Friday, November 18, 2016

Narcan Nonsense

I read an article recently that looked at one of the issues involved with overdose of narcotics; that being, premature death. At this writing, there is definitely a major problem in the USA (and the world) regarding the excessive use of analgesic substances. The author postulated that if persons known to be users of narcotics were given take-home Naloxone (Narcan) when they left the Emergency Room, this action might reduce unintentional death. To me, this seems like nonsense.

It is one thing to encourage people who are allergic to stuff like peanut butter, bee stings, and melon, to have on hand an Epinephrine injector, which can help to counteract anaphylaxis. In general, people who know about their allergy, logically and actively, attempt to avoid the substance they are sensitive to.

In contrast, when considering a narcotic overdose, we are talking about people who are intentional users. Whether they are addicted or not, is not the point; it is an illogical solution. First of all, who is going to administer it? Imagine, I’ve just taken a little too much Oxycontin, and drifted off to a pleasant dreamy state; am I going to wake up and say, “Gosh, I think I have overdosed…….where in the heck is my Narcan nasal spray?” Second, if I am addicted to narcotics, and I have an antidote on hand, perhaps I will be thinking that I can get away with taking an extra pill or two, because I have an antidote in the kitchen. Narcan, and most other antagonist / antidotes, are best left in the trained hands of health professionals.

Would the author also propose that every person who is prescribed a beta-blocker, be given Glucagon for home use, in case of overdose? Should we offer Praxbind for every user of Pradaxa, or Digibind, for those Digoxin prescribers? Of course not!

The answer is education, not medication. Whether one is addicted to something, or merely needs to take some kind of life-saving chemical, there always exists the chance of overdose. But to hand out an antidote, to every bloke out there, is just nonsense; in this case, Narcan Nonsense.

Narcan in the bathroom
For every woman and man,
Addicted to opiods
Some think, that's a plan,
For the avoidance of death
Regarding drug overdose,
Is this a sound solution?
It doesn't even come close.

Now, suppose you have an allergy
To peanut butter or a bee sting,
You actively avoid
Ever getting near this thing,
And it makes good sense
To carry an Epipen,
For that rare, but deadly exposure
You'll need an antidote then.

Contrast, the narco addiction
Some like to call it a disease,
Brain chemistry screwed up
You have pain when you sneeze,
Or a hundred different reasons
Intentional or not,
Keep the antidote on hand?
You've been smoking too much Pot.

I take a couple pills
To regulate my heart,
If I take too much
The rhythm comes apart,
Why shouldn’t I
Have some antidote?
A sensible doctor
Would never cast that vote;
The average consumer
Doesn’t know jack,
About overdose
Or heart attack,
Can barely administer
A basic eye drop,
Gets confused
When ordering at IHOP.

Too many ways
To get it wrong,
Handing out antidotes
To the public throng,
The better alternative
Is the medical approach,
Emergency responders
In the Paramedic coach.


Old FoolRN said...

Opiates bring out the worst ideas in just about anyone associated with them. I don't know which is worse overprescribers or addicts. In the good old days there was a rule in medicine that said if a patient has an adverse reaction discontinue the drug. Do not treat a side effect with another drug. Now days we have drugs like Movantic to treat opiate induced constipation (another ailment promoted by the pharmaceutical industry) Opiates don't work for chronic pain ( at least that was the theory in the good old days.) Wouldn't it be more prudent to taper off the opiates than add another drug to the regimen?

Fibril_late said...

Dear Old Fool
If only you and I could take control............