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Witnessing someone you care about struggle with addiction can be heartbreaking. However, understanding how to administer Narcan could potentially save their life and provide you with a sense of empowerment. Misusing legal or illegal opiate drugs can easily result in an overdose, leading to respiratory failure. Fortunately, Narcan (naloxone, also known as Evzio) can often reverse opiate overdoses. With easily administered forms of naloxone now available to the public, the battle against addiction may become more manageable. When offering assistance, it's crucial to closely monitor the individual, call emergency services, perform CPR if necessary, and effectively administer Narcan, whether as a nasal spray or injection.
Steps to Administer Narcan
Administering Intranasal Narcan
Before administering Narcan, it's essential to check for signs of an overdose. These may include:
- Slow or shallow breathing.
- Gasping noises while sleeping or unusual snoring.
- Pale or bluish skin.
- A slow heartbeat.
- Low blood pressure.
- Unresponsiveness and inability to wake up.
Immediately dial emergency services. Contact 911 or the relevant emergency services in your area without delay! Ensuring help is en route should be your first priority.
Assess the individual's airway and provide rescue breaths. Inspect the person's mouth and throat to confirm there are no obstructions. Place one hand under their chin, tilt their head back slightly, and close their nostrils. Then, form a seal over their mouth with yours, inhale, and exhale air into their mouth. You should observe their chest rising as you administer the rescue breath and falling when you withdraw.
- Administer one breath every five seconds.
Remove the yellow covers from the syringe. Prepare the nasal syringe promptly following the provision of several rescue breaths (if necessary). Remove or pull off the yellow covers. Typically, there are two – one at each end of the syringe.
- A syringe isn't equipped with a needle; rather, it's a plastic device designed to accommodate the needle – or in this case, the part where the Narcan attaches.
- You can obtain Narcan through the getnaloxonenow.org website.
Discard the red cap from the Narcan. The Narcan tube (also identified by its generic name, naloxone) might feature a red cap. Pry it off and dispose of it.
Assemble the three components. Grasp the clear plastic wings of the nasal atomizer (the cone-shaped applicator) and affix it to the syringe. Gently attach the Narcan container to the syringe's barrel.
- Avoid priming or testing the spray. It's intended for single use and cannot be reused.
- Some Narcan nasal sprays are supplied in single-use, pre-assembled packages, containing two needle-free devices – one for each nostril.
Administer half of the Narcan into each nostril. Position the individual on their back with their head tilted back. Insert the white cone applicator into one nostril and firmly press the end of the capsule to release the Narcan spray. Administer half of the container (1cc).
- Repeat the process immediately in the other nostril.
Utilizing Narcan in Injectable Form
Detach the outer casing. EVZIO, the injectable form of Narcan, is enclosed in a case. Remove the device from the case, but refrain from removing the red safety guard until you're prepared to administer the medication.
Remove the red safety guard. When ready to administer the injection, remove the red safety guard. You may need to exert some force to detach it. Avoid contact with the black area of EZVIO once the red safety tab is removed, as this is where the needle is situated.
Position the black end of the device against the outer thigh and inject. Position the black area of the device on the middle of the individual's outer thigh directly over the muscle. To administer the medication, press the device firmly against the thigh for five seconds. There's no need to remove the person's clothing for this procedure.
- You'll hear a click and hiss as the device automatically administers the medication into the thigh. This is normal and indicates the device is functioning.
- The needle will retract into the device upon completion of the injection.
Summon emergency services. Immediately dial 911 (or emergency services in your region) after administering the injection or ask someone to call for help while you administer the injection.
Monitoring the Individual and Providing Post-Treatment Care
Administer Narcan only if specific criteria are met by the individual. Reserve Narcan administration for individuals demonstrating the following signs of overdose:
- Unconsciousness, lack of responsiveness, and inability to be aroused
- Pinpoint (constricted) pupils
- Slow and shallow breathing, with less than 8 breaths per minute
Offer supportive assistance until assistance arrives. Upon discovering an unconscious individual, attempt to rouse them by shouting and rubbing knuckles on the center of their breastbone. If they awaken, Narcan is unnecessary. If not, immediately contact emergency services and indicate a potential overdose. Before administering Narcan, assess if CPR is necessary - it could be life-saving! Adhere to these steps:
- Assess their breathing: Listen at their mouth while observing chest movement for 5-10 seconds. If breathing is absent or less than 8 breaths per minute, administer a few rescue breaths before Narcan.
- Check for a pulse for 30 seconds by placing middle and forefingers on the neck just below the jaw. If no pulse is detected, initiate CPR chest compressions.
Ensure prompt transfer of the individual to a medical facility. Emergency services must transport the individual to intensive care for monitoring without delay. If immediate access to emergency services is unavailable, transport the individual to the hospital as soon as they regain autonomous breathing. Medical attention is imperative even if Narcan reverses the overdose.
Advise the individual against further drug use for the day. Narcan may induce withdrawal symptoms, leading the individual to crave their drug again. Using it again could result in another overdose. These cravings may pose challenges for both parties. Offer emotional support to the individual and discourage drug use for the remainder of the day.
Store Narcan appropriately. Ensure Narcan is securely sealed in its original container and kept out of children's reach. Store it at room temperature in a dark, dry place, avoiding areas prone to heat or moisture, such as bathrooms. Never freeze the medication. Discard and replace Narcan if the red safety guard is missing, it's expired, appears cloudy, or contains visible particles.
- Keep it safely away from children. Do not share your medication with others.
Procuring and Using Narcan Properly
Familiarize yourself with the individual's drug of choice. If a loved one uses illegal substances or misuses prescription medications, inquire about their substance of choice. Express concern for their well-being and educate yourself about Narcan's ability to reverse the effects of opiate drugs such as:
- Heroin
- Prescription painkillers like fentanyl, morphine, methadone, buprenorphine, hydrocodone, and oxycodone
- Common brand-name medications including Percocet, OxyContin, Vicodin, Percodan, Tylox, and Demerol
Acquire Narcan from a healthcare professional. If you or a loved one struggles with opioid addiction, consult your doctor about obtaining Narcan for emergency use. Options may include liquid Narcan for injection into a vein, muscle, or under the skin, or a nasal spray. Some states require a prescription for Narcan, while others do not.
- Automatic injection devices (Evzio) may be available, featuring voice instructions for ease of use. After one use, discard the device. This is the optimal choice for individuals without medical training.
- In the event of an overdose, you may be unable to administer Narcan to yourself. Therefore, ensure friends, family, and loved ones are familiar with Narcan's use and whereabouts.
Conduct a brief check for signs of opiate overdose. It's not always clear what substance someone has overdosed on, or if they've used drugs at all. Act swiftly, but be observant for indications that the individual may have overdosed on opiates. Look out for prescription drug containers, morphine or fentanyl patches on their body (remove them!), or visible drug paraphernalia such as syringes, spoons, and tourniquets.
Suggestions
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If you know someone battling opiate addiction, inform them about community and national services like the Harm Reduction Coalition and other support resources for recovery.
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When administering rescue breaths, gently tilt the individual's head back and raise their chin to open their airway. Seal their nose shut with one hand. Form a seal over their mouth with yours and blow air into their mouth. Ensure their chest rises with each breath – if not, exhale more forcefully.
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Regularly check the expiration date of your Narcan supply, and replace it if it's expired.
