Opioids such as heroin, morphine and other prescription painkillers are abused by an estimated 467,000 people according to the National Institute on Drug Abuse (NIDA). Worldwide, that number is between 26.4 million and 36 million. This epidemic of drug use and abuse has a lot to do with the strength of opioids and how they affect the user. These popular drugs include Vicodin and Oxycontin since these are most often prescribed for pain. Those recovering from surgery, for example, are frequently prescribed semi or fully synthetic opioids. These drugs work by attaching themselves to opioid receptors in the body – found in the brain, GI tract, spinal cord and in other organs. These drugs reduce the perceived pain and give users a general feeling of well-being. Some adverse side effects include:
Opioid use is leading to heroin use in prescription opioid users due to its affordability and accessibility. However, because heroin is not regulated as with prescription pain medications, the likelihood of overdose is increased. This is where the life-saving antidote Naloxone comes into play.
What is Naloxone and How Does it Save the Lives of Opioid Users?
Naloxone is a drug often administered by emergency healthcare technicians to reverse the effects of overdose due to opioid use. For many, this life-saving drug gives them a second chance at life. For opioid overdoses, the user’s breathing slows and can stop, resulting in organ failure. However, Naloxone cannot do anything to affect drugs like benzodiazepines, alcohol, sedatives, cocaine, etc. The drug works specifically to reverse the activation of the brain’s opioid receptors. The higher the dosage of the opioid, the more Naloxone needed to counter the drug’s effects, especially for drugs like fentanyl and carfentanil. According to NIDA, “The liquid for injection is commonly used by paramedics, emergency room doctors, and other specially trained first responders. To facilitate ease of use, NARCAN® Nasal Spray is now available, which allows for naloxone to be sprayed into the nose. While improvised atomizers have been used in the past to convert syringes for use as a nasal spray, these may not deliver the appropriate dose. Depending on the state you live in, friends, family members, and others in the community may give the auto-injector and nasal spray formulation of naloxone to someone who has overdosed.” There are no side effects of using Naloxone except that opioid withdrawal symptoms can become worse directly after using. These symptoms include restlessness, agitation, vomiting and headache. When injected intravenously, it can take effect within one minute and can last up to 45 minutes. The automatic injector version was fast-tracked by the U.S. Food and Drug Administration (FDA) due to the rising death toll in opioid users.
The Dangers of Opioid Use and the Need for Naloxone in the United States
The Centers for Disease Control (CDC) reported that in 2015 more than 15,000 users died from prescription opioids. Overdose rates were highest among 25 to 54 year olds of caucasian, non-Hispanic descent. For heroin, death rates increased by 20.6% – that’s 13,000 deaths in 2015. Those who suffered from heroin addiction often had previous experience using prescription opioids. Poverty level is also a factor here: 2002 – 2013 saw a 62% increase in users within households that earned less than $20,000. In synthetic opioids, such as fentanyl, death rates have increased by 72.2% from 2014 to 2015. The CDC states, “Fentanyl is a synthetic (man-made) opioid that is 50x more potent than heroin and 100x more potent than morphine.” There is a pharmaceutical version that is prescribed for chronic pain. There is also illicitly manufactured fentanyl that is often “cut,” or mixed, with heroin or cocaine in order to make the drug stronger. Users do not know what has been added to their drug. This results in a higher likelihood of overdose and adverse reactions to the drug.
Why are Naloxone Prices Becoming So Expensive?
Recent uproar had been reported over Naloxone prices increasing due to the company Kaleo. Kaleo, a pharmaceutical company, manufactures the Evzio autoinjector. Since 2014, the drug has increased in price 600% from $690 for 2-pack injector kit to $4,500. The company has gone on record saying that the price hike is justified due to negotiated insurance cost and rebates for bulk buyers. Kaleo also manufactures Auvi-Q, and an injectable epinephrine kit. Business Insider states, “The list price for a two-pack of the Auvi-Q comes in at $4,500 as well, though the company maintains that the cash price for people without insurance is $360 and that more than 200 million people will be able to get the device with a $0 copay. That list price is roughly 640% higher than the list price of the EpiPen, which was singled out in August 2016 for increasing the price of a two-pack by 500% over the course of seven years.”
Police and Healthcare Officials are Worried About Naloxone Use in the Long-term
There are many first responders who are worried about the use of Naloxone. Although it’s easy to administer and highly effective, first responders are worried about the lack of follow up with patients. Many who are given the life-saving antidote walk away without seeing the inside of a hospital or talking to a healthcare professional beyond first responders. They may go on to use and abuse more drugs. The fear is that this easy-to-access medication may not be helping ongoing users beyond the immediate remedy. Although some users are sent to jail for drug possession, others can not be held for any reason and are released. This “treat and release” method is not ideal for recovery. Although some substance abusers use their overdose as a starting point for their recovery, some do not. It is agreed that training and resources must be put in place to provide options for recovery and safe detox that doesn’t take place in a jail cell. For those who are ready to take the next steps, a variety of rehabilitation options are available. Learn more about opioid rehab.