Naloxone in the news

[walkitout]

Naloxone is what you give to people who have overdosed on opioids. That's not its only use, but it's the most important one, from a public policy perspective. If given in the right time frame, via IV, it can take someone who otherwise would be dead and revive them more or less instantly. It is amazing stuff.

https://en.wikipedia.org/wiki/Naloxone

Best of all, it doesn't have a lot in the way of side effects. If you haven't taken any opioids, about the worst thing that can happen is you might discover you've got some pain that naturally produced endorphins were masking.

So you might wonder, why isn't this shit available everywhere all the time? I mean, might that not save some lives, given the epidemic of opioid abuse that white people around the country are suffering from?

http://www.reuters.com/article/us-cvs-health-nalaxone-idUSKCN0VA38U

"CVS Health Corp said it would make the opioid overdose antidote, naloxone, available without a prescription at all its pharmacies across Ohio, a state with one of the highest rates of overdose-related deaths." It was already available without a prescription in several states, but this is a commitment to a higher degree of availability. Judging by those two medic memoirs I just read (_A Thousand Naked Strangers_, and _Welcome to New Orleans ... How Many Shots Did You Hear?_), one of the biggest issues involved in getting naloxone into a person who has od'd is not being sure that's why the person is unconscious and not breathing -- and bystanders who are more worried about being prosecuted for drug abuse than getting the person who is (nearly) dead back in the realm of the living again. (Look, if people who abused opioids had good judgment, they wouldn't abuse opioids, so it shouldn't be a surprise that they tend to make that kind of choice under pressure.)

Naloxone is rapidly joining the EpiPen in availability to people who are (sort of) first responders.

http://www.wlky.com/news/coalition-provides-free-naloxone-kits-and-training/37756222

I hope this helps. Apparently more people are dropping annually from opioids than die in auto accidents. We really need to fix this.

Comments

[rolandgo.livejournal.com]

Google news search "naloxone schools" and find out about the various states where it's getting stocked there too.

Also, you are surely aware that naloxone can also be given into a muscle or via nasal spray as well as by IV (albeit with slower action). I'm wondering if the OTC programs are distributing the nasal spray -- given the prescription only nature of needles in many states.

you really are inviting a "let me google that for you"

[walkitout]

http://www.popsci.com/cvs-expands-over-counter-sales-drug-to-treat-heroin-overdose

Injectable AND nasal.

The list of states appear to be: RI, MA and now: "Arkansas, California, Minnesota, Mississippi, Montana, New Jersey, North Dakota, Pennsylvania, South Carolina, Tennessee, Utah and Wisconsin".

Oh, look, here are instructions! In case you are the bystander or perhaps you are a concerned family member who stumbles across a situation calling for this kind of knowledge.

http://harmreduction.org/issues/overdose-prevention/overview/overdose-basics/responding-to-opioid-overdose/administer-naloxone/

This notes that you can get needles from a needle exchange program, as well as from a pharmacy.

Oh, and here is a table summarizing (presumably more correctly than you have when you assert "prescription only nature of needles in many states") the actual statutes and regulations involving needles.

http://www.temple.edu/lawschool/phrhcs/otc.htm

As many websites note: insulin syringes, and syringes in quantities 10 and under are available OTC nearly everywhere.

ETA: Anyone sitting here wondering why needle restrictions have been relaxed so much versus previous decades should go read _The Wisdom of Whores_. Making it easier to prosecute a stupid drug prohibition amplifies blood-based transmission of the horribles. So we are VERY VERY SLOWLY stopping being stupid. Slowly. *sigh*

ETAYA: Oh, here we go. I thought I heard about this. You CAN use an insulin syringe to IV naloxone.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3343634/

People who inject drugs recreationally are probably at least as good at it as a noob EMT, so honestly, recruiting this crowd to help out in the event of an OD makes a ton of sense.

I am NOT going to provide links to people who explain what to say to pharmacists when you go in asking for an insulin syringe and you don't have an answer for the apparently inevitable question about how much insulin you are prescribed for.

ETA Still more: Discussion of intranasal. Big issue is bleeding in the nose preventing the naloxone from absorbing. Well, the biggest issue is always the same: are we really looking at an OD here or something else.

http://intranasal.net/OpiateOverdose/

The big reason for preferring intranasal appears to be needle stick risk, altho another benefit is that intranasal is a bit more likely to bring the OD'd person up to breathing but not consciousness, which is a better deal than consciousness, if Hazzard's _A Thousand Naked Strangers_ is to be believed.