Pros Talk Naloxone

“I remember fading into black and then coming to with a bunch of people staring down at me,” explained Devon the beautiful young man I was treating for heroin addiction. At 23, Devon appeared to have it all –handsome, smart, charming, and Ivy League educated. But the lovely externals of his life contradicted the horrific internal pain that in his mind, only heroin could banish.

And while naloxone brought him back to life from his overdose, it would never “cure” him of his opioid addiction. The sad truth of the matter is that nothing would completely cure Devon of his disease; it would remain with him throughout his hopefully long and fruitful life, seducing him back to its promise of pure bliss and ecstasy.

Rather than curing Devon, naloxone gave Devon another chance to heal from his disease by learning how to stay away from heroin a second at a time. More than another medical intervention, Devon ultimately needed more time, more courage, more hope, more patience and more capacity to tolerate the pain of life and the piercing discomfort of his emotions. He needed to be desensitized the trauma of his past, learn how to turn down the piercing volume of his present and sidestep his paralyzing fear of the future. In short, he needed a diverse set of tools to enable him to hold and tolerate the fullness of his highly sensitive human existence.

Was naloxone a critically important part of this tool box? Absolutely. It allowed Devon and me to continue working towards his solution, rather than being forever trapped in the finality of his death. Is it a comprehensive cure for an opioid epidemic? Absolutely not. Rather than a cure, naloxone is a critically important agent that delivers men, women and families back to the hope and healing force of the universe where they belong. It gives them another chance to continue walking, however labored and haltingly, towards a life based on freedom rather than enslaved to the darkness of their disease.

Read more from Pro Talk author Paul Hokemeyer, Ph.D.

We are in the midst of an opioid overdose epidemic in America. The tragedy of overdose happens to 100 of our sons, daughters, mothers, fathers and friends every day. Naloxone is a life saving medication used for reversing opioid overdose that should be as widely available as possible.

Family, friends, healthcare professionals, emergency workers and anyone else who may be in a position to save a life should be trained in the proper administration of naloxone. Where naloxone is currently being distributed, lives are being saved, the research is clear on this. There is no risk. Naloxone distribution does not give permission to drug users to use drugs any more that teaching the heimlich maneuver gives people permission to choke on food.

However, naloxone alone will not “cure” the opioid overdose epidemic. A complex mix of psychological and social factors gives rise to the excessive drug use that results in overdose. People use drugs in problematic ways for a variety reasons including a lack of honest information about the risk, attempts to manage significant physical and psychological suffering, complex reactions to traumatic experiences, difficulties managing uncomfortable feelings and more. Our generally punitive social context of stigmatizing and criminalizing drug users contributes to their fear of punishment, shame, anxiety, guilt and self-hate and the tendency to hide their use and not seek help when drug use becomes problematic.

The “cure” must include a change in social attitudes toward a more compassionate and understanding acceptance of people who choose to use drugs, as well as increased availability of improved treatments that accept drug users where they are. We must address the psychological complexity of problematic drug use, in addition to widely available naloxone.

Read more from Pro Talk author Andrew Tatarsky, Ph.D.

There will be no simple cure for the opiate overdose epidemic. Having naloxone at hand (for police officers, ambulances, family members, etc.) will likely prevent some deaths, perhaps many deaths.

From my perspective there is no significant downside to wide distribution of naloxone, unless the presence of naloxone leads us to relax other efforts to promote recovery from opiates. Naloxone is critical at the moment of overdose, but there are many other moments in the course of opiate addiction, where intervening could be helpful.

Broader issues are to recognize that opiate users are not fundamentally different than other substance users, and that we need to have respectful services available for them.

Read more from Pro Talk author Tom Horvath, Ph.D.