Imagine coming home from surgery with a bag containing things for pain management, anti-nausea medication and blood clot prevention- then finding a box of naloxone inside.

If you aren’t familiar, naloxone (brand name Narcan) is an overdose reversal medication that is being made widely available to the public. Lethal fentanyl overdoses in Seattle account for about three times as many deaths as car accidents and gun violence combined according to Sara Jean Green, a reporter from The Seattle Times who has reported extensively on the crisis. Prescribing naloxone for overdose prevention has become more and more common.

During a one-on-one interview with Ripley (name changed to protect the source), a member of the use-dependent community, they said “Formal training is always going to be better but the really nice thing is that it’s pretty foolproof, anybody can open the box and just use it.”

“It’s reasonable and responsible to send naloxone home with people being prescribed opioids,” said Green “It’s so easy to make a mistake if your brain is fuzzy, ‘Did I take a pill already? I don’t remember, I’ll just take another one now.’”

According to this study published in JMIR Formative Research from December 2020, many opioid users declined no-cost naloxone. One aspect of the study focused on how the participants thought the stigma of carrying overdose reversing drugs could be minimized. Many of their suggestions have been implemented, such as education about how to identify an overdose, recognizing that anybody can overdose, knowledge that naloxone cannot do any harm to a person not experiencing an opioid overdose and that prompt administration of the drug can save somebody’s life.

It is not known how frequently naloxone is being administered. “As you can imagine, people may be using naloxone in many settings and don’t report when they reversed an overdose,” Sharon Bogan, a communications specialist in the King County Public Health department said. “What we do have is data on the number of naloxone kits distributed by King County with over 13,000 naloxone kits distributed in 2022.”

So what impact has the recent influx of naloxone had on the substance use disorder community? Are they taking more risks with their use?

“We have not heard evidence that naloxone leads to an increase in use,” Bogan said “The greater concern is stigmatization of people who have a substance use disorder and ensuring that our medical system, and the community at large, understands that substance use disorder is a medical condition and that stigmatizing people can make it much more difficult for people to access treatment when they are ready.”

There is still a lingering concern about misidentifying the signs of an opioid overdose and accidentally administering naloxone to the wrong person but, as Ripley puts it, “I’ve probably administered naloxone on people that weren’t experiencing an opioid overdose, and it’s perfectly safe to use on someone that’s not overdosing. Obviously, it’s wasteful to give someone medicine when they don’t need it, but I like to think of it like a tetanus shot. Chances are you might not get tetanus from your injury but giving the vaccine just to be sure doesn’t hurt.”

This isn’t always the case. One of the concerns brought up by Bogan was the potential to put a user into withdrawal. It’s one thing to reverse an OD for an occasional user, but it’s more difficult to know how much medicine to give to a person that uses frequently. This is why you should always call 911 and try to stay with the person until help arrives. Withdrawal can be shockingly painful. It can cause many unexpected symptoms and they might not want to stay to receive more care.

Unfortunately, sometimes naloxone is present but it can’t be utilized. There have been some reports of deaths where naloxone was nearby. “It's positive to know that naloxone is becoming more available. However, it’s heartbreaking to know that someone used alone, or that there wasn’t someone nearby who could reverse their overdose.” Bogan said. She also expressed the Public Health Department’s push to encourage people to avoid using alone.

Cities like Vancouver are seeing a 35% reduction in fatal overdoses in the area around a supervised injection site called Insite. People who used Insite were much less likely to share needles than individuals who shot up in unsupervised places. Insite also helped get people sober. “Of the 6,532 people who visited the facility in 2015, 464 were referred to addiction treatment, and more than half of them completed it.”

Narcan Saves Lives

Northwest Immigrant Rights Project