Gemini on Question 16, Sep 17

Disclaimer: The following information is for educational purposes. If you suspect someone is overdosing right now, call 911 (or your local emergency number) immediately and administer naloxone if you have it.

Naloxone (commonly known by brand names like Narcan or Kloxxado) is a life-saving medication that can rapidly reverse the effects of an opioid overdose. Here is how it works and when a bystander should use it.

Part 1: How Naloxone Reverses an Overdose

To understand how naloxone works, it helps to understand how opioids cause an overdose.

Opioids (such as fentanyl, heroin, oxycodone, and morphine) travel through the bloodstream to the brain, where they attach to specific proteins called opioid receptors. When opioids bind to these receptors, they block pain, but they also slow down the central nervous system—most dangerously, the respiratory system. In an overdose, a person's breathing slows down to a dangerous level or stops entirely, depriving the brain of oxygen.

Naloxone reverses this process because it is an opioid antagonist.

• 1.Stronger Attraction: Naloxone has a much stronger affinity (attraction) to the brain's opioid receptors than opioids do.
• 2.The "Bouncer" Effect: When administered, naloxone rushes to the brain and physically knocks the opioids off the receptors.
• 3.Blocking: It then sits on the receptors, temporarily blocking the opioids from reattaching.
• 4.Restoring Breath: Once the opioids are knocked off the receptors, the brain’s drive to breathe returns. This usually happens within 2 to 3 minutes.

Important Note: Naloxone only works on opioids. It will not reverse an overdose caused by alcohol, benzodiazepines (like Xanax), or stimulants (like cocaine). However, it will not harm someone if they are given naloxone and do not actually have opioids in their system.

Part 2: When a Bystander Should Use Naloxone

You should use naloxone immediately if you suspect someone is experiencing an opioid overdose. Because naloxone is harmless to someone who doesn't have opioids in their system, the rule is always: When in doubt, use it.

Signs of an opioid overdose include:

• •Unresponsiveness: The person will not wake up to a loud voice or a hard rub of knuckles on the center of their chest (a sternal rub).
• •Breathing issues: Breathing is very slow, shallow, erratic, or has stopped completely.
• •Abnormal sounds: You may hear deep snoring, choking, or gurgling sounds (often called a "death rattle").
• •Skin color changes:
• •In people with lighter skin: Lips and fingertips may turn blue or purple.
• •In people with darker skin: The skin may look grayish or ashen, and the lips/fingertips may look pale or white.
• •Physical signs: The body goes completely limp, and the pupils of the eyes shrink to the size of a pinpoint (though you shouldn't waste time checking eyes if breathing has stopped).

Steps for a Bystander to Take

If you see these signs, act quickly:

• 1.Check for responsiveness: Shout their name and rub your knuckles hard on their breastbone.
• 2.Call 911: This is critical. Naloxone only lasts for 30 to 90 minutes. Long-lasting or highly potent opioids (like fentanyl) can outlast the naloxone, meaning the person could slip back into an overdose once the naloxone wears off. They need professional medical care.
• 3.Administer Naloxone:
• •Nasal Spray (most common): Peel back the package, place the tip of the nozzle into one nostril until your fingers touch the bottom of the patient’s nose, and press the plunger firmly to release the dose.
• •Injectable: If using the injectable version, inject it into the muscle of the upper arm or thigh.
• 4.Provide rescue breathing/CPR: If the person is not breathing and you are trained/comfortable doing so, begin rescue breaths or CPR.
• 5.Wait and repeat if necessary: Wait 2 to 3 minutes. If the person has not woken up or started breathing normally, give a second dose of naloxone (use a new nasal spray in the other nostril).
• 6.Recovery Position: Once the person is breathing on their own, roll them onto their side (the recovery position) with their hands supporting their head and their top knee bent. This prevents them from choking if they vomit. Stay with them until help arrives.

Naloxone is available in all 50 U.S. states without a prescription at most major pharmacies. Many community health organizations also provide it for free.