September 20, 2018  Last Update: November 27, 2017, 8:52 pm

Narcan Saves Money. Now can people have it?

Naloxone injection (Hospira) and molecule (NIH)

A report in the SF Weekly shows that public access to naloxone (Narcan), the opiate blocking anti-heroin drug, saves society money. Maybe now the regulators will allow more public access.

“The city prescribes the drug — known by the trademark Narcan, more formally as naloxone — to users through the city’s needle-exchange sites, nonprofits, and community services like Glide Memorial Church. They also conduct training in county jails, and prescribe the drug to people who live in residential hotels, plus to the friends and family of heroin users. The drug works for opiates such as heroin and morphine, and puts a comatose body into withdrawal within one to three minutes, creating an undesirable sensation within moments.” — SF Weekly

Narcan is classified as a prescription drug, but is not a controlled substance under Federal law. It is still widely believed to be a “narcotic”, when it is really a competitive narcotic antagonist, which means it blocks narcotics from working. It doesn’t get you high. In fact, it has been used by emergency response teams for 40 years, to reverse the effects of heroin overdose.

Narcan competes for the same brain receptor sites that lock onto opiates, which enables the opiates to do that magical brain chemistry thing that gets people high and hooked on getting higher. But Narcan doesn’t get you high. So if Narcan is in the blood stream, opiates can’t do their magic. If you’re already high, and headed for overdose, a shot of Narcan can stop the process dead in its tracks. It literally throws a heroin addict into heroin withdrawal, since the brain can’t get access to any more heroin.

Recently people have petitioned regulators to loosen the strings attached to naloxone. Many argue that a little Narcan should be in every first aid kit. Some of the cities with big heroin problems are trying it, to see if Narcan makes the world better or worse. Now, it seems we have data suggesting Narcan saves us all a lot of money in emergency response and emergency room costs.

"...the city’s emergency department visits due to heroin were cut in half from 2004 to 2009"

The idea of allowing “narcotics” into the hands of the public is distasteful to regulators. Perhaps ignorance is behind that perspective.  Perhaps some people really do believe that, if there was an easy way out from life threatening overdose (like more readily-available naloxone) drug addicts would feel safer pushing their limits and doing more drugs.This is the same argument being tested by the harm reduction proponents in British Columbia (home of the Insite state-sanctioned “shooting gallery”).

After 3 years, San Francisco is proving that access to naloxone saves a lot of money.

"Being given naloxone is a very unpleasant experience... They don’t say now I have this, I can use drugs for the rest of my life."

We’ve become a nation of people who routinely trade our principles for cash, so maybe this is an opportunity for larger tests of improved access to naloxone, to save lives AND save money?

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Naloxone is saving lives and saving money. Time to legalize it?
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References:

Abstract from the DOPE Project:

Opiate overdose is a significant cause of mortality among injection drug users (IDUs) in the United States (US). Opiate overdose can be reversed by administering naloxone, an opiate antagonist. Among IDUs, prevalence of witnessing overdose events is high, and the provision of take-home naloxone to IDUs can be an important intervention to reduce the number of overdose fatalities. The Drug Overdose Prevention and Education (DOPE) Project was the first naloxone prescription program (NPP) established in partnership with a county health department (San Francisco Department of Public Health), and is one of the longest running NPPs in the USA. From September 2003 to December 2009, 1,942 individuals were trained and prescribed naloxone through the DOPE Project, of whom 24% returned to receive a naloxone refill, and 11% reported using naloxone during an overdose event. Of 399 overdose events where naloxone was used, participants reported that 89% were reversed. In addition, 83% of participants who reported overdose reversal attributed the reversal to their administration of naloxone, and fewer than 1% reported serious adverse effects. Findings from the DOPE Project add to a growing body of research that suggests that IDUs at high risk of witnessing overdose events are willing to be trained on overdose response strategies and use take-home naloxone during overdose events to prevent deaths.

Comments

  1. I am in total agreement with the thought “If you can’t beat them Save Them” theory, in the state of california there are more shooting galleries than any other state in the nation, mostly in San Francisco. They actually have like the little Fire Alarm boxes ” Break Glass In Case of Overdose” and within that little box is a syringe filled with 0.5 Mg of Narcan administer intramuscular and wait 10 minutes and you will have a wide awake and probably pissed off drug user albeit alive but pissed because you just killed his “High” but not him. I think they should distribute them like Epee-Pens, except instead of having epinephrine in them have 0.5Mg of Narcan in them. A major life Saver. I am a prescribed opiate user and had an adverse reaction to one of my medications and had requested an injection of Narcan as a precaution, albeit a horrible experience because you go through a complete withdrawal symptoms and all in about 30 to 180 seconds. But I am still alive and now know I can ad that particular opiate to my allergic list.

    The Condor

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