May 23, 2024

Naloxone: The Life-Saving Overdose Antidote

Naloxone, also known by the brand name Narcan, is a life-saving medication designed to rapidly reverse opioid overdose. It works by blocking opioid receptors in the brain and restoring normal respiration to a person whose breathing has slowed or stopped as a result of an opioid overdose. Narcan has no potential for abuse and is not a controlled substance. It has been used safely by medical professionals for decades to reverse overdoses.

How Does it Work?
Opioids like heroin, morphine, oxycodone and fentanyl work by binding to and activating opioid receptors in the central nervous system and gastrointestinal tract. This interaction is responsible for the analgesic and euphoric effects but can also greatly slow or stop breathing when opioids are present in extremely high doses. Naloxone acts as an opioid antagonist – it binds tightly to the same opioid receptors without activating them. This effectively kicks the opioids off the receptors and allows breathing to resume. Narcan has a much higher binding affinity for opioid receptors than opioid drugs themselves. It can reverse and block the effects of opioids within 2 to 8 minutes.

Who Can Access and Administer Narcan?
For years, narcan was available primarily through medical professionals like doctors and paramedics. However, opioid overdose rates surged to crisis levels and it became clear more expansive access was needed to effectively counter this epidemic. Most states now have laws allowing laypeople to purchase and carry narcan after basic overdose response training. It is commonly distributed through overdose education and narcan distribution programs. Narcan can now be obtained directly from pharmacies without a prescription in many areas as well. This puts the lifesaving medication within reach of anyone who may witness an overdose, including family and friends of those at risk.

Forms and Administration of Naloxone
There are a few different narcan formulations on the market. Narcan hydrochloride injection comes in prefilled syringes for intramuscular or subcutaneous use. An automatic injection device called Evzio voices instructions and administers a single dose with just two steps. Narcan nasal spray is easy to use – one spray is delivered into one nostril. For best results, emergency responders are trained to administer multiple doses until the person is breathing regularly on their own and emergency medical services have arrived. Additional doses may be needed if the overdose involved a long-acting opioid or fentanyl.

Widespread Distribution is Saving Lives
As of 2020, there is widespread agreement within the medical community that expanding access to narcan is an important public health strategy for mitigating the harms of the ongoing opioid overdose crisis. Preliminary data shows narcan distribution programs have succeeded in putting this antidote into the hands of those who need it most. A 2021 study found narcan access laws are associated with a 9-11% reduction in opioid overdose deaths. Other reports indicate layperson narcan reversals have helped save hundreds of thousands of lives across the US and Canada in the last decade alone. With overdose numbers remaining at an all-time high, expanded narcan distribution continues to be a vital part of multi-pronged approach towards remedying this crisis.

1. Source: Coherent Market Insights, Public sources, Desk research.
2. We have leveraged AI tools to mine information and compile it.