Indiana has seen a staggering increase in the number of overdose deaths tied to heroin and other opioids since 2000, and the state ranked 16th nationally in 2014 for drug overdose deaths. The state is committed to saving lives by making naloxone, a drug that reverses the symptoms of opioid overdose, available to first responders, family, friends and others who are likely to be the first on the scene if someone overdoses.
Naloxone, also known by the brand name Narcan®, is a non-narcotic medication that is an antidote for opioid overdoses. If administered in a timely manner, naloxone can reverse the life-threatening respiratory failure that is usually the cause of overdose deaths. Naloxone has been proven effective in reversing overdoses caused by heroin and prescription medications such as OxyContin, Percocet, Methadone and Vicodin.
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Naloxone can be given through subcutaneous, intramuscular or intravenous injection, or intranasally. Two types of naloxone are commonly available for non-medical personnel. Evzio® is an autoinjector, complete with voice-recorded instructions for use, similar to some epi-pens. Narcan® Nasal Spray is an intranasal device that requires no assembly and involves spraying the drug into a nostril.
Yes, call an ambulance immediately after you have administered the naloxone. Give rescue breaths and start CPR, if you know how, until the person is breathing on his or her own. Position the person on his or her side in the recovery position once breathing has resumed. If there is no response to the first dose, give a second dose. Tell the people in the ambulance that you gave naloxone and at what time and show them the dose.
Governor Mike Pence signed Aaron’s Law into effect in April 2015. The law was named for Indianapolis resident Aaron Sims, who died of a heroin overdose in 2013 at the age of 20. The law was amended in 2016 to allow the Indiana State Health Commissioner to sign a statewide standing order for naloxone to entities that register with the Indiana State Department of Health (ISDH) to dispense this life-saving drug to Hoosiers without a prescription
Licensed healthcare providers can prescribe naloxone to individuals. Individuals or agencies who register with the ISDH as entities to dispense naloxone may also distribute naloxone to anyone who would like to carry it. You can find locations where naloxone is available at www.optin.in.gov. The locations pinned on the map are entities registered with the State of Indiana to dispense naloxone to people without a prescription. No prescription is needed. A person seeking naloxone can ask the entity to use the state health commissioner’s statewide standing order.
The ISDH has created the Overdose Prevention Therapy-Indiana, or optIN, registry where entities can register as naloxone dispensers. The registry, which can be accessed at www.optin.in.gov, allows nonprofits, pharmacies, local health departments, addiction treatment facilities, correctional facilities and other entities to register as providers of naloxone. Entities must provide training in the use of naloxone, instruct those who administer it to call 911 and provide a list of options for substance abuse treatment. Registered entities must annually report, among other things, the number of naloxone doses distributed to the state.
Naloxone is only effective at reversing opioid overdoses. If naloxone is administered to a person who has overdosed on a drug that is NOT an opioid, it won’t hurt the person, but it won’t help them, either. Many people who use opioids for medical or non-medical reasons will often take them with alcohol or other drugs that can slow down their heart rate and breathing. If a drug overdose is suspected, even if you aren’t sure about the drug used, using naloxone could potentially be life-saving.
Naloxone has a shelf-life of about 2 years. Make sure you check the expiration date listed on your naloxone, and replace it if it has expired. If you are responding to an overdose and you notice that your naloxone is expired, you can still use it. Expired naloxone may still be effective enough to save a life, and it won’t hurt anyone if you use it.
Naloxone is designed to only work if opioids are present in a person’s system. There are no adverse effects or negative consequences for people, including children, who have not been using opioids outside of the extremely small risk of allergic reaction. There may be a risk to children from the containers and devices used to administer the medication. Some containers are small and made of thin glass, which could break and pose a choking hazard. In the case of injectable naloxone, children could come across a sharp needle. The new Narcan® Nasal Spray is easy enough for a child to spray. If a child plays with it, the dose may be wasted and not available for use in an overdose situation. For this reason, it is best to store your naloxone in a safe place out of reach of small children.
Ideally, naloxone should be kept between 40° F and 80° F (5° C to 25° C) in a dark, dry place. Naloxone is sensitive to temperature, and prolonged storage at temperatures above or below those recommended by the manufacturer may decrease the effectiveness of the drug. If your naloxone is left in freezing temperatures, make sure you hold it in a warm hand to thaw it prior to using it. Naloxone stored at high temperatures may lose some of its effectiveness but can still be used in an emergency.
Individuals who are using opioids may experience withdrawal symptoms such as nausea, vomiting, confusion, agitation or combativeness when given naloxone. Naloxone is not an opioid or a controlled substance and has no potential for abuse. Allergic reactions to naloxone have been reported but are extremely rare.