Rehab 4 Addiction

More people die of drug overdoses today than ever before.

While crime in North America thankfully began to decrease after the early 1990s rather than keep on increasing, drug overdose deaths continued to rise.

While deaths from drugs such as cocaine have been rising over the last ten years, most drug overdose deaths today involve synthetic opioids.

Both illegally created opioids and doctor-prescribed painkillers can quickly kill.

The intensity of the withdrawal symptoms that one experiences if they quit opioids keeps people hooked even when the will to detox is strong.

Opiates are also dangerous because of how rewarding they are for the brain.

Many drugs are used to treat opioid addiction.

Opiates are dangerous because they affect breathing, and in high enough doses can cause a person to lose consciousness and cease to breathe while unconscious.

One drug that has saved many lives in the fight against the opioid epidemic is Naloxone.

Naloxone works by blocking the brain receptors that opiates effect. If the drugs cannot get through to the brain, they also cannot lead to slow breathing and death.

Naloxone is so effective that a person who loses consciousness due to an overdose can be walking and talking within a few minutes after receiving the drug.

Naloxone has treated tens of thousands of people suffering from opioid overdoses.

While the drug has existed since 1971, it took longer than that for Naxalone to begin widespread use.

Authorities have been reluctant to allow Naxalone outside of hospital settings.

Between 1996 and 2014, Naxalone was easy for first responders and not merely hospitals to get their hands on.

During this time, more than 20,000 people received Naxalone for opioid overdoses. However, medical authorities have recently made it more difficult for first responders to carry the drugs.

What is an opioid overdose, and how does Naloxone treat it?

When a person is using opioids, they will experience intense feelings of relaxation and pleasure, due to the chemicals affecting these parts of the brain.

Opiates can shut down parts of the brain that deal with essential life-sustaining functions and cause death.

When a person is suffering from an opioid overdose, the pupils of their eyes will contract to points (although this can happen as a result of using the drugs without coming close to overdose), and they will lose consciousness.

Sometimes, a person who is suffering from an overdose will appear to be sleeping. They are not obviously in any trouble at first glance. Their fingernails and lips are likely to turn a bluish colour, and their skin will become pale.

When someone tries to awaken an overdose victim, they will not respond. The victim will remain unconscious and will have shallow breathing or, at worst, no breathing at all.

Sometimes, it can take hours rather than minutes for drug-taking to turn into an overdose.

Giving Naloxone to an unconscious victim as soon as one discovers them can often be enough to save their life.

If one avoids opioids for a while, they are at higher risk of overdose as their tolerance has decreased.

The homeless are at high risk of overdose as well.

The effectiveness of Naloxone

Naloxone’s effectiveness comes from its ability to allow a victim to breathe.

Naloxone does not last for very long; its effects on the body quickly cease.

Opiates, on the other hand, are long-lasting drugs.

For this reason, it is possible for someone who is revived by Naloxone to slip back into unconsciousness and death.

Naloxone is not a cure for opiate addiction

Naloxone is not a “cure” for opioid overdose. It is a life-saving antidote but does not replace more comprehensive medical attention.

After Naloxone revives a victim, the victim must go to a hospital for monitoring and treatment.

Naloxone is not a drug that anyone abuses. It does not affect the mind and cannot produce a high.

A highly addicted person may not believe that their overdose was critical enough to warrant medical attention.

They may be annoyed by having their high interrupted by the drug. In some cases, they will refuse medical treatment and want to take more of their opiates.

A person revived by Naloxone may become angry and aggressive for this reason.

The sudden interruption of their high may cause intense cravings for more of the drug.

When a person takes Naloxone, their brain can no longer be affected by opiates for a short time, which can cause intense cravings.

Naloxone does not work for people who overdose on drugs in general.

It only affects the part of the brain that is receptive to opiates.

Therefore someone who is also using cocaine, alcohol, or any other drug must be treated for other forms of intoxication.

Side effects of Naloxone

Naloxone can have serious side effects. Heavy over-breathing may occur in some victims.

Nausea, a fast or irregular heartbeat, or fluid filling the lungs may occur.

Blood pressure can either increase or decrease.

These side effects are relatively safe. Naloxone is only for those who are in danger of permanent injury or death due to drug overdose.

A worst-case scenario for Naloxone is a heart attack.

The drug can sometimes cause heart attacks in persons who already have heart disease. Therefore, there is the possibility of death from Naloxone in the worst cases.

In spite of the unlikely possibility of a heart attack, Naloxone saves lives.

If a person is unconscious as a result of an opioid overdose, they must have Naloxone.

The odds of Naloxone ending a life is far less than the odds of Naloxone saving it.

The initial dose of Naloxone should not be huge. Only if the victim fails to respond to an initial treatment do they need a more massive dose.

Does Naloxone cause drug users to take more risks?

One could argue that the presence of Naloxone could cause those who use opiates to take higher doses of these drugs.

With the possibility of recovering from an otherwise fatal drug overdose due to Naloxone treatment, a victim might behave more carelessly than they would otherwise.

However, this argument has been studied and proven false.

According to a 2010 study, a person who receives a Naloxone treatment uses less rather than more drugs during the next three months than they did before.

Naloxone does not make opiates safe by any means, and it is not likely that drug users see it as such.

One argument against giving Naloxone kits to drug users is that the drug users will use the needles to inject illegal drugs. Needles are easy to find.

A drug user will never avoid injecting drugs due to lacking needles.

Clean needles are given to drug users for free for the sake of harm reduction.

The needles used for Naloxone injections are less suitable for illegal drug use than the needles given away to drug users for free at syringe exchanges.

Is Naloxone safe enough to be widely available?

While Naloxone is a potent substance, the benefits of making it widely available vastly outweigh the risks.

The drug has no potential for abuse. While opiates that are given to addicts for the sake of treating their withdrawal symptoms are abused, this is not the case for Naloxone, which has no abuse potential.

There is also the possibility of a severe allergic reaction to Naloxone. The possibility of an allergic reaction is also never a reason to not use the drug.

Even the limited risk of a fatal heart attack is not enough to avoid using Naloxone. Naloxone is for a person whose life is in danger.

Naloxone is only used in critical situations. Using the drug will also cause a person to suffer from severe opiate withdrawals. While this can be very unpleasant, there is little possibility of opiate withdrawal symptoms putting a person’s life in danger.

How can one tell if an overdose is severe enough to justify Naloxone?

If a person is unconscious and does not respond to being shaken or shouted at, they have overdosed.

Gurgling noises and snoring are typical among people who have lost consciousness due to opiates but have not yet stopped breathing.

If they are revived before they stop breathing, they will usually not suffer any permanent injury.

If breathing has stopped, on the other hand, there is a good chance of permanent injury or death. Any person who has lost consciousness is in enough danger to justify Naloxone use.

Is it possible to use Naloxone without injection?

Yes, it is now possible to give Naloxone to a victim without needing to use a needle or a syringe.

Other options make it easier for people with little or no medical training to administer Naloxone. These alternative means of delivering the drug are known as Narcan and Evzio.

Narcan is a nasal spray for those who have no training with injections. Unlike Narcan, Evizo is an injection.

However, an Evizo kit contains audio instructions for how to administer a needle properly, making it easier for untrained persons to use.

It is also simpler to inject a victim using an Evizo kit than using a typical syringe and vial kit.

Is Nyoxoid effective?

Yes, Nyoxoid is another needle-free option for administering Naxalone. Like Narcan, Nyoxoid is a nasal spray.

Each pack of Nyoxid contains two doses of nasal spray and instructions for how to use the drug. Nyoxoid expires quickly and must be replaced each month, or else the drug will become ineffective.

If you carry Nyoxoid, make very sure that you replace the medication monthly.

If you carry the drug, make sure that an overdose has occurred first.

After ensuring that the person is unconscious and not merely sleeping, call an ambulance. The ambulance should be called even before the drug is administered. Nothing is more critical than the ambulance reaching the victim as quickly as possible.

After calling the ambulance, immediately administer the medication. If the person does not wake up in two or three minutes, deliver the second dose. If the person initially wakes up but quickly slips back into unconsciousness, the second dose should be used.

Like other Naloxone drugs, Nyoxoid contains a chemical that fits into opiate receptors in the brain. Naloxone molecules can fit into these brain receptors even more quickly than opiate molecules can.

The Naloxone molecules, therefore, crowd out the opiate molecules and prevent them from interacting with opiate receptors.

All opiate drugs work in the same general way, and all Naloxone drugs have the same method of treating opiate overdose.

After a victim regains consciousness, they are not necessarily safe.

Anyone who carries Nyoxoid should know how to put a victim into a recovery position, which is a lying position where it is easy for them to breathe. Pay attention to and comfort the person until the ambulance arrives.

When the ambulance arrives, immediately tell them that you have given them Nyoxoid.

The victim may end up suffering from dangerously severe withdrawal symptoms, which the emergency personnel must be prepared for. After using Nyoxoid, throw your Nyoxoid kid away and replace it.

Do not carry a half-empty Nyoxoid kit around, and make sure that any drug remaining in a used spray bottle is disposed of.

Whenever one is trying to revive a victim with Nyoxoid, one should make sure that they are lying on their back, with their head tilted back.

One should put their hand on the back of the person’s neck to make sure that the head tilts back correctly.

This ensures that the nasal spray will reach the brain in enough quantity to make a difference.

Do not be horrified if the victim acts angry after being given this life-saving medication. They are disoriented and not able to reason. It is typical for someone having an opiate overdose to act mad at their rescuer.

How does one acquire Naloxone?

How difficult it is to acquire Naloxone varies from one country and one region to another. Ideally, it should be publicly available for free

. It is not likely to be used outside of life-saving emergency situations where its risks are tame compared to its benefits.

In the U.K., one can talk to their drug treatment service provider about free naloxone kits.

Persons working in services for the homeless should not have any trouble acquiring the drug.

You will have to have a discussion about how much of the medication you will need and how many of your staff will carry it.

As well as being able to acquire the drug for your paid staff, you may be able to allow your volunteers to bring the medication.

Residents of homeless shelters may also be allowed to carry it. In other countries and in other circumstances, the medicine may be more restricted.

The drug has a reputation for being more dangerous than it is, so its availability remains limited in many places.

How take-home naloxone programmes save lives

While drug overdose deaths continue to increase rapidly in the United States, there has been a slight decrease in Europe in recent years.

The decreasing death rate in Europe may be due to the increasing prevalence of take-home Naloxone kits. If drug addicts and people close to them are trained on how to use Naloxone, lives can be saved.

Without these take-home kits, many drug overdoses occur in the presence of others.

Is it dangerous to give Naloxone to a person who is not unconscious?

Yes, the drug is too potent to use unless the victim is actually unconscious.

If a person is asleep while using opiates, one may falsely believe that they are knocked out and suffering from an overdose.

Many people use opioids, especially heroin before they go to sleep.

Do not panic and administer Naloxone unless the person is actually unconscious.

If they do not respond to yelling, try to shake them awake.

If even shaking does not work, they have had an overdose. In that case, first, call an ambulance, then put the victim in the recovery position, and then administer the drug.

Can Naloxone be stored anywhere?

No. Naloxone has to be stored properly.

Unless the room that Naloxone is stored in is between 59 and 86 degrees Fahrenheit at all times, the medicine can lose its effectiveness.

How long it can be stored depends on the form of the drug.

In a typical injectable form, the drug can be stored for two or at least one and a half years without losing effectiveness. The drug must also be kept out of sunlight.

Is rescue breathing necessary in addition to Naxalone?

Yes, one should always use rescue breathing in addition to and prior to using Naxalone.

Lack of oxygen can permanently damage the brain even if the victim survives.

Calling an ambulance is the most crucial and should occur first. The second step is to practice rescue breathing, followed by administering Naxalone.

Do not practice rescue breathing for more than a short time. One should quickly move past that stage and give the victim the drug.

To perform rescue breathing, one must first put the victim on their back, and then tilt their head back with one’s hand on the back of their neck.

After getting their head into the right position, one should make sure that the mouth is clear of anything that may block their airwaves.

The victim may have vomited, which will render rescue breathing ineffective unless the mouth is cleared.

After clearing the mouth, pinch the person’s nose and blow air into their mouth.

One breath should go into their mouth every five seconds. One should only perform rescue breathing for a minimum of time – say two or three breaths – before moving on to giving the patient Naloxone.

How does one properly administer an injection?

First, the skin should be clean. Pushing a needle into unclean skin can push bacteria that is on the surface into the body.

Use an alcohol wipe to clean it. If one does not have an alcohol wipe, one should deliver the injection anyway.

Remove the cap from the Naloxone vial and entirely fill the syringe with Naloxone, making sure to empty the flask and not leave some of the drug remaining in it.

The upper arm, buttocks, and thigh are all excellent places for a Naloxone injection. Inject all of the medicine into the victim, and hopefully, they will recover.

How different is Evzio than a typical injection?

Evzio is designed to be more comfortable for untrained people to use than a typical vial and syringe kit is.

With an Evzio kit, it is not necessary to drain a flask into a syringe. The injector is already full of liquid.

Don’t touch the black base of the injector when pulling it out of its case. There is a red safety cap on the nozzle, which must be removed. Then, simply push the injector against the victim’s other thigh for five seconds.

Sometimes, these treatments will not restore breathing. In that case, continue to perform rescue breathing for a few minutes while you wait for the ambulance to arrive.

Rescue breathing can be enough to prevent the victim from dying or suffering brain damage.

After reviving the victim

After reviving the victim, make sure that they seek medical care.

They might prefer to avoid the hospital in spite of the seriousness of what just happened to them.

Avoiding the hospital is very dangerous as there is still plenty of opium in the person’s system even if Naxalone is preventing it from affecting the brain.

Naxalone does not last long enough for the opiates to leave the person’s body. After the Naxalone wears off, the victim might die.

How many side effects does the drug have?

Naxalone is a shock to a person’s system and can have many unpleasant and dangerous side effects.

It affects the digestive system (nausea and vomiting), the heart (at worst a fatal heart attack), the mind (from agitation to hallucinations), and the nervous system (potentially dangerous convulsions). One must, therefore, only use Naxalone if the situation is at least somewhat life-threatening. Naxalone is too strong to be given to a conscious person.


Boris is our editor-in-chief at Rehab 4 Addiction. Boris is an addiction expert with more than 20 years in the field.  His expertise covers a broad of topics relating to addiction, rehab and recovery. Boris is an addiction therapist and assists in the alcohol detox and rehab process. Boris has been featured on a variety of websites, including the BBC, Verywell Mind and Healthline.