Naloxone: Why Are More Doctors Prescribing it?

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Naloxone, also known as Narcan, is a medication used to reverse the effects of an opioid overdose.1 Doctors may prescribe naloxone to those struggling with opioid use, or you can buy naloxone over the counter at various pharmacies, depending on the state you live in. In combination with buprenorphine, a medication known as Suboxone, it is also an effective treatment for people who have an opioid use disorder. Under a doctor’s supervision, it can be a powerful tool when fighting opioid addiction.2

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What is Naloxone?

On its own, naloxone is a life-saving opioid overdose reversal medication that the layperson or a first responder can administer to someone who has overdosed on opioids, such as heroin or prescription painkillers. It works by binding to opioid receptors in the brain and can reversing and blocking the effects of opioid drugs.1 One of the main dangers of an opioid overdose is the profound respiratory depression that occurs—naloxone reverses that respiratory depression and can save a person’s life.

The combination medication, Suboxone, comprised of naloxone and buprenorphine, is used as a form of medication-assisted treatment (MAT) for opioid dependence and addiction. As opposed to naloxone, it is not given acutely to treat overdose; rather, it is a medication maintenance, meaning you take it every day to curb opioid cravings and avoid relapse. Typically, medication-assisted treatment with buprenorphine/naloxone is combined with counseling and behavioral therapies.3

Who May Benefit from Naloxone?

Naloxone on its own is primarily used to treat people who are experiencing an opioid overdose. So, anyone who abuses opioids may benefit from naloxone. In fact, naloxone is available over the counter in many states, so you may want to see if you can purchase some to keep on you. That way you will have it if you accidentally take too much of an opioid or use an opioid that has been cut with something extremely potent like fentanyl. Likewise, if you know someone who misuses opioids, you may also want to purchase some naloxone to keep with you.

There are many drugs in the opioid family, including some you may not be aware of. If you or a loved one uses the following drugs or medications, naloxone may be a life-saving drug for you, should an overdose occur:4

  • Heroin
  • Hydrocodone
  • Morphine
  • Fentanyl
  • Methadone
  • Oxycodone
  • Oxycontin
  • Percocet
  • Vicodin
  • Tramadol

Naloxone is most effective when administered immediately after an opioid overdose, so if you feel that you or your loved one may have taken too many opioids and are at risk of an overdose, please seek medical care immediately.

Moreover, when naloxone is combined with buprenorphine, it is beneficial for anyone with an opioid addiction or dependence who wants to quit using opioids.

Naloxone/Buprenorphine Maintenance Therapy

Naloxone/buprenorphine maintenance therapy for people who are addicted to opioids is a relatively new practice. Multiple studies have shown that medication-assisted treatment with Suboxone, which comes in sublingual tablet form, is effective in preventing opioid relapse and overdose death.2

Buprenorphine is a partial opioid agonist, which means it binds with the opioid receptors in your brain to relieve opioid cravings but without getting you high. The reason naloxone is combined with buprenorphine is that it acts as a misuse deterrent. If you try to inject Suboxone to get high, the naloxone component of the medication will cause you to go into an immediate state of opioid withdrawal.5 Opioid withdrawal is extremely unpleasant and distressing and thus, you will be less likely to abuse Suboxone or buprenorphine.

Buprenorphine is the first opioid dependence medication that you can receive in a doctor’s office, significantly increasing access to this opioid addiction medication and helping more people get sober. Previously, recovering individuals could only receive methadone, another opioid dependence medication, through a specialized methadone clinic, which was less convenient and often a barrier to treatment for many people.3

Naloxone/Buprenorphine Combined with Counseling

Naloxone/buprenorphine maintenance therapy is just one component of a comprehensive opioid addiction treatment plan. This plan should include a myriad of therapies and counseling to help you address the underlying issues that drove you to abuse opioids in the first place, as well as learn and build relapse prevention skills like healthy coping mechanisms, drug refusal skills, emotional regulation skills, and more.3 You may receive these therapies on an inpatient or outpatient basis. Many people enjoy the structure of an inpatient program, where you are separated from your old using environment and can focus on your recovery. After an inpatient program, it can be beneficial to begin outpatient treatment to build upon the skills you learned in rehab.

The amount of time that you’re taking naloxone/buprenorphine for medication-assisted treatment depends on your doctor and your unique needs.3 Some people may take Suboxone indefinitely while others may take it on a shorter schedule. Either way, once you are ready to stop taking Suboxone, your doctor will create a gradual tapering schedule for you in which the dose of naloxone/buprenorphine you take is slowly decreased over a predetermined schedule. This will likely occur over many weeks.2

Naloxone/Buprenorphine Side Effects

For those who might be taking buprenorphine/naloxone as maintenance therapy, some possible side effects may be experienced. However, studies have shown that most often, the medication is well-tolerated, without any adverse side effects.2

If side effects do occur, they may include the following:2

  • Headache
  • Pain
  • Nausea
  • Constipation
  • Sweating
  • Insomnia

If any of your side effects of buprenorphine/naloxone use are severe, call your doctor immediately. They can adjust your dose to see if you tolerate it better, or they may decide to change your medication.

Find a Naloxone/Buprenorphine Treatment Program

If you are addicted to an opioid like heroin, oxycodone, or fentanyl, help is available. There are many addiction treatment programs that specialize in the treatment of opioid dependence and addiction. These rehabs utilize buprenorphine/naloxone in the form of medication-assisted treatment while also providing a number of therapeutic interventions, such as:

  • Group counseling
  • Family therapy
  • Individual therapy
  • Support groups
  • Holistic activities, such as yoga, music therapy, mindfulness, and equine therapy

Every opioid rehab is different, so make sure to ask if they prescribe and dispense Suboxone, if that is something you’re interested in.

Additionally, the Substance Abuse and Mental Health Administration (SAMHSA) offers a convenient buprenorphine practitioner locator you can use to find a physician near you. All you have to do is enter your zip code and choose your preferred distance from you.


Resources

  1. Handal, K. A., Schauben, J. L., & Salamone, F. R. (1983). Naloxone. Annals of Emergency Medicine, 12(7), 438-445.
  2. Orman, J. S., & Keating, G. M. (2009). Buprenorphine/naloxone. Drugs, 69(5), 577-607.
  3. Substance Abuse and Mental Health Services Administration. (2021). Buprenorphine.
  4. American Society of Addiction Medicine. (n.d.) Opioids: Brand Names, Generic Names, & Street Names.
  5. Stoller, K. B., Bigelow, G. E., Walsh, S. L., & Strain, E. C. (2001). Effects of buprenorphine/naloxone in opioid-dependent humans. Psychopharmacology, 154(3), 230-242.

the Take-Away

With the opioid epidemic continuing to take thousands of lives every year, naloxone has become more available in an effort to reduce the number of fatalities.