Naloxone Saves Lives, but Is No Cure in Heroin Epidemic

Every day across the country, hundreds, if not thousands, of people who overdose on opioids are being revived with naloxone. Hailed as a miracle drug by many, it carries no health risk; it cannot be abused and, if given mistakenly to someone who has not overdosed on opioids, does no harm. More likely, it saves a life.

As a virulent opioid epidemic continues to ravage the country, with 78 people in the United States dying of overdoses every day, naloxone’s use has increasingly moved out of medical settings, where it has been available since the 1970s, and into the homes and hands of the general public.

But naloxone, also known by the brand name Narcan, has also had unintended consequences. Critics say that it gives drug users a safety net, allowing them to take more risks as they seek higher highs. Indeed, many users overdose more than once, some multiple times, and each time, naloxone brings them back.
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Naloxone, also known as Narcan, temporarily blocks opiate receptors. Credit Tristan Spinski for The New York Times

Advocates argue that the drug gives people a chance to get into treatment and turn their lives around and that there is no evidence naloxone increases the use of opiates. And, they say, few addicts knowingly risk needing to be revived, since naloxone ruins their high and can make them violently ill.

With drug overdoses now killing more people than car crashes in most states, lawmakers in all but three — Kansas, Montana and Wyoming — have passed laws making naloxone easier to obtain. Its near-universal availability reflects the relatively humane response to the opioid epidemic, which is based largely in the nation’s white, middle-class suburbs and rural areas — a markedly different response from that of previous, urban-based drug epidemics, which prompted a “war on drugs” that led to mass incarceration, particularly of blacks and Hispanics.

This more compassionate response has been on display this week at the Democratic National Convention in Philadelphia. Speakers there have talked about addiction and the need for more accessible treatment, and a call by Senator Jeanne Shaheen of New Hampshire for all emergency responders to carry naloxone drew applause from the delegates.

Nonprofit organizations began distributing naloxone to drug users in the mid-1990s, but most of the state laws making it more accessible have been enacted only in the last few years. Between this and so-called good Samaritan laws that provide immunity to people who call 911 to report an overdose, the chances are much greater now that someone who overdoses will be saved and given medical attention instead of left for dead or sent to jail.

The federal government still requires a prescription for naloxone, but that is under review by the Food and Drug Administration, which has also approved a Narcan nasal spray that is easier to administer and is growing increasingly popular.

There is no question that the nation’s death toll from heroin and prescription opioids would be significantly higher without naloxone. Prince, the pop superstar, is just one of those who were saved by it. After he overdosed on Percocet, an opiate painkiller, on his airplane in April, the plane made an emergency landing, and he was revived on the tarmac with naloxone — only to overdose on fentanyl six days later and die when no one was around to administer naloxone.

In 2014, in Maine alone, 208 people died from overdoses. That year, emergency responders saved 829 lives with naloxone. But that was just a fraction of those saved here, as most uses go unreported. In 83 percent of cases, according to a national survey last year by the Centers for Disease Control and Prevention, naloxone is given by other drug users, the people most likely to be on the scene, not by emergency responders.