It is hard to recall when one medicine, except Viagra, attracted so much attention like naloxone did in the last few months. Approved for opioid overdose by the FDA in 1971 as Narcan, this well-made drug blocks the effects of opioids usually within minutes if given soon enough.
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The rise in heroin use is believed to be linked to prescription drug abuse and deaths from overdoses from 2000 to 2014 more than tripled in the U.S., killing more people than heroin and cocaine combined. During 2014 only, 6.5 million Americans misused a prescription drug as estimated by the National Survey on Drug Use and Health.
Why people abuse painkillers in the first place? It is believed because it is cheaper and often easier to get.
Sold under the brandname Narcan among others, naloxone is advertised almost as a miracle medicine. It is important to know that it only reverses the effects of opioids such as heroin, methadone, morphine, opium, codeine, or hydrocodone. So, it can't be used in cases of alcohol, sedatives, cocaine, amphetamines or other types of drugs.
It is most often injected into a person experiencing an overdose. It attaches to the same parts of the brain that receive heroin and other opioids, and it blocks the opioids for 30-90 minutes to reverse the respiratory depression that would otherwise lead to death from overdose.
Now, what happens during heroin use?
When someone takes heroin there is an immediate rush. Then the body feels an extreme form of relaxation and a decreased sense of pain.
When heroin finds itself inside the body, it turns into morphine, a chemical structure similar to endorphins, the chemicals the brain makes when a person in under stress or feels pain. Endorphins inhibit neurons and they create a good feeling by stopping pain impulses.
Morphine, to be able to halt pain, connects to molecules in the brain called opioid receptors. When those receptors are blocked, that creates a "high" feeling. And that's where the problem starts.
Heroin makes people sleepy but since neurons are inhibited, such is the case in heroin overdose, the body during the sleep forgets to breathe and the outcome is clear.
But heroin has more bad effects. Blood pressure may dip significantly and then heart fails. The outcome is again fatal.
An arrhythmia can appear too and then the heart is not able to pump enough blood, and lack of blood has bad consequences on all organs in the body. That bad blood flow from the heart can lead to return of the blood back into veins, a pressure in the vessels increases and fluid goes into the air spaces in the lungs, making it hard to breathe. This too can lead to a heart attack or lead to kidney failure.
And now naloxone steps into action with its simple, but very effective idea and that's why it is entering markets around the world. First, it only works if a person has opioids in their system, which means there's no danger if it is given to a person free of opioids.
Then, it can be administered after a minimal training, so every drug addict can help a friend, and every volunteer working with addicats can learn very fast how to use it. That saves valuable time because very often time spent while waiting on ER to come means death. There is also no potential for abuse.
Naloxone may be injected in the muscle, vein or under the skin or sprayed into the nose. It is a temporary drug that wears off in 20-90 minutes and it works within about 5 minutes. Even better, repeated doses may be given if a person is showing signs of overdose even after the first application.
It has some side effects, and main are pain, burning, or redness at the injection site; sweat; or hot flashes. Some symptoms - rapid or irregular heartbeat, hallucinations, loss of consciousness, seizures or - require emergency medical treatment, but since the opioid addict should be checked in a hospital, the doctors will take care of that.
A drawback that is slowing down naloxone use is its price. Several companies are making their branded version of naloxone, and due to rising demand prices of some versions jumped 17-fold in the past two years.
From initial $2 per dose, the price skyrocketed to $500, depending on the delivery systems because systems easier to use - and thus more appropriate for people without medical experience - are also more expensive. Naloxone is now available over the counter in pharmacies is some countries and some U.S. states without a prescription. ■