What Medications Can Reverse a Heroin Overdose?
Heroin addiction, abuse, and overdose are on the rise.
According to the Centers for Disease Control, heroin poisoning, overdose, and death has tripled in the United States from 2000 to 2013, and most of that increase occurred after 2010.
Heroin is a strong, illegal street narcotic drug. When ingested, the body metabolizes this drug into morphine, which then binds to opioid receptors in the brain. Opioid drugs mimic neurotransmitters like endorphins, so people taking heroin feel relaxed and happy almost immediately. They also don’t feel pain, which can be dangerous. When an individual takes a first dose of heroin, effects are felt within 10 minutes. It is very easy for a person to take too much heroin, which can cause the body to relax and stop breathing. This is why heroin overdose often leads to death.
Medications to Discourage or Treat Heroin Overdose
There are a small number of medical treatments to stop or reverse a heroin overdose, and a few medications are used therapeutically to ease the symptoms of withdrawal. These medications include:
- Polyethylene glycol is sometimes used to flush heroin from an individual’s system. While this medication is typically used to treat severe constipation, the laxative can take excess heroin out of the individual’s intestine so that it is not absorbed in the system.
- Naltrexone is an opioid antagonist that stops heroin overdose or other opioid overdoses by binding to the brain’s opioid receptors. It has also been shown to stop the high associated with heroin and other opiates, and it could be used in a therapeutic setting to address opioid addiction by reducing cravings for the drug. It does not, however, stop symptoms of withdrawal.
- Nalmefene is a medication typically used to reverse or stop the effects of alcohol poisoning. Because neurotransmitters in the opioid system in the brain are also involved in alcohol addiction, nalmefene is sometimes used to help people suffering from a heroin overdose. This medication is used intravenously and binds to the same opioid receptors in the brain that heroin and other narcotics do. Some research indicates that nalmefene actually kicks opioids off the receptors, which can reverse the effects of heroin overdose very quickly. This medication has a longer half-life than naloxone, so it might be more effective for long-term treatment or severe overdoses. However, this drug has not been approved for use outside of a hospital setting. This medication also does not combat withdrawal symptoms.
- Buprenorphine, prescribed under the brand name Suboxone for several years, is an opioid medication used to ease withdrawal symptoms in individuals suffering from heroin or opioid painkiller addiction. It is a prescription medication that people may take at home to reduce cravings for heroin and ease withdrawal symptoms. Some medical professionals are beginning to reduce prescriptions for medications like methadone or buprenorphine because these drugs can also become addictive for people struggling with opioid addiction.
Although naloxone has been available to treat opioid overdoses for several decades, the medication has become more popular in the past few years due to the surge in opioid and heroin addiction and overdose. Emergency rooms at hospitals have used this drug to stop narcotic overdoses, and now many emergency responders, including police officers, are able to carry naloxone to administer to people experiencing a heroin overdose. Families of people suffering from opioid or heroin addiction are also receiving training to help their loved ones in the event of an overdose.
This medication blocks the effects of opioid drugs by binding to the same receptors in the brain. Naloxone binds faster than opioid drugs like heroin, so the body quickly stops responding to heroin, which means the overdose stops. However, if a person takes a very large amount of heroin, naloxone will not stop the overdose completely.
Naloxone is metabolized out of the body faster than most opioids, so there is a chance that heroin will remain in the individual’s body and continue to be metabolized after naloxone leaves the system.
This means that the person can go into heroin overdose again after naloxone is administered, which is why it is vitally important for the person administering naloxone to also call for emergency medical help.
The FDA recently approved a nasal spray form of naloxone under the brand name Evzio. This medication is available by prescription to caregivers of people who have large prescription doses of painkillers, so they can stop an accidental overdose. However, emergency responders such as police officers, firefighters, and EMTs are allowed to carry Evzio legally in a growing number of states. These professionals can administer the medication to a person experiencing an opioid or heroin overdose when they arrive on the scene. They then wait for other emergency medical personnel to arrive, or use naloxone while the individual is being transported to the hospital for further treatment.
Naloxone is so effective at stopping heroin overdose that medical researchers are investigating the possibility of using this drug to treat heroin addiction or abuse, as well. Because this medication stops opiates’ effectiveness, it could be beneficial as a therapy to wean people suffering heroin addiction off the drug. When the body fails to experience the high associated with heroin, individuals could stop craving the drug as they stop associating it with pleasure.
Post-Overdose Treatment for Heroin Addiction
If an individual is struggling with heroin addiction and has suffered an overdose, inpatient rehabilitation is normally needed. These inpatient treatment facilities remove the individual from triggering life stresses that lead them to crave addictive substances, and also remove the person from access to heroin. With medical monitoring, as well as talk therapy, Cognitive Behavioral Therapy, and group therapy, a person struggling with heroin addiction can find medical support as well as emotional support, enabling a full recovery.