/health/vipp/drug/ProjectDAWN.aspx

We live in a time that is plagued with bad news. Whether it is politics, foreign affairs, or events close to home, life recently hasn’t been fun. Let’s do our part to bring good news–“another life saved from heroin.”

References

  1. Reichle C, Smith G, Gravenstein J, Macris S, Beecher H. COMPARATIVE ANALGESIC POTENCY OF HEROIN AND MORPHINE IN POSTOPERATIVE PATIENTS. Jpetaspetjournalsorg. 2017. Available at: http://jpet.aspetjournals.org/content/136/1/43.short. Accessed February 26, 2017.
  2. Watch Truth About Drugs Documentary Video & Learn About Substance Addiction. Get The Facts About Painkillers, Marijuana, Cocaine, Meth & Other Illegal Drugs. Foundation for a Drug-Free World. 2017. Available at: http://www.drugfreeworld.org/drugfacts/heroin.html. Accessed February 26, 2017.
  3. Overdose Death Rates. Drugabusegov. 2017. Available at: https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates. Accessed February 26