Naloxone: A lifesaver that is quickly gaining appeal

Registered Nurse Babette Richter, with the South Jersey AIDS Alliance, holds up a container of the heroin overdose antidote, naloxone, also known by its brand name Narcan, in Camden, N.J. on Saturday, Feb. 22, 2014. An overdose of opiates essentially makes the body forget to breathe. Naloxone works by blocking the brain receptors that opiates latch onto and helping the body "remember" to take in air. (AP Photo/Mel Evans)
Registered Nurse Babette Richter, with the South Jersey AIDS Alliance, holds up a container of the heroin overdose antidote, naloxone, also known by its brand name Narcan, in Camden, N.J. on Saturday, Feb. 22, 2014. An overdose of opiates essentially makes the body forget to breathe. Naloxone works by blocking the brain receptors that opiates latch onto and helping the body "remember" to take in air. (AP Photo/Mel Evans)
Posted: April 05, 2014

Thursday's approval of a prescription overdose-reversal injector for home use is just the latest in a flurry of moves to get the drug to the front lines of the nation's deadly opioid epidemic.

The same day, New York announced that every state and local enforcement officer will carry naloxone. The day before, Gov. Christie said that 32 Ocean County police departments are participating in a pilot program.

A month before that, police chiefs and the district attorney in Delaware County, where several dozen people a year have been dying from overdoses, called on Harrisburg to pass legislation that would allow them to do the same.

And the month before that - in February - a group began training laypeople in Camden how to administer the drug in the event that a son, daughter, buddy, or stranger was overdosing; the South Jersey AIDS Alliance on Wednesday reported its "third life saved" through the program.

An established Philadelphia program says it has documented nearly 200 saves that way, and probably many more. A Pittsburgh effort claims more than 1,000. Nationwide, laypeople reported reversing more than 10,000 potentially fatal overdoses, the Centers for Disease Control and Prevention said in 2012.

And you never heard of naloxone?

"It is one of the best pure antidotes that we have in medicine," said Charles P. O'Brien, a University of Pennsylvania psychiatry professor who has been studying the short-acting drug - and its longer-acting sibling, naltrexone - for 40 years.

"If you find somebody unconscious, the best thing to give them is a naloxone injection. If you're wrong, and it's a subdural hematoma" - bleeding in the brain - "this wouldn't hurt," O'Brien said.

The needed dosage varies depending on the cause of the overdose. Heroin laced with fentanyl, a dangerous combination, requires more. With too much, however, "the worst that it can do is put you into withdrawal," O'Brien said.

Discovered more than a half-century ago, naloxone hydrochloride (also known by the brand name Narcan) was the first "pure antagonist" - a drug that completely blocked receptors in the brain, preventing opioids from attaching, yet had no opiate effects of its own. It is not a narcotic and cannot cause addiction.

An overdose from heroin or other opioids, like Percocet and OxyContin - overdoses typically involve more than one drug - kills slowly. The user gets sleepy, almost comatose. Eventually he or she stops breathing and dies.

Naloxone blocks the opioid receptors immediately. The breathing reflex usually is restored within seconds.

Paramedics and emergency room doctors have used it for years. Anesthesiologists keep it for emergencies. It is given in delivery rooms to revive babies who absorbed opioids from their mothers, due either to addiction or excess narcotic pain relievers administered during birth.

In some areas of the country, physicians hand high-risk patients prescriptions for naloxone along with scripts for the pain reliever OxyContin, an idea that has generated some interest here as well.

As overdose deaths skyrocketed in recent years, programs that work with addicts - typically exchanging clean needles for dirty ones, as they do in Philadelphia, Pittsburgh, and Camden - began providing clients and families with the drug, and training them how to use it.

The legality of these programs can be murky, however. New Jersey's programs began only after legislation was passed. Philadelphia and Pittsburgh didn't wait.

Several bills have recently been introduced in Harrisburg covering both naloxone and so-called 911 Good Samaritans - granting immunity from prosecution to people who may be afraid to report an overdose because they are carrying drugs. Trenton has passed a similar law.

Scott Burris, a law professor at Temple University who has been involved with the naloxone movement for a decade, said several states have passed legislation since the actor Philip Seymour Hoffman's overdose death in February.

Preventing addiction is a complex societal problem, he said. Reversing overdoses, while late in the game, is simpler.

"The thing about naloxone and Good Samaritan is that basically they can save lives when they can be saved.

"There's a very strong appeal," Burris said, to "empowering friends, and moms and dads, sisters and brothers, to save their loved ones."


dsapatkin@phillynews.com

215-854-2617

@DonSapatkin

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