Narcan 101: How to use it, why it works and how to get it – Detroit Free Press

Lindsey Parton was driving home from work on the sixth anniversary of her sobriety date when she hit a traffic tie-up on Eight Mile Road in Warren. As she inched along, she spotted the reason for the jam: a car stopped in the far right lane. And as she got even closer, she noticed the driver’s door was open and the man behind the wheel appeared unconscious — his head was tilted back, his mouth wide-open.
Harm reduction: What it is, how it works, why it’s being embraced
Without hesitation, Parton stopped her car, pulled out her Narcan kit, tried to wake the unconscious man and when he didn’t respond — she also spotted a needle on the floor of his car — dosed him with two shots of the opioid antidote and brought him back to life.
That was in October 2020. Since then, Parton, 33, has celebrated another year of sobriety from alcohol and drugs.
And the number of overdose deaths continues to rise, leaving some to wonder what they can do to help.
Related: Michigan drug overdose deaths skyrocketed in 2020
More: Where and how to get Narcan, fentanyl test strips and clean needles
Parton received Narcan training at her job, managing CARE of Southeastern Michigan’s Recovery United Community Center. But just about anyone can be trained on how to use Narcan. Classes are free. And upon completion, you’ll get free Narcan, too.
“Fentanyl is killing people and I think it’s so important that everybody feel comfortable using Narcan and feel empowered to easily, so easily, save someone’s life,” Parton said. “They have another chance at recovery and just living.”
With that in mind, here’s everything you need to know about Narcan.
Narcan — generic name: naloxone — is a medication that reverses opioid overdoses. It can be administered intravenously, by injection or, as is most common outside hospital settings, via nasal spray.
It only works on opioid overdoses — heroin, fentanyl, pain medications such as oxycodone (OxyContin), hydrocodone (Vicodin), hydromorphone (Dilaudid). It will not reverse the effect of cocaine or alcohol or benzodiazepines such as Xanax or Valium. 
If they’re unconscious or have stopped breathing, that can be a sign they’ve overdosed. Other signs: loud snoring or gurgling; slow or shallow breathing; pinpoint pupils; they’re unable to speak; their body is limp; they’re pale; their lips and fingernails are purple.
The answer is always Narcan. Most street drugs — pills, cocaine, methamphetamine — are laced with the synthetic opioid fentanyl, which is up to 100 times stronger than morphine and up to 50 times more potent than heroin and responsible for the majority of the nation’s overdose deaths. So chances are good the person who is overdosing has ingested some fentanyl, whether or not they intended to do so. If it turns out they don’t have an opioid in their system, naloxone will not harm them. It’s possible to have an allergic reaction to Narcan, but generally speaking, when you suspect an overdose, go with Narcan.
If a single dose is going to work, it will usually do so in around 2 or 3 minutes. If nothing happens after that time, give the overdosing person another dose. Rescue workers and people who work in addiction treatment say that it’s not uncommon to need more than one dose to work against the ultra-potent drugs that have flooded the market. Last month, for example, it took four doses of naloxone to revive a 34-year-old Wyandotte man who overdosed after snorting fentanyl. Once conscious, the man refused to go to the hospital for follow-up treatment.
Not necessarily. Naloxone only lasts between 30 and 90 minutes. Often, opioids remain in the body longer than that. Which means it’s possible for the naloxone to wear off before the drugs wear off. And that means it’s possible for someone to re-overdose on the drugs already in their system. Someone who has overdosed needs to be monitored for 2 hous or, in some cases, even longer from their last dose of naloxone. 
More: Downriver mom drives son to heroin dealers — to keep him alive
More: Narcan training aims to save lives in the midst of the opioid crisis
Again, not necessarily. Because it cancels the impact of opioids, naloxone can throw a drug user into withdrawal — which can mean cramping, nausea, vomiting, diarrhea, sweats, anxiousness and agitation. (“While being in withdrawal is terrible, it’s a whole lot better than being dead,” said Dr. Keith Kocher, an emergency room physician at Michigan Medicine who also serves as director of the Michigan Emergency Department Improvement Collaborative (MEDIC), a statewide group focused on improving emergency room care.)  If an overdose patient ends up in the emergency room, doctors can give him or her medications to ease symptoms of withdrawal. That means anti-nausea medication or even buprenorphine, an opioid that softens withdrawal and is used in addiction treatment. Some doctors — those like Kocher who have a waiver from the U.S. Department of Health and Human Services to prescribe buprenorphine — can send a patient home with a prescription for a few days supply to keep them out of withdrawal until they can get into treatment.
Last year, the U.S. Food and Drug Administration approved a higher dose of naloxone, upping it from 4 mg to 8 mg. The higher dose naloxone is expected to be available later this year.
Drug overdose deaths are at an all-time high. According to the most up-to-date provisional data from the U.S. Centers for Disease Control and Prevention, a record-breaking 101,200 people — including almost 2,900 in Michigan — died from drug overdoses during the 12 months ending in June 2021. Fentanyl is the leading cause of death for people ages 18 to 45.
Meanwhile, the state’s hospital emergency departments reported 29,218 visits for nonfatal drug overdoses in 2021, up from 28,017 in 2020, according to the Michigan Department of Health and Human Services. Did Narcan make a difference in keeping some of those people alive? Most definitely. 
The National Institute on Drug Abuse believes people who have family members living with addiction should keep Narcan available in case of overdose.
Experts recommend wearing a mask  — preferably a N95 or KN95 — when administering Narcan. If you are able and comfortable doing rescue breathing or chest compressions, it’s best to suit up in PPE. Most Narcan kits come with gloves and CPR masks.
Here’s what Vital Strategies, the public health organization, recommends when it comes to rescuing someone during the pandemic.  
And always call 911 for help.
Like most states, Michigan has Good Samaritan laws that mean someone who is overdosing won’t be charged criminally with using or having drugs for personal consumption. The laws also mean that rescuers won’t be charged for using or having drugs for personal consumption. The aim of Good Samaritan laws is to make people less fearful of reporting overdoses. Fear of calling for help leads to more deaths.
Some people believe it does. But harm reduction advocates, public health officials, doctors, the National Institute on Drug Abuse say it does not and point to research that backs them up.
Of course they do. Consider Parton, who saved one woman with Narcan in summer 2019 and saved that man on Eight Mile in October 2020. She is a former addict who is now seven years sober — and expecting her first baby in the spring. “I used to use heroin through needles,” she said. “People can be so quick to judge that (someone) who uses needles is a waste of life and will always be that way. But I’m proof that lives can completely change. That’s why I choose to use Narcan and save lives.”
MEDIC is spearheading a program to distribute naloxone free of charge to emergency room patients. Since March 2020, it has distributed more than 2,500 Narcan kits to participating emergency rooms across the state.
The MDHHS is expanding its Naloxone Leave Behind Program where EMS workers who respond to nonfatal overdoses leave a naloxone kit with the patient or family members or friends. Last year, they left behind more than 125 naloxone kits. So far all or part of 24 counties — including Macomb, Washtenaw and Livingston — are participating in the leave behind program. 
Several police departments are — along with peer counselors and medical personnel — are returning to the scene of nonfatal overdoses to prevent the patient or family members with naloxone and information about drug treatment.
The Oakland County Jail has installed a naloxone vending machine for people who are leaving jail. Drug users who leave incarceration are especially vulnerable to overdose. Abstaining from heroin/fentanyl for a period of time, say during a jail sentence, reduces a user’s tolerance for the drugs. Often, people who have been abstinent restart their habit using the same amount of drugs they used before they stopped. Doing so is overwhelming to their bodies. With the vending machine, anyone leaving jail has access to Narcan.
You can get naloxone free by mail from here.
A number of organizations offer free Narcan training and provide those in attendance with free Narcan after completion of the training. Most offer trainings for workplaces or groups. Among them:
Care of Southeastern Michigan’s Recovery United Community Center in Fraser offers drive-up naloxone training. It also offers training for workplaces and groups. For info: Click here or 586-552-1120.
Families Against Narcotics offers virtual and in-person Narcan training. Some of the trainings are open only to Macomb County residents, others are open to all Michigan residents. For info: click here or 586-438-8500.
Alliance of Coalitions for Healthy Communities, based in Troy, offers twice-weekly virtual Narcan trainings. For info: click here or 248-221-7101.
Detroit Wayne Integrated Health Network, based in Detroit and serving Wayne County, offers virtual Narcan training. For info: click here or 313-833-2500.
It’s also available at participating Michigan pharmacies with no prescription. It’s not free. But coupons that may provide a savings are available at GoodRx.  To find a pharmacy. .
Sources: National Institute on Drug Abuse: Vital Strategies; U.S. Centers for  Disease Control and Prevention; Michigan Department of Health and Human Services; U.S. Department of Health and Human Services.


Leave a Comment

Your email address will not be published. Required fields are marked *

Shopping Cart