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Go 4 It: How Narcan reverses opioid overdoses

DETROIT – Narcan, also known as Naloxone, is a critical tool to fight overdoses. It rapidly reverses the potentially fatal effects of opioids in the body, but how does it do that?

In over 30 years as an emergency physician, I’ve probably given thousands of doses of Narcan -- and if you’ve ever seen how effectively it reverses the effect of an opioid overdose it might seem almost like magic. That’s how effective it can be.

---> Go 4 It: Why administering Narcan is always worth trying

First synthesized in the 1960s and approved by the FDA in 1971, it would take a half-century for it to become available over the counter for use by nonmedical people. But in order to explain how it works, I need to explain what opioids do.

We have receptors throughout our bodies that opiates -- like morphine or heroin -- lock onto and activate. When those receptors are turned on by an opiate, signals get sent through our nerves and our brain, where different effects are triggered. In our thinking brain, the effect is calm and sleepiness, but in our brainstem, the effect can be to slow or even stop someone’s breathing.

That’s where the danger happens and that’s where Narcan comes in. Narcan has a stronger attraction for opiate receptors than the opiate so it knocks the opiate off and attaches to the receptor without activating it. It then blocks opiates from having any effect and when that happens in the brainstem, the person will begin breathing again.

Dr. Jake Manteuffel is a Henry Ford Health Emergency Physician who is also board-certified in addiction medicine.

“The medication can wear off. We find that in a review of our own patients, about 40% of our patients that receive Narcan end up needing an additional dose,” Manteuffel said. “So, if you just take it and assume you’re OK, that’s probably not a good idea and you and you still need to seek medical attention.”

Narcan only works to block the opiate receptors for 30-90 minutes and once the Narcan lets go of the receptors, any opiate still in the body can reattached and cause the person to fall back into an overdose again.

Hopefully understanding how it works also helps understand another limitation -- while Narcan is excellent at what it does, some narcotics are so strong that a standard dose of Narcan may not be enough to force it off of the opiate receptors. If that’s the case the person will likely need high doses of Narcan through an IV or may just need to have their breathing supported until the opiate wears off.

---> Go 4 It: Learn how you can prevent overdose deaths at Sept. 24 event in Taylor


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Thanks to our Go 4 It sponsor partners, Masco, Henry Ford Health, and the Gilbert Family Foundation.


About the Author
Frank McGeorge, MD headshot

Dr. McGeorge can be seen on Local 4 News helping Metro Detroiters with health concerns when he isn't helping save lives in the emergency room at Henry Ford Hospital.

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