Naloxone - What Is It and How to Use?

Naloxone or Naloxone hydrochloride is a non-prescription medication used to reverse opioid overdose. This drug, which is available over the counter online and at Walgreens and CVS, and many others, is used to save lives when someone uses too much of an opioid drug or the drug turns out to be stronger than expected.

With over 100,000 opioid overdose-related deaths in 2021, drugs like Naloxone are becoming more and more important. Ensuring that people know how to use these drugs, that they have access, and that people are encouraged to carry Naloxone on their person when using can literally save lives.

In addition, because Naloxone and its analogues like Narcan are the only real drugs available to reverse an overdose, it’s also important to learn about the drug to combat stigma and to understand why people should have it and have access to it.

What is Naloxone?

Naloxone is a narcotic blocker used to treat opioid overdose. It’s commonly available as a prescription medication but many states also make it available as an over-the-counter drug. This is especially true for the nasal spray and oral ingestion tablets, which can be taken by nose or mouth rather than injection. In addition, some states, like New York, actually offer custom programs to pay for most or all of the cost of Narcan and Naloxone for uninsured individuals or individuals whose insurance does not cover enough of the cost of the drug.

Naloxone itself works by binding to the opioid receptors in the brain, blocking and removing opioids from doing so. Much like when you put oil in water, the Naloxone repels the opioids, preventing them from rebinding until the Naloxone wears off. For this reason, Naloxone can reverse an overdose. However, it can also cause a physically dependent or addicted person to go into withdrawal. In fact, people who take Naloxone frequently go into opioid withdrawal – sometimes experiencing significant symptoms.

History of Naloxone

Naloxone was developed in the late 50s and was first patented in 1961. Following extensive testing, the drug moved into trials. By the early 90s, the U.S. and Canada began distributing it as part of longer-term trials to test efficacy and long-term effects. And, by 2010, those trials had reversed over 10,000 overdoses – effectively proving Naloxone is an indispensable drug. This was later recognized by the World Health Organization, which listed the drug as an essential medication.

In 2015, the first Naloxone nasal spray was approved by the FDA, with Narcan hitting the markets. In 2021, that was followed by Koxxado, a higher dose nasal spray. Today, these drugs are increasingly available over the counter and for free at pharmacies and via drug and support shelters.

How do You Use Naloxone

Almost all Naloxone products are available as nasal sprays. However, you may also have access to an oral tablet or even an injection. In some cases, patches are also available, although these are typically distributed as part of maintenance programs for persons on methadone or buprenorphine and who have already undergone drug rehab. That’s important because taking Naloxone while still addicted to opioids will normally cause you to go into withdrawal which can be significant and even dangerous.

The nasal spray is also extremely easy to take. Here, most bottles should be inserted into the nostril and sprayed by pulling the cap all the way down. The drug itself should take effect within 2-5 minutes. From there, you normally have 20-30 minutes to get the individual to a hospital. This is important, because without a follow-up dose of Naloxone, most people will go back into overdose. That’s because Naloxone lasts for 20-30 minutes but opioids last for 6-12 hours. Therefore, you should always call the ambulance after administering Naloxone.

If you have a tablet, it should normally be taken by placing on or under the tongue, depending on the instructions on the package. And, if you have an injection, it injects into the bicep, hip, or thigh – and you should take care to ensure the needle goes into a large muscle. Injection naloxone is becoming increasingly less common because it can take as long as 30 minutes to take effect, which can be too late if someone is suffering from an overdose.

In most cases, Naloxone is also administered after you get to a hospital. Here, the hospital will dose it via an inline IV, meaning that it can stay effective for as long as is needed to move the individual through overdose.

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Naloxone in Drug Addiction Treatment

Naloxone is frequently used as part of drug addiction treatment. Here, you might see Naloxone in medication assisted treatment (MAT) programs. You might also see it as part of a longer-term maintenance program.

MAT – Here, a MAT program uses a different opioid such as methadone or suboxone to reduce cravings and to allow the individual to recover before going through physical withdrawal. Naloxone may be used as part of treatment to ensure that those opioids are not abused. For example, Buprenorphine and Naloxone sublingual tablets allow the individual to take medication with little oversight and maintenance. That’s because Naloxone is poorly absorbed orally. Once it’s crushed and injected, which would be necessary to get high from the buprenorphine, it takes effect, causing the buprenorphine to not have an effect. In this case, the individual would also go into withdrawal – which might require medical attention. Therefore, these types of programs are only recommended under close supervision and with the addition of behavioral therapy.

Patches – Patches are normally only sold as part of medication assisted treatment programs (MAT) in which you are intended to wear a patch over the course of the day. Doing so prevents you from abusing an opioid because, if you do, you won’t experience any of the effects of the drug. Patches are essentially slow-release versions of Naloxone and are typically intended for at least 24 hours.

Does Naloxone Have Side Effects?

Naloxone has a small number of side effects. In addition, a small number of people may experience allergic reactions. In most cases, side effects are significantly stronger when the drug is injected, meaning that, for the most part, you’ll see very limited side effects.

When you do get side effects, they normally include hot flashes, sweating, heart palpitations, potential arrythmia, and burning around the injection site.

In addition, most people who take Naloxone can expect to experience withdrawal symptoms. This is an unavoidable part of taking a drug that blocks opioids if you are addicted to opioids.

Otherwise, Naloxone is safe with very few side effects. For example, it does not have an overdose risk and it has no risk of abuse. Therefore, it is very safe to take without supervision. If you use patches, you may experience light withdrawal symptoms when getting off it.

Getting Help

If you or a loved one is struggling with opioid abuse, it’s important that you have Naloxone on hand to prevent overdose. However, it’s also important that you work towards getting help. Mental health treatment including behavioral therapy, good detox services, and longer-term counseling and group therapy can help you to build the skills to quit abusing drugs, to rebuild your life, and to get back on track. Naloxone can help, but it is a short-term solution.

Asana Recovery provides a full continuum of highly effective drug rehab and alcohol rehab programs. If you have questions for yourself, or your loved one, contact us today to speak in complete confidence with one of our experienced and caring addiction treatment team.