MBEMSC /PIER Committee
Nasal Naloxone/Introduction
Purpose:
 Early intervention can help reduce fatalities
 The First Responder Narcan Program is designed to
educate first responders in recognizing signs and
symptoms of opiate overdose
OBJECTIVES
At the conclusion of this training participants will be
able to:
 Recognize signs and symptoms of opiate overdose
 Initiate appropriate treatments and interventions
 Assemble the nasal narcan delivery device
 Successfully administer appropriate dosing of Nasal
Narcan
Background
 Annually XXXX # of patients suffer from opiate
overdoses in Massachusetts
 XXX # result in death
 Timely administration of Narcan has proven to reduce
the # of opiate related deaths
Since officers started carrying Narcan in October 2010, 163 doses have been
administered, resulting in 157 overdose reversals. In the 18 months before October
2010, there were 46 overdose related deaths. In the 18 months after the implementation
of the Narcan program there were 22 overdose related deaths.
Read more: PAUL KEENAN: The Quincy Narcan model is saving – and changing – lives
- Quincy, MA - The Patriot Ledger
http://www.patriotledger.com/topstories/x1590647422/PAUL-KEENAN-The-QuincyNarcan-model-is-saving-and-changing-lives#ixzz2VUSpPut3
Under Creative Commons License: Attribution Non-Commercial
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Naloxone
Generic Name :
Naloxone Hydrochloride
Brand Name :
Narcan®
•
Endo Pharmaceuticals brought Narcan® to
the market in the 1960's
•
Narcan® is currently available generically
under the name Naloxone
Naloxone is..
An opiate antagonist which reverses opiate overdoses
Some commonly abused opiates are:
Heroin
Oxycontin
Percocet
Vicodin
Methadone
Morphine
Narcan®/Naloxone has been used in
emergency rooms and EMS for more
than forty years as an antidote for
opiate overdoses.
Pharmacology
•
•
•
Opiates produce their effects as an agonist on
the mu receptors in the central nervous system
Mu¹ receptors are responsible for a large
portion of analgesic (pain management)
effects
Mu² receptors are responsible for respiratory
distress

Naloxone kicks opiates out of the brain by
blocking certain receptor sites.

Naloxone occupies the receptor sites and
prevents opiates from binding to the brain.

Naloxone in conjunction with rescue
breathing has life saving potential.
An opiate overdose is..
 When opiates settle in the part of the brain that
regulates breathing.
 The immediate concern during an opiate
overdose respiratory depression.
• The effects of Naloxone wears off between 30-
60 minutes after administration
• Heroin lasts 6-8 hours
• Methadone lasts 24 hours
• Opiates outlast Naloxone
• BE PREPARED FOR THE PATIENT
TO RELAPSE
When am I supposed to give
©
Narcan ??????
Signs and symptoms of
Opiate Overdose
Signs and Symptoms
 In addition to a known history of opiate abuse,
responders should look for:
 Weak/Thready pulse
 Slow or Absent Respirations
 Constricted Pupils
 Weakness/Unresponsiveness
Administration
 First Responder administration of Narcan© will be
Intra-Nasally.
 A preloaded syringe will be affixed with a mucosal
atomization device (MAD)
Administration
 Pre loaded syringes contain 2mg in 2ml.
 Per statewide treatment protocols for EMTs and
Paramedics the dose for Naloxone in 0.4- 2.0 mg and
may be repeated if necessary
Storage of
©
Narcan
Common Misconceptions
•
Administering
Naloxone does not
require extreme
force
Schedule
•
•
Naloxone is not in the DEA schedule of drug
classes, yet requires a prescription
Naloxone has no potential for abuse
 Naloxone has no other purpose besides
reversing an opiate related overdose.
 Naloxone has no mind altering effects
 Naloxone is the only treatment in medicine
that literally cannot hurt anyone.
 The only possible effect is the individual
may become dope sick (withdrawal).
 Naloxone is specific, safe, and effective
Epidemiology
People coming out of jail or treatment have
highest risk of overdose.
Most deaths are among opiate users who are in
their late twenties to early thirties and have been
actively using for the past five to ten years.
Only 17 % of opiate related deaths are among new
users.
 Programs that work with drug users are educating them
in the use of Naloxone.
 The Chicago Recovery Alliance has been providing
Naloxone in Cook County, IL since 2001
 From the 2011 Annual report Chicago Recovery Alliance
reports 2,972 peer reversals using Naloxone since
the programs inception.
If interested in knowing more
about overdose..
 Mass DPH-Bureau of
Substance Abuse
Services
 www.mass.gov/dph/bsas
Bottom Line
Nobody needs to die from an
opiate overdose
Questions??????