Despite Effectiveness, Narcan Recipients Mortality Rate Remains High

HEALTH NEWS (3/15/2024) – In the ongoing battle against opioid overdoses, naloxone, commonly known as Narcan, stands as a crucial tool for saving lives. This medication acts as a fast-acting treatment, capable of reversing the effects of opioids. However, research has shown that a significant number of naloxone recipients may still eventually die from an overdose.

Narcan is one of two brand names under which naloxone is distributed, the other being Evzio.

As an opioid antagonist, naloxone possesses no inherent morphine-like properties. Its primary function lies in its ability to competitively bind to opioid receptors in the central nervous system (CNS), particularly targeting the mu, kappa, and sigma receptor sites. This action effectively blocks opioids from exerting their effects, leading to the reversal of opioid-induced symptoms.

Importantly, according to the National Institutes of Health, naloxone has shown no evidence of inducing tolerance, physical dependence, or psychological addiction. However, when administered to individuals with opioid dependence, naloxone can precipitate withdrawal symptoms. The severity and duration of these symptoms depend on factors such as naloxone dosage and the type of opioid dependence present.

The onset of naloxone’s action is rapid, typically within two minutes when administered intravenously. Subcutaneous or intramuscular administration may lead to a slightly slower onset. The duration of action varies based on dosage and administration route, with intramuscular administration resulting in a more prolonged effect. Nonetheless, due to the potential for naloxone’s effects to dissipate before those of opioids, repeat dosing may be necessary.

Despite its life-saving potential, naloxone is not without risks. Adverse effects such as hypotension, hypertension, cardiac arrhythmias, respiratory distress, and pulmonary edema have been reported. In some cases, excessive doses of naloxone can lead to the reversal of analgesia and agitation, particularly in postoperative patients.

A recent study conducted in 2017 sheds light on the sobering reality of opioid overdose outcomes, even with naloxone intervention. The study, led by S.G. Weiner and colleagues, analyzed data from EMS, payer claims, and death records in Massachusetts to determine the one-year mortality of patients who received naloxone and initially survived.

The findings revealed a high mortality rate among individuals who received naloxone by EMS. Approximately 10% of patients in the study cohort succumbed to death within one year of naloxone administration. Alarmingly, more than half of these deaths occurred outside of the hospital setting, indicating a significant number of overdose fatalities preceding medical attention.

While naloxone aka Narcan may be effective at addressing an overdose in the short-term, it is only a temporary fix, and does not address the root causes of the opioid crisis, including lack of adequate mental health care and availability of addiction treatment and prevention.

Story by multiple RFHC contributors