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Rachele Corn

Professor Barnes

ENG 1201

13 April 2019

Narcan

At one point or another in a person’s lifetime someone they are close to or know has

fallen into the dark, unforgiving, no mercy showing hands of addiction. I know I have seen it

happen all too often with those I love or friends I use to be close with. I remember walking

into my best friend’s house homecoming night to pick her up for the homecoming football

game, even though we had both been out of high school for several years, we still went t o

show support for our school team. Something didn’t seem right, I’d yelled for her several

times while walking through her apartment, but no response. Making my way to her

bedroom, I could see her lying on the floor, I ran down the hallway only to find h er lifeless

body slumped over and a needle lying next to her. Immediately, I called 911, and began

CPR like instructed to do. EMTs arrived and hit her with a dose of Narcan; slowly she began

waking and was taken to the hospital. It was that very moment I realized, she wasn’t clean

like she had claimed to be and had I not arrived when I did, she may not be here today.

Without notice I had just been introduce to the life-saving agent, Narcan. Before this very

moment I had never even heard of Narcan, nor did I know what Narcan was capable of

doing.

All around America, thousands of people are being saved every day with the use of

Narcan. Narcan is an opioid antagonist and is used to reverse the effects of an opioid and

heroin overdose. Narcan ranges from $20 to $30 per dose for the off-brand, and $120 to
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$130 for a 2-dose kit for the name brand,

naloxone. The use of Narcan is a very

controversial topic in today’s society and most

wonder whether the use of Narcan is contributing

to the drug epidemic in the U.S., or is it helping

stop it? Are drug abusers being given the tools to

stop their drug abuse or allowing for greater

experiments?

After experiencing this traumatic event in life at such an early age, the research

began. Not knowing anything about Narcan, but seeing the “magic” Narcan was capable of

in that very moment, had curiosity setting in.

Narcan was first patented in New York in 1961 (History 2). The original use of

Narcan was to assist with the constipation, which can be caused by taking strong doses of

pain killers for lengthy periods of time. By 1971, the FDA had approved the use of Narcan

for opioid overdoses (2). At that time there were only two ways to administer Narcan, by

intravenous and intramuscular. By 1996, medical professionals had come up with a way to

administer Narcan, which didn’t require emergency personnel. This would later be known as

the nasal spray, which can now be bought in most states over-the-counter.

The U.S. Health Department released information showing a drastic increase in overdose

deaths from 2010 to 2016 (Surgeon 7). Overdose deaths increased by 21,160 deaths in just 6

short years. This increase is believed to be caused by the tremendous amount of individuals on

prescribed pain killers to help manage long-term pain. Over time those with a prescription for

these pain killers could potentially and accidentally overdose on these medications as their
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bodies need more and more to manage the pain (Surgeon 7). Eventually their bodies will build a

higher tolerance and require stronger doses or even stronger medication altogether.

When most think of a drug overdose the first drug that comes to mind is heroin. What

most don’t realize is heroin isn’t the only street drug used when overdoses happen. The majority

of drugs used in overdoses are heroin, fentanyl, carfentanil, hydrocodone, oxycodone, and

methadone (Jordan 3). If caught in time, Narcan can be administered in an attempt to revive

these individuals.

The big misconception about a drug overdose is that it can only happen to those using

street drugs, such as heroin. This isn’t true. Overdoses can happen to anyone, not just those

who use street drugs. It can happen to those that are prescribed a controlled substance such as

pain killers, as well.

According to Dr. Adams, in Dimensions of Critical Care Nursing Clinics of North

America written by Kathleen Gould, the increasing use of Narcan will be the key to help stop

the drug epidemic in today’s society (Gould 1). Narcan is used to reverse a drug overdose, but

only if administered not long after the overdose happens. Narcan connects to the opioid

receptors in the brain instead of allowing the opioid to attach to the brain.

According to the National Institute on Drug Abuse, there are different ways to administer

Narcan (Opioid 5). One way is through an auto injector, which is used the same way an epi-pen

is used. Another way is injectable, which can only be administrated by a trained professional.

Usually the trained professional is an emergency personnel. Finally, Narcan can be

administrated through a prepackaged nasal spray, which can be bought in most states over-the-

counter (5). Below is a picture showing all the different ways Narcan is administered.
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The U.S. National Library of Medicine reports each state has different rules and

regulations on the opioid reversal drug, Narcan (Med 4). Some states offer it over-the-counter to

anyone, while others require a prescription. Some experts believe making Narcan available

over-the-counter will cause the use of opioids to rise because they have access to Narcan at any

time (Jordan 3).

Studies show the number of overdoses in rural and urban areas is higher than in the inner

cities (Opioid 5). In 2017, Ohio had a population of 11,658,609 people and out of those

2,356,269 was living in rural areas. Within those rural areas in Ohio, 58% of individuals that

have received Narcan were between the ages of 25 and 54. A great deal of these overdoses was

accidental overdoses using their prescribed pain medication.

When a person begins overdosing on their drug of choice if Narcan isn’t available

emergency personal should be contacted immediately. Upon arrival they will make the

determination whether or not the life-saving drug, Narcan needs to be administered. Once a

person has received their first dose of Narcan, the individual should begin to show signs of

revival within minutes (Med 4). After 2 to 3 minutes from the initial dose and no signs of

improvement are seen, a second dose can be administered.

After being revived using Narcan, a patient needs to be monitored for 6 to 12 hours to

ensure the individual isn’t going to slip back into an overdose when Narcan wears off. Narcan

can stay in ones’ system for 30-90 minutes (Med 4). After Narcan stops working, depending on

the amount of drug the individual used, they may slip right back into a drug overdose. This is

why it is extremely important they are monitored by trained professionals during this time.

When a person is coming out of an overdose, they may become combative or

aggressive. The emergency personnel have just administered Narcan and have killed the drug

abuser’s buzz, costing them a great deal of money. Now they have an extremely irate patient to

not only calm, but provide care to. Those administering Narcan need to be aware of this

possibility and protect themselves and anyone else around. Once revived, a person can

experience symptoms of a drug withdrawal. Some of the symptoms of a withdrawal are

anxiety, aggression, nausea, vomiting, diarrhea, and abdominal pain (Med 4).

Most EMT and police will error on the side of caution if an individual is believed, based

on warning signs, to be in an active overdose to rule that out. Narcan has little to no side effects

if given to someone that isn’t in active overdose stage. The only way anyone would have side

effects that isn’t in active overdose stage, is if they were allergic to any of Narcan’s

components. If given Narcan and an individual has an allergic reaction they could experience

high or low blood pressure, seizures, and abdominal pain (Tasha 8).

Once Narcan wears off, there is a possibility of an individual experiencing respiratory

distress where breathing may slow to 12 breaths a minute (Med 4). This is another reason why

it’s extremely important anyone who has received Narcan should be monitored by emergency

professionals. After receiving Narcan, most patients will refuse treatment and may even claim

they just want to be left alone. EMTs can’t do this, receiving Narcan voids a patients’ wish to
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not receive treatment because ultimately, they were dead or knocking on deaths door when

found and require monitoring.

Truthfully, drug users aren’t worried

about whether or not they are going to die

from an overdose. All they are worried about

is how they are going to get their next hit and

where they are going to find the money for

that hit. With continued use of their drug of

choice, their body tolerance becomes higher

and higher, which in return means they need bigger and bigger hits to get that feeling they are

looking for. Increased dosage of drugs ultimately results in the possibility of an overdose.

Several will overdose more than once especially because they know they will be saved

and there isn’t a consequence for their action (Seelye 6). Drug overdoses now kill more people

than a car crash in the U.S. (Tasha 8). Some argue that Narcan isn’t helping the drug

epidemic, rather making it possible for drug users to experiment with higher doses and continue

their drug usage knowing they will be saved each time. The users fear of dying is non-existing

because they can be saved, and could potentially increase the usage and spread of the drug

epidemic. Another fear of those not in favor of Narcan use is crime rate could potentially

increase due the opioid use and the ability to save drug users with no regulations placed on

Narcan allowing for this to take place.

There are always two sides to every story and the use of Narcan is no different. There

are those who feel the use of Narcan is what this world needs to decrease the mortality rate and

give drug users another chance to make better choices and get help. Then there are those who
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feel restrictions should be placed on the use of Narcan. The most popular answer, when asking

random people to complete a poll, was Narcan should only be administered one time and then

after that the drug user is on their own. It was their one get out of jail free card, if you will and

once it’s used sorry about their luck. Others suggested using 3 strikes you’re out policy.

There was an area all seemed to agree on and that was there should be a way to track

who has received Narcan and this way no one gets more than the allotted amount. A few

individuals spoken to were completely against the use of Narcan as they felt there were better

uses for their tax dollars. Explaining to the groups Narcan is paid for through grants received by

the Health Department didn’t change the way the anti-Narcan group felt.

Those for the use of Narcan believe everyone makes mistakes and deserves another

chance to make it right. If this life-saving agent wasn’t available we would have an enormous

mortality rate due to the opioid crisis seen here in the U.S. Before the spike in Narcan use,

death rates were through the roof. Funeral homes had to get portable storage buildings to keep

the bodies of drug users due to the limited space within their building. Many went unidentified

and unclaimed being placed in unmarked graves. These individuals are someone’s brother,

sister, mother, daughter, etc. and their families are mourning the loss of their loved one for a

second time. The only difference between when they first lost them to the drug of their choice

and the loss now is there is no coming back, no second or third chance.

Others, who were on the fence about the use of Narcan, believe Narcan only gives drug

users the ability to experiment with higher doses and the invincible feeling of “nothing will

happen to me.” It acts as a safety net for drug users and abusers. The fear is without placing

rules and regulations on the use of Narcan some drug users are and will continue to abuse the

system using tax payer’s money. If tracking systems were put into place and Narcan had to be
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administered more than once, the individual should be held responsible for the cost of Narcan.

They also believed when someone receives Narcan they should be required to either willingly

check their self into a rehab center or be court ordered into a rehab center for a set time. If they

don’t comply with court orders, a warrant be issued and placed in jail. This will require them to

get help and get clean either willingly or court ordered.

Finally those that believe Narcan shouldn’t be used at all; say it’s the drug user’s

problem. They put themselves in this situation and they should get themselves out without

using tax payer’s dollars. There are plenty of rehabilitation centers and programs available to

those that really want help. Some were very firm with their belief this is a choice verses a

disease. No one forced them to experiment with any type of drug it’s something they chose to

do. Why should everyone else have to pay for it? Narcan is being used as a gateway to continue

the behavior with no consequences or accountability.

For those who were completely against the use of Narcan, they were then asked “who

should pay for the rehab costs when the drug user couldn’t afford the help?” Several were fine

with knowing their money was going to help these individuals get clean. The big issue noticed

was the lack of compassion and increased frustration towards drug users, drug abusers, and drug

dealers. If these folks were willing to actually accept the help being offered to them, a good

handful of individuals interviewed, were willing to assist in paying for the treatment. Less drug

users in their minds mean less drug dealers because the demand would be down. Then less drug

dealers means their children and grandchildren will be less likely to ever experiment or become

addicted to these life changing substances.

The use of Narcan can’t be the only treatment used or we will continue to see repeat

offenders. First and foremost the drug user must want to get help or nothing anyone says or
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does to try and help them is going to work. They must get themselves help by checking

themselves into a rehabilitation center and finding a new crowd to hang out with once they have

been released from the treatment center. Drug addiction isn’t something that is cured overnight.

In most cases, the process takes months before the individual is even ready to go back into the

community. Once back in the community the temptations are everywhere. The real work

begins once released, as now they are on their own to find new ways of coping with the

everyday stresses and obstacles. Those stresses and obstacles will be the true test as to how bad

a person wants to remain clean.

Treatment facilities have panels of team members who are trained to handle the drug

addiction from all angles. The panel usually consists of a Psychiatrist, Psychologist, Counselors

specializing in different areas, therapists who are also trained in different areas, doctors and

nurses. Everyone works together to put together a plan and program based on each individual’s

needs. If the underlying “issues” aren’t treated as well as the drug addiction, once this person is

released from rehab they won’t know how to cope with the outside world. When they are faced

with hardships, the easiest coping mechanism will be run right back to the drug of their choice.

Making them numb to the problems and then the process starts all over again, only this time

they may not be so lucky.

For most, upon release moving to a completely different area or even a different state is

needed for the best success rate. Starting over where they know no one and don’t know who or

where to go in order to get the drug of their choice. This will allow for fewer temptations and

allow for a new routine to be built. Getting involved in an exercise program or starting a new

career are different ways to deter their minds away from the “need” to get that fix they once

craved. Even if these individuals have completed their rehab stays, doesn’t mean the urges are
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magically gone. It simply means they have been given the tools to appropriately handle the

stresses of day to day life without the numbing, mind altering agent.

Relapse can and usually does happen to drug abusers especially if they don’t change

their way of life upon release. Everything about their life must be changed, from “friends” they

use to hang out with, to “hang out” spots. Those places and people will be the biggest triggers

for a recovering addict and won’t help when it comes to keeping their sobriety. Creating and

having a strong and healthy support system is a must as well. Without these things in play

before release, the recovering addict is only setting themselves up for failure again.

Upon release of my best friend from the hospital observation required due to the use of

Narcan, I could tell she was scared and sick. She was going through the withdrawal stages from

the use of drugs. We never made it to the homecoming game, but the next day she checked

herself back into rehabilitation and started her journey to sobriety again. Throughout the

process she was gaining the skills she needed to be a successful and productive community

member who didn’t require life altering substances.

To conclude, Narcan can be used as a life changing agent for those that are ready to get

help but are scared of the withdrawal process. Those who are ready and chose to use the chance

given by the use of Narcan are making the best of their life and second chance. Those who

aren’t ready for sobriety and don’t believe they have a problem, will continue to abuse the

system and the use of Narcan, until one of three things happens, a regulation gets put on how

many times Narcan can be used, or they finally realize they need help, or the unfortunate

inevitable happens, death. In most cases, Narcan is helping with the opioid epidemic. In other

cases, Narcan is continuing to allow for continued use of increasing doses of drugs. It’s all in

how the addict choses to use the second chance they were given.
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Work Cited

Gould, Kathleen Ahern,. "Dimensions of Critical Care Nursin." Got Narcan. Wolters Kluwer

Health, Inc, Jan 2019. Web. 10 Mar 2019. http://journals-lww-

com.sinclair.ohionet.org/dccnjournal/fulltext/2019/01000/Got_Narcan_.1.aspx

"The History of Naloxone - Cordant Solutions." Cordant Health Solutions | Drug Testing

Services. Cordant Solutions, Jul 2017. Web. Apr 2019. http://cordantsolutions.com/the-

history-of-naloxone/

Jordan, Mathew R.. "NCBI." Naloxone. StatPearls Publishing LLC, 27 Oct 2018. Web. 10 Mar

2019. https://www.ncbi.nlm.nih.gov/books/NBK441910/

Med J., Am . "U.S. National Library of Medicine." An Evaluation of Naloxone Use for Opioid

Overdoses in West Virginia. 9 Jul 2015. Web. 10 Mar 2019.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4675355/

"Opioid Overdose Reversal with Naloxone." National Institute on Drug Abuse. Apr 2018. Web.

17 Mar 2019. https://www.drugabuse.gov/related-topics/opioid-overdose-reversal-

naloxone-narcan-evzio

Seelye, Katharine. "New York times." Naloxone Saves Lives, but Is No Cure in Heroin

Epidemic. New York Times Company, 26 Jul 2016. Web. 10 Mar 2019.

https://www.nytimes.com/2016/07/28/us/naloxone-eases-pain-of-heroin-epidemic-but-

not-without-consequences.html
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"Surgeon General." Surgeon General’s Advisory on Naloxone and Opioid Overdose. Web. 10

Mar 2019. https://www.surgeongeneral.gov/priorities/opioid-overdose-

prevention/naloxone-advisory.html

Tasha. "Do the Benefits of Narcan Outweigh the Negatives? - Banyan Treatment

Center." Customized Addiction Treatment Programs | Nationwide Drug

Treatment. Banyan Treatment Center, 18 Sep 2018. Web. 17 Mar 2019.

http://www.banyantreatmentcenter.com/2018/09/18/do-the-benefits-of-narcan-outweigh-

the-negatives/