To Narcan or Not to Narcan? That is the Question!

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To Narcan or Not to Narcan? That is the Question!

By Bernie Leonard, OSS Expert Witness | Wed, 28 May 2014

Many agencies are now issued or may be considering issuing law enforcement officers Narcan for administration in the event they encounter a person that is suffering from an overdose.  In fact, Narcan is extremely effective in cases of opiates overdoses with little or no adverse effects and proven itself effective in the field on numerous occasions recently.

How Narcan Works

Narcan (generic name, "Naloxone”) works by blocking a person’s opiate receptor sites, which reverses or prevents toxic effects of narcotic (opioid) analgesics such as heroin or morphine.  Women that are pregnant and/or breast-feeding should not receive Narcan unless they are nearing respiratory arrest as a result of an opiate overdose, in which case, Narcan administration is critical to survival of the mother and baby.

Narcan is ineffective for overdose of barbiturates or benzodiazepines such as valium.  However, there is no contraindication for administration under those circumstances.  It simply will not have any beneficial effect.

Considerations of Narcan Administration

There are some important cautions when administering Narcan, the most important of which is your safety! You know the ol' saying, “If something is good, more must be better,” not so in the case of Narcan. Using the “more is better” philosophy is a recipe for disaster!  Narcan should only be administered to treat respiratory failure or pending respiratory failure.  Here’s why … your overdose victim just spent his last $200 on his current “high”.  Here you come with your nasal Narcan, squirt the entire contents of the syringe into his nose and poof, there goes his high!  Guess what?  Now, they may be really unhappy with you and may attempt to hurt or even kill you!

Again, Narcan should only be administered to restore the respiratory process to somewhat normal.  Returning the respiratory rate (or in reality ventilatory rate) to greater that 8 times/minute is adequate.  More will certainly result in a physical conflict that you don’t want or need.

Proper Dosing of Narcan

Narcan dosing should be administered in increments of 0.4mg/minute until the persons respirations are at or above 8 breaths/minute.

For more about our new Expert Witness Consulting Services, review Pre-Hospital Healthcare / Emergency Medical Services.

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