Opiod abuse has been a prevalent issue in the West since the First British Opium War in the middle of the 19th century. The effects of the poppy plant as an easily applied pain reliever had been lauded by the medical institutions of the time – and still are – and its use has therefore only integrally diminished since this time.
However, opioids also have well-documented side effects with the most prevalent being long-term, acute addiction and its adherent withdrawal after cessation of use.
It’s currently estimated that anywhere from 26 to 36 million people are heavily addicted to opioids such as heroin worldwide, with over 2 million individuals suffering from addiction in the United States alone.
Withdrawal symptoms are about as bad as you could imagine and include sweating, vomiting, lack of sleep, and so on. However, the most dangerous effect of heroin, morphine, oxycodone, or other opioid abuse, is the overdose on the substances – which could result in blood toxicity and death.
Over 50,000 people died of opioid overdose in 2013. Typically, if the patient is still breathing, they are dealt with by medical staff supporting the individual with breathing and supplying oxygen. In cases where the individual is not breathing, the drug Nalaxone is typically used.
Naloxone is sold under a number of brand names (depending on the country in which it’s being sold), and will typically block the effects of opioids, thus allowing the patient to come out of the withdrawal and start breathing on his or her own.
It can be applied in a variety of ways – nasally, in pill form for long-term effect, and is most commonly administered by intravenous injection. In the latter case, the drug is immediately released into the bloodstream and starts taking effect very quickly, and most often this occurs within two minutes.
This prevents blood hypoxia (which can result in brain damage) and lets the patient recover on their own, though of course supervision is typically practiced, in case there is a negative interaction with other unknown medications, for instance.
Naloxone has been around since 1961, but it is no longer under patent. This brings us to what – in the grand scheme of things – may seem like the last thing on a patient’s mind: price.
Particularly in countries that do not provide socialized medicine, the price of medications can leave a person that already has an addiction with a problem exacerbated by added expenses.
As such, the availability of Naloxone for as little as 50 cents per dose cannot be ignored. Second, it’s remarkably safe, and because of this, it has been added to the World Health Organization (WHO) list of essential medicines.
It typically does not interact with other medications, and typically has absolutely no effect on the body should there not be opioids present in the individual’s system prior to consumption.
It has even been shown to be safe for pregnant mothers to take to term (with a maximum dose of 10mg), though to an extent there is a need to continue studies into effects on whether the drug can indeed cross the placental barrier.
For individuals with a compromised immune system or liver damage, further testing may also be required; however, at present, there has been relatively little risk categorized as part of its use.
It does have the capacity to be applied towards prevention of addiction in individuals who have long-term or repeat instances of sliding back into opioid addiction (or are in an at-risk category); however, due to a natural inefficacy for naloxone to be absorbed when taken orally, it’s typically combined with other preventative medications, such as buprenorphine.
In such cases, the patient will still often feel the effects of opioids in a non-abuse situation, though the effects of most opioids will be at least partially blocked should the individuals then engage in opioid-abusive behavior (such as the injection of heroin).
Naloxone Side Effects
By-and-large, the array of side effects relevant to the use of the drug stem from the abuse of the opioid itself. Naloxone has the natural capacity to speed up the process of withdrawal without overdosing. Therefore, the normal effects on an individual heavily dependent on heroin can sometimes commence immediately after the drug is applied.
As such, it may, therefore, cause profuse sweating, trembling, extreme nausea and vomiting, overheating/flushing and headache, which are unfortunately natural side effects of opioid withdrawal.
In very rare cases, naloxone has been reported to result in more severe side effects, which may be life-threatening.
Whereas these are not higher than what would be the case of individuals suffering from an anaphylactic reaction (an acute allergic reaction to a substance) – and typically hovers around .01%, these side effects may include extreme musculoskeletal pain, hallucinations, and in extremely rare cases cardiovascular problems such as tachycardia (rapid heartbeat), ventricular fibrillation, as well as pulmonary edema (the loss of respiratory function).
Naloxone Common Products
As stated above, naloxone has been around since 1961, having been approved by the U.S. Food and Drug Administration (FDA) in 1971. As a result, it’s no longer under patent and therefore has a very low cost, as well as wide product distribution.
Branded products are, further and as a result, very prevalent (Suboxone, Zubsolve, Narcan, and Bunavail being but a few).
The most prevalent applied methods are by intravenous injection, or by the use of nasal sprays (due to the more rapid/effective uptake of the drug over oral ingestion), thus under the brand name of Narcan.
Whereas the drug is relatively ubiquitous and inexpensive, home use by high-risk individuals is expensive, perhaps as a result of attempts to curb the use of the naloxone by opioid-abusing individuals.
Auto-injectors, a method by which a person who may think he or she is overdosing (or may apply naloxone to another who they think may be overdosing) were priced at around $4,500 in 2016, having increased nearly six-fold in price over the previous two years.
Naloxone Final Words
Naloxone is a generally beneficial product, whose application in comparison to other drugs is relatively innocuous, especially in consideration of reasons for an application, where less than 1% are perceived to experience acute side effects.
As such, new uses with regard to handling opioid addiction are most likely going to continue to be a big part of treatment regimes.