Naloxone and Heroin Addiction

Paper Summary:

In this article, the writer notes that heroin use is a problem plaguing countries all over the world. One of the most common and successful ways to combat heroin use is with pharmacological measures. The writer points out that naloxone, a narcotic antagonist, is used to reverse the effects of a heroin overdose. In 2002 it was approved in a combination tablet with buprenorphine for the treatment of heroin addiction. The writer discusses that the approval of the combination buprenorphine/naloxone tablet means that more nurses working in an outpatient setting will be administering naloxone to patients seeking help for heroin and opiate abuse. The writer them emphasizes the importance of explaining the indications and possible side effects of any drugs administered to patients, and to know the proper procedures to take should a patient misuse the medication. The writer concludes that hopefully, as the medical community becomes more aware of the problems associated with drug use and dependence, we will be able to come up with better solutions to solving the problem.

From the Paper:

"In a study done by Cantwell et al., paramedics assessed patients for respiratory status, concurrent drug intoxication, and evaluated the patient according to the Glasgow Coma Scale. Overdose victims were more likely to receive less than the standard dose of naloxone with each single increase in number of breaths. With an increasing Glasgow Coma Scale score, patients were more likely to receive less than the standard dose of naloxone. Patients with concurrent alcohol intoxication were more likely to receive greater than the standard dose of naloxone. It is thought that alcohol combined with heroin causes greater CNS depression than that produced by heroin alone. The trend towards older patients, and male patients receiving higher doses was also seen. The study suggests that patients with a higher level of consciousness and respiratory rate require a smaller dose of naloxone to return to a normal state than those patients with a lower respiratory rate and decreased level of consciousness."

Sample of Sources Used:

• Alexander, J. L., Burton, J. H., Bradshaw, J. R., & Colin, F. (2004). Suspected opioid-related emergency medical services encounters in a rural state, 1997-2002 [Electronic version]. Prehospital Emergency Care. 8(4), 427-431.
• Anonymous (2003). Drugs approved for opiate dependence [Electronic version]. FDA Consumer. 37(1), 6.
• Bailey, K. P. (2004). Pharmacological treatments for substance abuse disorders [Electronic version]. Journal of Psychosocial Nursing & Mental Health Services. 42(8), 14-21.
• Berardinelli, C. & Kupecz, D. (2003). Annual update: Drugs, diagnostics and devices [Electronic version]. Nurse Practitioner. 28(3), 30-38.
• Cantwell, K., Dietze, P., & Flander, L. (2005). The relationship between naloxone dose and key patient variables in the treatment of non-fatal heroin overdose in the prehospital setting [Electronic version]. Resuscitation. 65, 315-319.

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• Research Proposal # 106444 : "Noncardiogenic Pulmonary Edema and Heroin Overdoses"

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