Naloxone (Narcan) pros and cons

[Itachi1990]

Hello,

I am a college student doing a project to determine whether or not making Naloxone (Narcan) available to prevent opioid overdose encourages users to keep using. I would like your perspective.

 

[RaizdByWolvz]

If Myself or any other addict had the choice to do dope with or without Narcan being available, I could care less about the Narcan being available...I’d still do the dope, so there’s no encouraging factor. The fact is people are going to use just the same with or without Narcan, it’s only 100 percent benefit that more lives will have the chance to be saved and then get into recovery.

 

[simco]

I am an ex-heroin addict and have been rescued by narcan twice.

There is no evidence that I'm aware of (and this is area that I deal with in my work) that the availability of naloxone causes people to keep using. The idea that providing naloxone is somehow 'enabling' is cruel and misguided. It only makes sense in the context of a a belief that addiction is a moral failing that people must somehow rise above to redeem themselves. Would anyone withhold medication to diabetics because it might encourage them to eat poorly and live unhealthily? Very few people are that short-sighted and cruel.

Naloxone availability has the potential to mitigate the public health crisis that opioid use has become in the US.

 

[pally pete]

I've been Narcan'd once. I foolishly took 800mg of Oxy in a 12 hour period and then my kidney's failed. Although coincidentally, the kidney failure was unrelated. Anyway, I'm sure they gave me 2 shots of Naloxone - one of the worst experiences of my life.

 

[falsifiedhypothesi]

No one, not a single person is like, "I'm gonna do as much dope as I want and if I OD it doesn't matter cuz I have narcan." No person is aiming to get as close as possible to overdosing, these people are only trying to get well or get high and they are going to do that whether or not they have narcan available.

Having narcan available OTC is nothing but a good thing, it takes stress off emergency responders and removes some of the financial burden on the state. Just like simco said with the diabetics and insulin it's not enabling people to give them life saving meds for a serious illness.

Whether or not you think addiction is an illness is irrelevant. These people can stop their addictions and trying to take away their chance by allowing them to die is not only wrong is sick and inhumane. Also some of these people are functioning addicts, perfectly productive and good people that are addicted.

 

[BurritoJimmy]

If providing narcan to opiate users encourages opioid use then emergency rooms and ambulance services for overdoses could be said to encourage drug use. It's a sick way to think of it imo.

 

[JessFR]

I'll preface this by saying I've never been brought back with Narcan so I don't have first hand experience in that way. But I'm pretty sure being brought back with narcan will put you into withdrawal.

Avoiding withdrawal is the number one motive driving everything I did as a heroin addict. So while I might get Narcan as a precaution to use in friends or for friends to use on me if someone were likely to die. No way in hell would I do anything that I would knowingly think would make it likely to have it used on me.

People don't use intending to OD. Addicts DO NOT use more thinking "oh well if I OD my friends can use narcan on me". I've been a junkie a long long time and been surrounded by junkies just as long. I just do not think any of us think like that.

It would imply not caring much about the idea of waking up in withdrawal after using too much and having to be narcanned. And NO opioid dependent person wants to risk being in withdrawal.

It just wouldn't happen. I don't believe it. The idea that junkies might use more because they have Narcan is the kind of thing you think cause you're NOT a junkie. It reflects a logic you only have cause you don't have hundreds of experiences of being in withdrawal burned into your subconscious making you do whatever you have to to avoid it. Addicts, serious opioid dependant people just don't think like that. They won't generally take risks that end in major withdrawal. Cause they've all been through it too many times already providing an extremely powerful psychological aversion the likes of which you can't comprehend if you've never experienced it.

Sure, you might take additional stupid risks sometimes, but not with that kinda logic behind it. I've never known a serious opioid user who would be that indifferent to the idea of ODing and waking up in withdrawal from Narcan. I haven't even experienced it and the idea of it scares the shit out of me.

So no, I don't buy it not for one second. Most people don't think they're gonna OD to that extent in the first place.

Having Narcan available is only a good thing. I simply don't believe that anyone's gonna go "oh well if I OD it doesn't matter, it only means I'll wake up in excruciating withdrawal so bad I'll wish I'd just died". Yeah right. Not happening.

If Narcan didn't put you into withdrawal by virtue of saving your life, then there might well be some merit to the idea of it causing people to take risks they might otherwise not have. But so long as it ends in withdrawal, I just don't see it happening. No way no how.

What I think it comes down to here is a reflection of how non addicts just don't truly comprehend how strong the compulsion to avoid withdrawal can be. Nobodies gonna play chicken when withdrawal is the price of failure. No freakin way.

 

[cj]

I can't believe this is even a debate

 

[Parabolan]

In terms of HARM REDUCTION and general public safety, i believe that there are ZERO Cons associated with having Narcan available..
It saves lives!!

 

[JessFR]

I can't believe this is even a debate

It's a debate only for the same reason as every drug related debate. Ignorance and politics. I don't mind the ignorance, everyone's ignorant about something. That's ok so long as the ignorant listen to the more informed or become more informed. The politics however, that's a much bigger problem.

A lot of people don't find harm reduction very intuitive. They figure whatever their first simplest thought was must be correct.

Theres nothing wrong with asking the question if harm reduction works. There's a lot wrong with refusing to believe the answer.

Having heard what we think, I'd encourage the original poster to do some research. Are there any statistics to suggest the availability of naloxone correlates with greater numbers of overdoses. (I'd be stunned if it did). And what is the net impact on fatalities resulting from overdoses. I suspect the numbers would be fairly marginal. But even marginally fewer deaths would be good enough to justify it if there's no downside.

I suspect the improvement is marginal because I've never seen anyone actually get naloxone since it was made available here. And honestly, I've given it thought but I haven't either. Would have taken time and money both of which I wanted to use in drugs. Not to mention me and my closest friend I was using with at the time had a tolerance two high that a fatal overdose was never particularly likely.

In my experience overdoses happen exclusively in people with low tolerance. Either because they're a new user or an old one who hasn't used in a while. Hence why so many fatal overdoses happen when people have just had a long stretch not using.