Doctors, paramedics say Narcan effective on overdose patients
Amanda Steen | Herald-Standard
Joe Filitsky of Fayette EMS holds a dosage of Narcan, an injectable drug that reverses the effects of an overdose, in this file photo.
Narcan can be injected or taken as a nasal spray.
Naloxone, commonly referred to as Narcan, can be prescribed to friends and relatives of addicts under a bill signed into law by Gov. Tom Corbett.
Amanda Steen | Herald-Standard
In this 2014 file photo, Joe Filitsky of Fayette EMS holds a dosage of Narcan, an injectable drug that reverses the effects of an overdose.
Doctors and paramedics say naloxone has been an effective and commonly used antidote for drug overdoses for many years, but they have concerns about allowing doctors to write prescriptions for the medication for potential overdoses.
A bill, which Gov. Tom Corbett signed into law last week after receiving unanimous approval in the state House and Senate, allows doctors to prescribe naloxone, referred to by the brand name Narcan, to friends and relatives of addicts, and allows police to administer the medication.
The legislation also offers immunity from criminal prosecution to those who help overdose victims. The law will take effect in 60 days.
Administered as a nasal spray or injection, naloxone reverses the effects of heroin and opioids like oxycodone by blocking receptors in the brain that opiates latch onto.
“It’s used way too much here,” said Dr. Jeff Frye, medical director of Uniontown Hospital’s emergency department. “I think we’re seeing an uptick in the amount of heroin and narcotic overdoes in the area for sure.”
He said it’s not uncommon for unconscious people who took an overdose of drugs to be dropped off at the emergency department in private vehicles.
“If it’s a drug overdose, that’s the drug we use to reverse it. It basically reverses the effects of narcotics,” Frye said, about Narcan
“Narcan has saved numerous, numerous lives in the 30 years I’ve been doing this,” said Rick Adobato, Fayette EMS chief.
However, he said putting naloxone in the hands of the general public might lead people to believe they can treat an overdose and don’t have to call 911 or take the person who overdosed to a hospital.
Heroin is much more potent now than it was 10 years ago when one or two doses of naloxone was enough, Adobato said. It is common to administer five to seven doses now because the heroin is stronger, he said.
“I’m very nervous about that part of it. I’m worried it will give a false sense of security. You still have to call 911, but people don’t want to get caught so they might delay calling 911,” Adobato said. “One dose might help, but it might not. That’s the danger with the public having Narcan.”
Anyone witnessing an overdose should immediately call 911 and the patient should be taken to a hospital, he said. An overdose patient could have so much heroin in his or her system that it remains active after the Narcan wears off, he said.
“Timing is of the essence,” Frye said.
An overdose can repress breathing and prevent oxygen from reaching the brain. Damage to the brain or death can result if the brain is deprived of oxygen for four minutes, he said.
Making Narcan available to the public could lead to people using high doses of drugs believing their friends can save them if they overdose, Frye said.
However, he said understands the logic behind the law.
Police officers can administer the nasal spray version of naloxone, but departments will have to decide if they want officers to take on that responsibility, Frye said.
He said police have some basic medical training, but asking them to administer medication expands their duties to that of paramedics.
“You’re expecting the police to become medical personnel,” Frye said.
There is no harm in using the nasal spray version, but it is not as effective as an injection, he said.
Paramedics often administer the nasal spray as the first dose while they set up an intravenous dosage, Adobato said.
Police could administer the spray, but it is up to them to decide if they want to, he said.
Narcan could be given to a person who didn’t use drugs without causing harm, he added.
“There’s no downside to this,” Adobato said.
A legislative study found deadly drug overdoses skyrocketed in the state between 1990 and 2011. Experts say the increase is due in large part to the abuse of legal painkilling opioids, whose users switch to heroin when their prescriptions run out or become too expensive.
Rural overdose deaths increased from about one per 100,000 residents to 13 per 100,000, according to the report by the Center for Rural Pennsylvania. Urban fatalities rose from about three to 16 per 100,000 residents, the study found.