Naloxone's Role: Benefits, Risks & Impact on Opioid Addiction Crisis

This essay provides a comprehensive analysis of naloxone, an opioid antagonist crucial for managing opioid-induced respiratory depression. It details naloxone's mechanism of action, highlighting its competitive antagonism of mu, kappa, and sigma receptors in the central nervous system to reverse the effects of opioids like cocaine and morphine. While naloxone effectively reverses analgesia, hypotension, and respiratory depression, it also presents adverse reactions such as excitement, seizures, and cardiovascular issues. The essay further discusses Virginia's standing order, allowing pharmacists to administer naloxone without a prescription, and examines the dual impact of increased naloxone availability: reduced mortality from overdoses versus potential increased opioid dependence due to a perceived safety net. The conclusion acknowledges naloxone's life-saving potential while cautioning about the possible exacerbation of opioid addiction risks, supported by relevant references.

Using Naloxone
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Naloxone, an opioid antagonist, is the key drug used in the management and emergency
treatment of opioid-induced respiratory depression. Naloxone is an antidote for the adverse
effects of opiods. It is also known as naloxone hydrochloride or Narcan (Narcan is a brand name)
(Wheeler,2012). It can be administered to the patient or client through the nasal route, the
intravenous route or intramuscular route (through the muscles of the body). Its ability to block
the deleterious effects of opioids on the brain and restore breathing makes it an essential drug for
opioid addiction-related complications.
Naloxone works by antagonizing competitively and briefly the mu, kappa and sigma receptors
within the central nervous system. Through this mechanism, it is able to reverse the analgesia,
hypotension, respiratory depression and cumulative sedation which are associated with opioids
such as cocaine and morphine (Harvey, 2012). The Mu receptors are the ones associated with
euphoria, miosis, analgesia and respiratory depression. On the other hand, Kappa receptors are
associated with sedation and analgesia. The Sigma receptors are associated with the control of
dysphoria and many other delusional anomalies.
However, naloxone is incompatible with many other solutions. It does not operate well, and
should not be mixed with, metabisulfite, alkaline and bisulfite substances and solutions. In
addition to its compatibility issues, naloxone should not be used in hypertensive patients. In this
case, some patients or clients may be hypertensive to some of the components that make up
naloxone.
Naloxone does not come with all good effects, it also possesses some negating effects and
adverse reactions. Within the central nervous system, for instance, naloxone causes excitement;
seizures; irritability; tremors; restlessness; nervousness and violent behaviors. Within the
cardiovascular system, naloxone causes hypertension; hypotension; ventricular tachycardia and

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ventricular fibrillation. That’s not all, naloxone also affects the gastrointestinal system (by
inducing nausea and vomiting), the skin (by inducing diaphoresis), the respiratory (by inducing
edema) and its possession of withdrawal symptoms (Katzung, 2004).
Virginia is one of the states that has been affected significantly by drug addiction and
specifically opioid addiction. The use of opioids such as morphine and cocaine has led to the
loss of many lives which would not have been lost. However, the state of Virginia came up with
legislation that allowed the use of naloxone as an opioid antidote for opioid-induced
complications such as respiratory depression and even death! Dr. Levine gave a standing order to
all pharmacists with an active license to administer naloxone without a prescription
(Wheeler,2012). This order symbolically represents a pre-written prescription to all the residents
of Virginia. This means they do not require a doctor’s prescription to receive a dose of naloxone.
The actual mortality rate in itself is affected by the availability of naloxone as an antidote for
opioid adverse reactions. However, even though the mortality rate decreases, the use of opioid
drugs increases. A higher likelihood of opioid dependence and drug dependence is likely to
increase since some addicts will assume direct access to naloxone as a fast antidote (Beheshti,
2015). The mortality caused by overdose will, however, decrease. Naloxone has saved over
10,000 lives in the United States.
Conclusion
Naloxone is both advantageous and disadvantageous. Its use will both save lives but will likely
increase the risks of opioid addiction (since addicts will assume the remedy for opioid reactions
is available).

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References
1. Beheshti, A., Lucas, L., Dunz, T., Haydash, M., Chiodi, H., Edmiston, B., ... & Sobota,
B. (2015). An evaluation of naloxone use for opioid overdoses in West Virginia: a
literature review. American medical journal, 6(1), 9.
2. Harvey, R. A., Clark, M. A., Finkel, R., Rey, J. A., & Whalen, K. (2012). Lippincott’s
illustrated reviews: Pharmacology (Vol. 526, pp. 165-169). Philadelphia: Wolters
Kluwer.
3. Katzung, B. G., Masters, S. B., & Trevor, A. J. (Eds.). (2004). Basic & clinical
pharmacology.
4. Wheeler, E., Davidson, P. J., Jones, T. S., & Irwin, K. S. (2012). Community-based
opioid overdose prevention programs providing naloxone— the United States, 2010.
MMWR. Morbidity and mortality weekly report, 61(6), 101.