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Antidote & Reversal Agent for Fentanyl Overdoses

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Naloxone (NARCAN®) is a medication that rapidly reverses a fentanyl overdose in progress. Fentanyl is a potent opioid, 50-100 times more powerful than morphine. (1) Consequently, fentanyl misuse is extremely dangerous–even a tiny amount is enough to kill the average person. While exposure to fentanyl often occurs when it’s added as an adulterant to heroin, it’s not uncommon for those with a high tolerance to other opioids to start using fentanyl to continue experiencing the effects they’re seeking.

If you’ve been struggling with an addiction to heroin, fentanyl, or other opioids, you are urged to seek professional help to negate the risk of experiencing a life-threatening overdose. Guardian Recovery provides comprehensive treatment programs led by a skilled, experienced team of medical and mental health providers who specialize in the field of addiction.

Contact us today to learn more about our personalized plans, multiple levels of care, and commitment to providing individuals with all the tools they need to overcome substance misuse and sustain long-lasting sobriety.

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How Does Narcan Work on Fentanyl Overdoses & Reverse Symptoms?

Naloxone is an opioid agonist, meaning it works by attaching to the same brain receptors as opioids, replacing them, and blocking their effects, such as severe respiratory depression. Naloxone can be found as a nasal spray, injectable solution, and auto-injector device and can be administered by healthcare providers or those who’ve been trained.

Due to fentanyl’s substantially increased potency versus other opioids, higher doses of naloxone may be needed to reverse an overdose effectively. In fact, naloxone has a very short half-life, meaning it’s rapidly broken down and expelled from the body. (2) For this reason, in severe cases, it must be administered multiple times or given in a continuous infusion to maintain the reversal of effects and the patient’s breathing.

Does Naloxone Only Work as an Antidote for an Opioid Overdose?

Naloxone only works for opioids and does not affect overdoses related to other substances. The antidote is specifically designed to reverse the effects of opiates, such as morphine, and synthetic opioids like heroin, fentanyl, oxycodone, and hydrocodone. Overdoses involving alcohol, cocaine, methamphetamine, or any other drugs that use GABA, dopamine, or other receptors cannot be reversed in any capacity with naloxone. It’s important to note that if someone overdoses on a drug other than opioids, they still require emergency medical attention and treatment.

How To Administer Naloxone:

  • Call Emergency Medical Services—If someone is experiencing an opioid overdose, call 911 or your local emergency number immediately.
  • Administering Naloxone Nasal Spray—If you have the nasal spray form of Narcan, remove it from the packaging and follow the instructions on the label. (3)
  • Administering Injectable Naloxone—If you are using the injectable form of naloxone, follow the instructions on the label for the correct dose and injection technique. (4)
  • Using the Auto-Injector Device: If you have an auto-injector device, remove it from the packaging and follow the instructions on the label. (5)

If the person is still unresponsive after using any of these methods, administer a second dose after 2-3 minutes. Next, monitor the person’s breathing, heart rate, and other vital signs until first responders arrive.

Should You Administer CPR Before Narcan?

If someone is unresponsive and not breathing, it’s essential to start CPR (cardiopulmonary resuscitation) immediately, even before administering naloxone. CPR can help to maintain blood flow and oxygenation to the brain and other organs until emergency medical services arrive. Moreover, CPR will circulate Narcan through the system, allowing it to work.

Here are the general steps for performing CPR: (6)

  1. Check for Responsiveness—Shake the person and shout their name to see if they respond. Call 911 immediately if there is no response.
  2. Check for Breathing—Look for chest movement and listen for breathing sounds. If the person is not breathing or is breathing abnormally, begin CPR.
  3. Perform 30 Chest Compressions—Place one hand over the other in the center of the chest. With shoulders directly above your hands, press down at least two inches and release, allowing the chest to return to normal position after each compression. Perform compressions at a rate of between 100-120 per minute.
  4. Give Two Rescue Breaths—Pinch the person’s nose closed and give two breaths into their mouth, watching for chest rise. If the breaths go in, continue chest compressions.
  5. Continue CPR—Alternate between performing 30 chest compressions and two rescue breaths until emergency medical services arrive or the person starts breathing independently.

If you have Narcan available, you can administer it after starting CPR. Monitor the person’s respiratory rate and other vital signs until emergency medical services arrive, even if they start breathing independently.

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Does Narcan Cause Side Effects When Used for Fentanyl?

Naloxone is generally considered a safe medication with few side effects. However, like all medications, it can cause side effects in some people. Common side effects of Narcan include:

  • Opioid withdrawal symptoms.
  • Elevated heart rate and blood pressure.
  • Heachache and dizziness.
  • Dry or stuffy nose.
  • Aches and pains in the muscles or bones.
  • Injection site pain, redness, and swelling.

The potential side effects of Narcan are generally mild and short-lived, and the benefits of the medication in reversing an opioid overdose far outweigh the risks.

Narcan Use Rates & Success as a Reversal Agent for Fentanyl & Other Opioids

The success rate of naloxone in reversing the effects of a fentanyl overdose is generally high when administered promptly and at the correct dose. For example, a Massachusetts review of emergency medical services data from 2013-2015 revealed that when given naloxone for an overdose, 93.5% of people survived. Another 84.3% were still alive one year following their overdose. (7)

Narcan’s success in reversing an opioid overdose depends on various factors, including the potency and amount of the opioid ingested, the person’s overall health, and the timing and administration of Narcan.

Who Should Keep Narcan on Hand?

Because an opioid overdose can happen to anyone who uses opioids, it’s recommended that Narcan be made available to individuals who may be at risk of overdose, as well as their family members, friends, and loved ones.

Individuals Who Should Have Narcan on Hand Include:

  • People who use opioids, including prescription painkillers, heroin, or fentanyl, especially those who have experienced an opioid overdose in the past.
  • Loved ones of those who use opioids may be able to identify overdose signs and administer Narcan in an emergency.
  • Healthcare providers, addiction specialists, and other healthcare professionals, who may encounter individuals experiencing an opioid overdose.
  • First responders, such as law enforcement, firefighters, and medical emergency personnel, who may encounter opioid overdose while on duty.

Other Important Considerations

While naloxone is an essential tool in saving lives during an overdose, it’s not an addiction treatment and does not take the place of professional medical care. Those appearing to have overcome overdose effects due to naloxone administration still need to be seen by emergency personnel immediately and undergo detox. Following this, comprehensive treatment for substance use is highly recommended to help individuals learn the coping skills they need to maintain sobriety, reduce relapse risk, and prevent further overdoses.

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Fentanyl misuse can have a range of severe health complications and potentially lethal consequences, including tolerance, dependence, profound respiratory depression, overdose, and death. In addition, using fentanyl can lead to numerous other repercussions, including financial strain, relationship conflict, and criminal charges.

Guardian Recovery was established to provide effective, evidence-based treatment for those suffering from substance use and co-occurring mental health disorders. Our highly-individualized programs include a wide variety of therapeutic services and activities, including medical detoxinpatient programsoutpatient treatmentaftercare planning, and more.

We encourage you to reach out to us to speak with an experienced Treatment Advisor to learn more about our straightforward admission process and full continuum of care. You can also receive a free, no-obligation assessment and health insurance benefits check. Contact us to begin your journey to sobriety.

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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.

(1)https://www.cdc.gov/opioids/basics/fentanyl.html (2)https://www.mind.org.uk/information-support/drugs-and-treatments/medication/explaining-the-half-life/ (3) https://www.mayoclinic.org/drugs-supplements/naloxone-nasal-route/proper-use/drg-20165181 (4) https://www.mayoclinic.org/drugs-supplements/naloxone-injection-route/precautions/drg-20095285 (5)https://www.pbm.va.gov/PBM/AcademicDetailingService/Documents/Academic_Detailing_Educational_Material_Catalog/38_IB_780_OEND_Patient_Naloxone_Kit_Instructions_Auto_Injector_v2.pdf (6)https://www.redcross.org/take-a-class/cpr/performing-cpr/cpr-steps (7)https://www.cnn.com/2017/10/30/health/naloxone-reversal-success-study/index.html

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Reviewed professionally for accuracy by:

Ryan Soave

L.M.H.C.

Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

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Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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The information provided on this website is intended solely for educational and informational purposes. Guardian Recovery aims to improve the quality of life for individuals struggling with substance use or mental health disorders by offering fact-based content about behavioral health conditions, treatment options, and related outcomes. However, this information should not be considered a substitute for professional medical advice, diagnosis, or treatment.

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