It’s now well recognized that naloxone saves lives. When administered to someone whose breathing has slowed or just stopped because of an opioid overdose, the antidote blocks opioid receptors in the brain, jolts the user into withdrawal, and restarts normal respiration.
The patient may feel nauseated or worse—and many are less than grateful. But they are alive, and their family members are relieved, saved from the enduring pain of having a loved one succumb to the disease of opioid addiction, which wastes lives so relentlessly.
In recent years, the tide has turned on our attitudes toward naloxone. No longer is the medication viewed as something only emergency room doctors or EMTs should have. In fact, just since January 2014, 32 states have enacted laws to equip police, firefighters, and other first responders with the drug. Texas’s law went into effect last week, bringing the total number of states with expanded access to 42.
Additionally, laws are changing so family members and others who might witness an overdose can get trained to administer naloxone and be supplied with an emergency kit. And despite the reluctance of school administrators to call attention to opioid problems in their districts, school nurses are also making headway in adding naloxone to their medical arsenal, along with EpiPens, which counteract dangerous allergies. On the national level, Congress will soon readdress the S.O.S. Act, “cementing as a federal priority educating and training the public, first responders, and caregivers of those at risk of overdose” in the use of naloxone.
On an individual level—with heroin and painkiller addiction permeating all ages, demographics, and communities—we can prepare ourselves to help by learning how to administer naloxone. Simple directions can be found online, and a growing number of communities are offering training workshops to the public. We also can keep the drug on hand if this makes sense for our circumstances. Naloxone is easy to administer, safe if given accidentally, and involves nothing like the drama Pulp Fiction presents. It is either sprayed into the nose or injected into the thigh or upper arm. Auto injectors even come with recorded step-by-step instructions.
Unfortunately, some individuals object to the expanded use of this drug. They suggest users may see it as a “get out of jail free” card to act recklessly. Yes, this may be a risk, but withholding access to a medication that has saved thousands of lives since 2010 is like withholding access to cardiac catheterization because we predict a patient won’t stick to his healthy diet.
More concerning is the idea that once lawmakers have expanded access to naloxone, they will wash their hands of further responsibility for ending our opioid epidemic—one that claims more than 100 lives a day and outpaces the number of deaths from auto accidents.
That’s why—hand-in-hand with naloxone accessibility—we must provide more beds for treatment. When we revive someone with the disease of addiction and send him back home or out to the streets, we waste an uncommon opportunity and undercut his future. We should be able to say, “You need to start treatment,” and have a bed ready 24/7. Changes in our health care system may jumpstart this shift, and a growing awareness of the need for proper treatment may spur politicians to action. Meanwhile, let’s keep expanding access to naloxone and providing training, say, wherever and whenever CPR instruction is offered—and slash the number of tragic opioid deaths that is becoming America’s sad legacy.
Steven Margolies, M.D.
Vice President of Medical Services and Medical Director
New York Region