Well, the difference with epi-pens is that an epi-pen is usually carried by the person who has the allergy, not a random responder, and so it’s unlikely that it’ll be accidentally administered to someone who’s not suffering from an anaphylaxic allergy. But if it’s really as safe as you say, then I guess that isn’t a big worry here. I’m just a little bit leery of any drug description that claims no side effects.
The worst common side effect is severe withdrawal symptoms if the person has taken opiates but not overdosed. The most common side effects are increased blood pressure, musculoskeletal pain , headache, and nasal symptoms which as far as I can tell might be due to withdrawal rather than the drug itself. According to the training I received when I received my kit (which contains the nasal spray) , there is no effect on those who haven’t taken opiates However, it was also part of the training that naloxone is not used instead of calling an ambulance - you call the ambulance even if you administer naloxone.
Just an FYI - I think part of the reason for the recent concern about overdoses is that the old stereotypes about heroin addicts shooting up are no longer true. Now the overdose victims include people who are taking things like vicodin or who started on vicodin and started snorting heroin because it’s cheaper/easier to get. And those people aren’t always so easy to recognize - so it’s entirely possible that you can spend a lot of time around an addict or two without knowing they are addicts.
IMO …
Nothing so complex as that.
Who doesn’t prefer the bar where the bartender pours oversized shots? Who, especially amongst the young and stupid, don’t consider that they hold their liquor better than most? Who among the people who like spicy food won’t tell you they like it hotter than almost anyone else they know? Why are restaurant desserts as huge as they are these days, and even huger than that in the extra-obese parts of the country?
People want a bargain, and they like to believe bigger=stronger=better.
In an underground industry where there’s no way to advertise, somebody selling to an OD is somebody who instantly gets the reputation of selling good enough stuff to get you really high; not like that heavily cut crap you usually get from the other guy.
It’s super-size me and nothing more.
The OP isn’t quite wrong. It probably is creating more overdoses, just not the way argued.
See, the overdose victims revived by Narcan still have a severe addiction to opiates. They might be jailed for a little while if the police actually found leftover opiates they hadn’t yet consumed when they were found, but once released, they are going to be jonesing for a fix. Jails and prisons or court mandated therapy is obviously not the Betty Ford clinic and so they will probably not successfully be treated for their addiction.
So they do some more, still severely addicted, probably buying from the same dealer, and they OD again. Get revived again, and so on.
The way to differentiate this hypothesis would be to count how many Narcan revivals are repeats.
The other possibility is that opiate addictions are getting worse these days because of the epidemic of prescription opiate abuse. Making the problem worse is that when they moved Vicodin to schedule 2 and have started prosecuting doctors, now the supply of legal prescription opiates is drying up. But addicts dependent on them to even function are still addicted, so…
(I would assume that black market opiates are easier to overdose on than prescription opiates - so all the people who are now being denied refills of their oxycontin prescription have no choice but to buy black market heroin or go into withdrawals.)
Yes, let’s do that. Then we can fire the meat inspectors and address e coli, listeria and salmonella by saying grace over the food.
No, I do not want to see them die. I am simply conveying a popular opinion. My opinion is that that we should help/save them.
This is one reason why I believe it should not be used by laypeople. The other is that people brought out of Narcan can become extremely violent, mainly because they didn’t like their nice, pleasant high interrupted. Other pharmacists have said that Narcan isn’t exactly flying off their shelves.
And c’mon. Does anyone really think that opiate addicts are going to have their own version of a designated driver? 
:rolleyes: :smack: I don’t think so.
Whenever I hear about an addict dying, I’ll admit it - I’m torn between “Their friends and family will miss them” and “Whatever friends and family they had left are probably relieved that this person will no longer be around to cause all kinds of problems.” Sad but true.
In short, my answer to the OP’s question is “Probably not.”
It means that s/he’s selling Some Very Good Shit, quite likely cut with fentanyl or even carfentanil, which is even stronger.
And… I don’t get it. You think it’s better we just let people die rather than risk them being angry?
Sad and NOT true - the second sentiment is far from universal. That’s just really cold and callous. Yes, some addicts have done that thorough a job of pissing everyone off but not everyone. In some cases friends and family aren’t all aware the person is using.
To my understanding of the Hippocratic Oath, arbitrarily choosing not to administer life saving treatment to an OD victim would be the same as a medical personnel not saving a gang banger’s life just because he’s been on his/her table multiple times and will be there many more times.
And any claims that lifesaving treatment makes people more likely to take potentially fatal risks would have to be weighed against the likelihood that they would continue to take these risks if they didn’t die.
There was some discussion among medical ethicists a few years back regarding people who blow themselves up in meth lab explosions, and whether they should be given any treatment other than comfort care. :eek:
The Narcan that would be used by a lay person is the same Narcan used by non medically trained police officers and first responders. It is in in a syringe with a special tip that sprays a mist into the victim’s nose. Taking a drug through inhalation takes a little longer to get into the system and works a little slower than what doctors and paramedics use, which is to inject Narcan directly into the vein.
I have responded to OD’s with paramedics. When they give Narcan via IV, I have seen the victims wake up rather quickly, swinging and extremely violent, (not all of them do this, but enough of them have that we are always prepared for it now). Just my opinion, but I don’t think the ones that wake up violent are actually mad that we ruined their high, as much as they are confused, surprised etc. (I think it would be like going to bed alone and waking up to several people standing over me and not knowing how they got in there or why).
I have also responded to OD’s where all we had available were the nasal injectors. These victims wake up a little slower, so we have time to talk to them and let them know what it going on. When we were trained on the nasal injectors, they told us that, depending on how much opioid is in the victims system, won’t reverse the entire effect of the opioid, but will help keep the victim alive until they get to more definitive care.
I have no idea how many OD’s I have responded to over the years, but I can say that it is a lot and it has become more common in the last several years. It is frustrating when you hear the same address come across the radio over and over again, but we still go and we still help them.
Up here in Alberta (I don’t think we are the only province to do it, but I am not sure) anyone can walk into a pharmacy and get a naloxone kit, and the kit comes with a needle and syringe. Judging from the instructions (middle of the thigh) it’s an IM injection.
Naloxone is a very safe drug. You could take it yourself with almost no chance of side effects. It is very easy to administer because it comes in an autoinjector, Evzio (like an Epipen). Naloxone usually lasts 30-60 minutes so can keep an OD victim breathing until they can get emergency medical care.
Actually causing more ODs? Of course not. Resulting in ODs? Cynically speaking, yes. I train veteran police officers and routinely ask them if they ever had to give Narcan to the same person twice in the same day. I’d say I get a 10-20% affirmative response. One guy had the same person OD three times in a 24 period. Without Narcan they wouldn’t have had the opportunity to repeat. The most common response from those treated with Narcan is to deny they were using any drugs. Many express disappointment (and even anger) that they were no longer high.