Narcan use evolves as heroin, opioid overdoses increase

May 29, 2014

The recent spike in opioid abuse cases in central New York and across the country has people discussing how to get their hands on Narcan, also known as naloxone, a drug that can be quickly administered in an emergency to reverse the effects of a heroin overdose.

Dr. Jerry Emmons is the medical director for the emergency department at Oswego Hospital. He says Narcan used to be a drug seen only in hospitals, but has made its way into the hands of first responders.

"Even more so, within the past few months, now it's being used in BLS, or basic life support first responder agencies, like fire departments," Emmons said. "So basic EMTs are now able to carry this medication that can be delivered nasally."

Some fire departments and ambulances have had the IV version of Narcan for years. But Emmons says there is not a discernable difference in the effectiveness or time it takes for the nasal form of the drug to take effect.

"You might be talking about an extra minute that it would take for onset through the nasal Narcan, which is... basically turned into a mist using a device called an atomizer," Emmons said. "So it's turned into a mist, that is then absorbed in through the mucus membranes in the nose. So that might take a minute longer than the IV form.

In fact, Emmons believes the nasal form of Narcan is actually the preferred method, because it doesn't involve needles and doesn't require a lot of medical training to use.

But the tools first responders have to help overdose victims dictate how emergency departments like his continue to treat them.

"We'll typically only dose enough to keep the patient breathing," Emmons said. "Many times we don't mind if they're a little bit sleepy and relaxed, as opposed to waking up very angry, as they've been put into instant withdrawal."

The Oswego Fire Department has Narcan, and ACR Health in Syracuse says it plans to train up to 500 people in central and northern New York to use the drug. He says the hospital is also interested in helping Oswego's police department get access to Narcan, noting that police officers may be best equipped to handle combative overdose victims.

"I'm looking forward to facilitating that because they're typically the first ones on the scene," Emmons said.