Fatal drug overdoses have skyrocketed in the past three decades. In fact, they claim the lives of more than 47,000 Americans each year. Opioids like prescription painkillers and heroin kill more than 28,000 Americans per year — 78 people per day. These are amazing numbers. We, as a society, are at war with these drugs and the drugs seem to be winning. While addiction treatment and education is the ultimate answer for permanent sobriety, society has been willing to try any and all methods if it saves just one life. One of these stop-gaps is a medical intervention drug called Narcan. It is used to help opiate overdoses come back to life and it is carried by most first responders these days. However, with the knowledge by addicts that first responders carry this intervention the question has arose: Is Narcan a path to healing or is it a crutch?

What Is Narcan?

Naloxone, more commonly known by the brand name Narcan, is an opiate antidote that reverses opioid overdoses. It is regularly carried by medical first responders and can be administered by ordinary citizens with little or no formal training. In its nasal spray form, Narcan is available to the public, with or without a prescription. An injectable form of naloxone is used by first responders to revive those who have overdosed on heroin, prescription painkillers like OxyContin and deadly opioids like fentanyl.

When someone overdoses on these drugs, their breathing slows to dangerous levels and they may fall unconscious and come very close to death. Injected or sprayed up the nose, naloxone works rapidly to stop an overdose in its tracks by blocking the effects opioids have on the brain receptors. On a biological level, this life-saving drug counters the life-threatening depression of the central nervous system and respiratory system. Narcan creates a small window of time to get someone to medical care after an overdose, as the effects of naloxone only last 90 minutes at most.

A Vicious Cycle

Unlike its buprenorphine-containing cousin Suboxone (another opioid antagonist), Narcan has no abuse potential and cannot be used to get high. Conversely, receiving a dose of this life-saving drug plunges addicts into immediate, overwhelming withdrawal symptoms. Some of the reported side effects of Narcan include vomitting, diarrhea, sweating profusely, runny nose, sneezing and runny eyes, and severe body aches. 

Stronger opioids like fentanyl often require two or more doses of naloxone. As the strength and unknown potency of opioids increases, more naloxone is needed to revive someone who has overdosed. In turn, these higher doses intensify the withdrawal symptoms felt by the person being brought back from the brink of death. This immediate sobering up caused by Narcan puts the addict into what is called being “dope sick.” The addict immediately starts to feel the physical withdrawals of the opiates and often lands substance users right back to square one, taking the same drugs they overdosed on just to ease the agony of Narcan-induced withdrawal. This is because naloxone not only reverses overdose, it also rips away the withdrawal relief addicts were seeking in the first place by using opioids. For this reason, naloxone is used by those with substance use disorders only as a last resort.

Narcan Saves Lives…

This heartbreaking, life-and-death-and-back-again cycle is all too familiar for Emergency Medical Service (EMS) providers, first responders and firefighters who carry naloxone. In Ohio alone, a sobering 19,792 naloxone doses were administered in 2016. Some of these doses were given by law enforcement agencies, who have started carrying the drug in greater numbers. Narcan is in high demand all across the Greater San Diego area in response to this public health emergency.

…But It’s No Cure For the Heroin Epidemic

An increasing number of states like California are advocating that naloxone use is a key component in overdose prevention, but not everyone thinks so. Critics of the drug claim that naloxone actually enables addicts, giving them a safety net to fall back on as they use greater amounts of opioids. In July 2016, Maine governor Paul LePage vetoed legislation allowing increased access to the life-saving drug, claiming naloxone only tides addicts over until their next fix.

“Creating a situation where an addict has a heroin needle in one hand and a shot of naloxone in the other produces a sense of normalcy and security around heroin use that serves only to perpetuate the cycle of addiction.” – Paul Lepage, Maine Governor

However, the scene that Governor Lepage paints is highly unlikely: the people who overuse opioids fear naloxone the most. Not only because of the aforementioned side effects but because addicts generally don’t use in order to overdose. They realize that there is always a potential but they don’t use to die. They use to stop feeling pain mostly.

Proponents for stricter Narcan laws also point to the inherently dangerous situations EMS staff find themselves in when administering the drug. Because Narcan causes acute withdrawal symptoms, a handful of treated patients awake aggressive and violent. Deputy Chief John Everett of Portland, Maine’s Fire Department knows this viciousness first hand:

“They’re usually very angry when we bring them around,” he noted. “One kid yelled at me, ‘You think this will make me stop doing drugs?’ I said, ‘No, the only thing that will make you stop doing drugs is a body bag.’”

FDA studies show that because of this unpredictable, unchecked rage, some first responders feel reluctant to administer repeat or future doses of Narcan. This only fuels the arguments against a drug that saves thousands of lives every year in California and beyond.

Naloxone: Crutch or Help?

On the other hand, there are those who fight vehemently for the drug’s continued usage and distribution. In response to the Governor LePage’s sharp remarks, Dr. Alexander Y. Walley of Boston Medical Center says, “…arguing that naloxone encourages riskier drug use is like saying that seatbelts encourage riskier driving.” Dr. Walley exclaimed that Narcan ruins drug highs and leaves people violently ill.  

Boston Police Chief John Rosenthal further advocates for the use of naloxone by first responders, saying,

“We cannot save a dead person. Every life saved with Narcan is an opportunity for a person suffering from the disease of addiction to reclaim their life.”

And a second shot at life is exactly what Narcan gives those who want to change their ways. For people like Sarah Connolly and Katrina Henry, repeated overdoses left them strung out in often public settings like a Burger King bathroom and in the middle of the road. Being revived with Narcan was the wake-up call they needed — and their second chance at life. Both women are reaching their full potential after lives of addiction, and it’s all thanks to a drug called naloxone.

How San Diego Sober Living Can Help

The opioid epidemic continues hand-in-hand with the Narcan debate. Still, hope isn’t lost. For those seeking an escape through substance use, the answer to lasting peace isn’t more pills, it’s an honest and diligent pursuit of sobriety.

As with all public health problems, there is no one solution to stop overdose deaths. A solution that includes increased access to evidence-based treatment and destigmatization of addiction is necessary to create lasting change. And that’s exactly the mission of San Diego Sober Living.