Naloxone is a topic with emerging significance that has reshaped the perspectives of society, public health, and policy regarding the opioid crisis. Naloxone is a life-saving medicine that can reverse the effects of an opioid overdose, and it is becoming more integral in society to implement Naloxone training and distribute kits. At Stigma Ends at CU, we encourage participating in Naloxone training and getting a kit to stop the overdose epidemic and to become an ally to those who struggle with substance use.
An overdose is characterized by abnormal breathing, which can appear very slow and shallow, inconsistent, or completely stopped. Some individuals will have a bluish tinge to their skin, or look ashen (Recognizing Opioid Overdose – National Harm Reduction Coalition, 2020). Noises, almost like ‘gurgling’ and vomiting are also common. These signs are when Naloxone should be administered, and emergency services should be called.
So, how does Naloxone reverse an overdose? Naloxone is an agonist, meaning it binds to receptors inside of a cell (Lovicott, 2023). When an agonist is competitive, it will bind to certain receptors before another substance can bind, effectively blocking and out-competing it. Naloxone, a competitive agonist, binds to these specific receptors in the brain before an opioid can, inhibiting the uptake of the drugs and replacing their spot. Naloxone is a temporary solution, as Naloxone is short-lasting, and opioids persist for long amounts of time, meaning emergency services will need to be called to ensure another overdose will not occur (Lovicott, 2023). It is also of note that Naloxone can induce withdrawal symptoms, can require intensive treatment, so calling emergency services is of utmost importance.
Naloxone comes in two forms: prepackaged nasal spray and injectable. The NARCAN® nasal spray is 4mg, which has a higher concentration than the intramuscular injection, however, the nasal spray has less bioavailability, so it needs more concentration to reach the similar systemic levels (NARCAN® Nasal Spray Efficacy for Emergency Treatment of Opioid Overdose, 2024). If someone is having an opioid overdose, inject 1 vial of Naloxone in their leg or arm, or lay the person on their back, insert the tip of the nozzle of the nasal spray into one nostril and press down on the plunger (Ontario Take-Home Naloxone Programs, n.d.). The two methods have little differences and they are both very effective, and in Canada, NARCAN® nasal spray is available at pharmacies without a prescription (NARCAN® Nasal Spray Efficacy for Emergency Treatment of Opioid Overdose, 2024). Being properly trained in administering Naloxone is important. It is possible to get a Naloxone kit and training for free from most Ontario pharmacies, and Naloxone kits are often offered at health and safety events in Canada. The kits will contain one hard case, 2 doses of either nasal spray or injectable naloxone, gloves, a rescue-breathing barrier, and an insert with instructions (Ontario Take-Home Naloxone Programs, n.d.).
Carrying Naloxone is significant, as it can rapidly reverse the process of an overdose and reestablish regular breathing before emergency services can arrive. It is key to end the opioid crisis and to increase the rate of survival when an overdose occurs. At Stigma Ends at CU, we are inviting everyone to join us in participating in Naloxone training and to carry Naloxone, especially at functions with substances. We aim to reduce stigma surrounding substance use, and to educate on how to ensure safety for all. More information can be found on the Stigma Ends at CU website or through Carleton Wellness about Naloxone training and upcoming events.
(Where to get take-home naloxone kits, n.d.)
Author: Laura Cross
References:
- Lovicott, M. (2023, August 24). Narcan/Naloxone — What is it and How Does it Work? UW–Madison Police Department. https://uwpd.wisc.edu/narcan-naloxone-what-is-it-and-how-does-it-work/
- Recognizing Opioid overdose – National Harm Reduction Coalition. (2020, September 1). National Harm Reduction Coalition. https://harmreduction.org/issues/overdose-prevention/overview/overdose-basics/recognizing-opioid-overdose/#:~:text=The%20following%20are%20signs%20of%20an%20overdose%3A&text=Breathing%20is%20very%20slow%20and,Vomiting
- NARCAN® Nasal Spray efficacy for emergency treatment of opioid overdose. (2024, August 29). https://www.ohtn.on.ca/rapid-response-narcan-nasal-spray/#:~:text=The%204%20mg%20dose%20of,comparable%20systemic%20levels%20(25).
- Ontario Take-Home naloxone programs. (n.d.). ontario.ca. https://www.ontario.ca/page/ontario-take-home-naloxone-programs
Where to get take-home naloxone kits. WDG Public Health. (n.d.). https://wdgpublichealth.ca/your-health/opioids-and-naloxone/local-opioid-resources
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