& Why Should You Know How to Use It?

TW: This article discusses opioid overdoses and statistics about opioid deaths.

A few weeks ago, I was riding the Amtrak between Seattle and Portland when a man across the aisle from me had an overdose. Luckily, there was a doctor sitting close-by who noticed and tried to assist. He called 911 and administered CPR, and eventually had to intubate using the train’s first aid kit. He sent people running up and down the train to see if anyone had Narcan, the life-saving Naloxone nasal spray used to treat opioid overdoses. No one did. Due to the fact that we were not in the city, but instead on the train tracks in the middle of a field, the ambulance did not show up for 10 minutes. By the time the ambulance arrived, the man had still not regained consciousness. The fact that no one on the train had Naloxone, including myself, was a serious wake-up call.

Opioid Overdoses in OR

Unfortunately, incidents such as this are far too common. Last year, opioid overdoses killed an average of 3 people per week in the Tri-County area..

According to a survey by the NIH, in 2017, there were 344 overdose deaths involving opioids in Oregon. During this time, there were increases in cases related to synthetic opioids. From 2015 to 2017, fentanyl-related deaths in Oregon rose from 34 in 85, and heroin-related deaths grew from 102 to 124.

NIH: Opioid-Related Overdose Deaths, revised March 2019

What is Naloxone?

Naloxone hydrochloride is the fast-acting non-narcotic opioid antagonist that blocks the brain cell receptors activated by opioids, as well as heroin and other opiates. When administered during an overdose, it reverses the mental effect of opioids and restores breathing within two to three minutes. Naloxone is non-psychoactive and non-addictive, and side effects from it are rare.

According to the Drug Policy Alliance, Naloxone has been administered in ambulances and emergency rooms in the US for over 40 years, and has a long history of being a fast and effective way to reverse an overdose with minimal side-effects.

However, it was only within the past five years that it started being available to laypeople. This was in response to the opioid overdose crisis and supported by research by the National Institutes of Health and the CDC demonstrating the effectiveness of community-based naloxone trainings. The CDC found that between 1996 and 2014, community-based overdose prevention programs trained and equipped more than 150,000 laypeople with naloxone, who successfully reversed over 25,000 opioid overdoses.

In April 2014, the FDA approved a handheld naloxone auto-injector device called Evzio, which employs voice prompts to guide the user through the accurate administration of naloxone. In November 2015, the FDA approved an intranasal naloxone formulation to be marketed under the brand name Narcan Nasal Spray. A cheaper, generic opioid antidote is set to be released mid-2019.

Why Should You Carry Naloxone?

If someone in your life has an opioid addiction and you are with them in the event of an overdose, if properly equipped with naloxone, you are 48 times more likely to save their life than a service provider. According to a CDC report in June of 2015, 82.8% of the reported reversals were done by individuals who use drugs, 9.6% were done by friends and families of a user, and only .2% were administered by service providers.

So how can you equip yourself to be prepared if this were to occur? Oregon law now allows lay people to carry and use naloxone on others. Any healthcare provider or pharmacist in Oregon can now prescribe naloxone to individuals who request it, given that they or someone in their life is considered at risk for overdosing.

According to Stay Safe Oregon, individuals who meet the following descriptions are considered at risk for overdosing:

People using heroin or misusing other opioids
People on high doses of opioid pills
People mixing opioids with sedatives such as Xanax or Klonopin
People who have previously overdosed
People with underlying respiratory problems – sleep apnea and Chronic Obstructive Pulmonary Disease (COPD).

People whose tolerance is much lower because they didn’t use for a period of time, for example because they were in treatment or in jail.

Ask your healthcare provider or pharmacist about your options for obtaining naloxone.

Upcoming Community-based Naloxone Training

There are several community-based trainings on how to use naloxone in the greater Multnomah area. Below are a few upcoming trainings:

Saturday 4/20, 2pm-4pm at the Alano Club of Portland
Friday 5/10, 5pm-7pm at 4th Dimension Recovery

For more information about other upcoming trainings, you can contact Outside In.

Online Training Resources

If you are not able to attend a community-based training session, there is plenty of helpful training information available online. Check out the following resources to learn more!

Naloxone Training Protocol by Oregon Health Authority

Pharmacies in Oregon that Distribute Naloxone

Multnomah County Health Department Naloxone Training Videos: