can narcan help with detoxing?

[fnord]

it releases opiates from your receptors so could this work?my friends not doing too good and want to help her out,shes got 2 vials of narcan so i was wondering i know its a long shot but just hopeing.

[Orchid_Suspiria]

Narcan=instant,painful withdrawal.You couldn't pay swim to mess around with this.

[fnord]

but does instant withdraw mean instant withdraw?after a few hours of agony would the person be completely done detoxing?

[Ethyl]

Originally Posted by fnord

but does instant withdraw mean instant withdraw?after a few hours of agony would the person be completely done detoxing?

About 10 years ago swie was using naltrexone (low doses) to reduce withdrawal peak time to a night.
In that night swie would suffer the most horrible of withdrawals but he knew that it would be much lesser time. Swie was brave and foul in those days..

[MrJim]

It would speed up the recovery, but in an intense way. Expect WD's to still last days because the brain needs the receptor sites to heal before one is better. Look at that note on Oxytrex in the Holy Grail thread - Maybe if really low dosages of it were taken at night with the opiate for days on end it could help heal more painlessly, although this is speculation.

[fnord]

hey its gotta work better then the nyquill shes using!anyone know if it can be absorbed oraly,anally? maybe this wold be a less harsh route?my good buddy remembers being narcaned and knows how harsh it can be.

[Laudaphun]

I guess that's how they do those rapid detoxes... Shoot a person up with an antagonist, percipiating withdrawl and then sedate the person so they are not conscious as the withdrawl symptoms are a bit more than the average person can deal with. I think they do this over like a 24 hour peroid of time or something like this, however withdrawl in this manner results in a high relapse rate I believe. I don't know if the narcan is very active anyway other than via injection. Narcan probably wouldn't a good idea in my opinion unless you really know what you are doing and have other substances to combat the nightmarish withdrawls that may result.

[tayo]

yeah that would make sense on the relapse rate... and swim read somewhere that there have been deaths during detox using a method that speeds it up in certain clinics that force withdrawals faster than the physical body would naturally go through, probably due to the combination of drugs used.

[fnord]

more info on other routes:03-07-2006, 07:11 PM
Here is our document in our SWO on the PROCEEDURE.

APPENDIX: U

TITLE: NASAL/RECTAL MEDICATION PROCEDURE


I. BACKGROUND:
Intranasal (IN) and Rectal (PR) administration of certain medications are alternatives when traditional vascular access (IV, IO) is not available or not desired. IN and PR administration may also be utilized when other routes (IM, SQ) would take too long to reach peak effects.
IN Midazolam has a slightly slower onset of action and peak effect compared to IV Midazolam, but acts twice as fast and has a 1-3 time higher peak plasma levels than PR and oral Midazolam. Therefore the IN route is preferred over PR for Midazolam.
IN Narcan is preferred over IM or sublingual (SL) Narcan due to the lower risk of needle sticks in a high-risk population. In addition IN Narcan has a predictable and rapid absorption rate faster than IM and comparable to SL. IV access is still the preferred method due to the possible complications with an unrecognized poly-pharm overdose.
II. EQUIPMENT:
3 cc slip syringe, injection needle, or vial spike.
Lubricant (Lubifax or equivalent) [for rectal use only]
Atomizer [for nasal use only]
Medication of choice:
- VALIUM (RECTAL)
- VERSED (NASAL)
- NARCAN (NASAL)

III. INDICATIONS:
- Status epilepticus without vascular access.

IV. PROCEDURES:
RECTAL ADMINISTRATION:
- Draw Valium into a syringe (draw only the amount to be administered).
*If subsequent doses are required, use the same Valium ampule with a new
syringe/needle. This method is suitable for short-term use.
- REMOVE THE NEEDLE.
- Lubricate the syringe.
- Carefully insert the syringe (through the anus past the rectal sphincter) -- approximately 3 to 5 cm [Note: Be careful not to inject directly into stool mass as rectal absorption will be poor].
- ADMINISTER THE APPROPRIATE AMOUNT OF VALIUM:
a. Up to 8 years of age: 0.5 mg/kg/dose (PRN) every 5 - 10 minutes MAXIMUM DOSAGE: 10 mg
b. 8 years of age and over: 5-10 mg every 5-10 minutes PRN
MAXIMUM DOSAGE: 20 mg
- Monitor for desired effects.

NASAL ADMINISTRATION
- Draw medication into a syringe (draw only the amount to be administered).
- REMOVE THE NEEDLE and attach the Atomizer
- Carefully insert the Atomizer into a naris.
- ADMINISTER THE APPROPRIATE AMOUNT OF VERSED:
Up to 10 years of age: 0.2-0.4 mg/kg (PRN) every 5 minutes
MAXIMUM DOSAGE: 5 mg
- ADMINISTER THE APPROPRIATE AMOUNT OF NARCAN:
Over 8 years of age: 1-2 mg every 5-10 minutes as needed.
MAXIMUM DOSAGE: 4 mg
- Place a gloved finger over the nares to keep the medication in for 1-2 minutes.
- Monitor for desired effects.
- Avoid giving more than 2 cc per nares. If required, split the dose between each nares.
Caution: Certain conditions may make nasal administration of a medication ineffective. Epistaxis, excessive mucous, nasal trauma, and septal abnormalities may inhibit absorption. If these conditions are present, alternative routes may be advisable.

Here is the actual opiate overdose protocol:

SECTION: R-2

PROTOCOL TITLE: Opiate Overdose

REVISED:


GENERAL COMMENTS: The goal in treating an opiod overdose patient is generally not to wake the patient, but to maintain breathing and the airway. While difficult, this is especially important as opiates are often mixed with hyperdynamic substances and other drugs at the street level, and the opioid may be masking or suppressing other toxic effects.

BLS SPECIFIC CARE: See adult General Toxicological Care Protocol R-1
- Oxygenation: some opiate overdose patients will respond well to simple assisted ventilations. See physician pearls.

ILS SPECIFIC CARE: See adult General Toxicological Care Protocol R-1

ALS SPECIFIC CARE: See adult General Toxicological Care Protocol R-1
- Attempt to identify co-morbid factors and other medical issues, including poly-pharmacy involvement.
- If patient has obviously aspirated, consider bypassing Narcan administration and transport the patient. Intubate as required.

Opiate Antagonist:
- Narcan (Naloxone)
 IV,SL: 0.1-2 mg every 1-2 min PRN to a max of 10 mg.
 IN/IM: 2 mg if IV access is unavailable. Use nasal atomizer.


PHYSICIAN PEARLS:
The Opiate Toxidrome consists of:

• Altered mental status
• Miosis
• Unresponsiveness
• Shallow respirations
• Slow respiratory rate
• Decreased bowel sounds
• Hypothermia
• Hypotension


Osterwalder, et al notes that “In 1000 clinically diagnosed intoxications with heroin or heroin mixtures, from 4 to 30 serious complications can be expected. Such a high incidence of complications is unacceptable and could theoretically be reduced by artificial respiration with a bag valve device (hyperventilation) as well as by administering naloxone in minimal divided doses, injected slowly.”
This is supported by other studies and case reports as well. It is recommended that a couple of minutes of careful ventilation with a BVM (with Sellick’s maneuver) be performed prior to Narcan administration to decrease the incidence of (uncommon but serious) complications.

Many Opiates have a longer bioavailability than Narcan, therefore assess for re-sedation. Readminister Narcan as needed.

[Nagognog2]

After boosting her with Narcan, finish off the night with a trip to the Eagle in NYC. A hard-core sado-masochism bar. She'd be screaming and yelling so loud, the manager might pay you to put her in one of the iron-cages they have hanging from the ceiling! After a few hours of people cracking bullwhips at her between the bars, she'd forget all about her drug withdrawl. And think only of YOU!

Better leave the country, kiddo.

[fnord]

Originally Posted by Nagognog2

After boosting her with Narcan, finish off the night with a trip to the Eagle in NYC. A hard-core sado-masochism bar. She'd be screaming and yelling so loud, the manager might pay you to put her in one of the iron-cages they have hanging from the ceiling! After a few hours of people cracking bullwhips at her between the bars, she'd forget all about her drug withdrawl. And think only of YOU!

Better leave the country, kiddo.

didint that close back in 2002?thanks for the info everyone i think my friends doing fine now,sadly without the bull whips/cages.just have to help her break the mental addiction now.it really hurts to see someone so close to you throw there life away over a cheap high.

[Laudaphun]

How long has your friend been dependent?

[fnord]

not long she was using 3 bags a day for 2 weeks,think its manly in her head,im sure she has some problems but they shouldent be that bad for such a small amount

[MrJim]

Yeah, That amount really shouldn't incapacitate her. She should go cold turkey just so that she can feel it. It will be uncomfortable, but not unbearable. A good sickness always makes one understand what a dependance really is.

[fnord]

she was told she wouldn't get any pity fro me,i was hoping the same thing would happen that you said.i love her but lessons should be learned.ive lost too many friends to addiction to see another go down the drain.

[Laudaphun]

2 weeks of high grade heroin is definitely long enough to make one feel pretty shitty if they were injecting it. Snorting, while it can also cause an unpleasant withdrawl is much more forgiving.

SWIM always remembered a familiar pattern when doing a cold turkey job... First for a day or two he'd be craving heroin like crazy. Then, the next couple days he'd just be pissed off that he was sick from the drug and the cravings would go away. Then about by day 5 or so of the withdrawl it would get a little bit better and it felt like his brain was beginning to produce its own endorphins again. Now that SWIM would begin to feel better from day 5 to 6 and 7, SWIM's cravings would start back up full force as soon as he was feeling better. This always seemed like a strange pattern to swim but it was pretty much true time and time again for swim.

With that said, when SWIM would do a 7 day cold turkey detox, he'd take a trip somewhere where he'd not have access to any drugs and could just lay around and be miserable.

[UNIBLACK810]

Originally Posted by fnord

it releases opiates from your receptors so could this work?my friends not doing too good and want to help her out,shes got 2 vials of narcan so i was wondering i know its a long shot but just hopeing.

narcan!!! Hells no. Narcan is used for someone who has o/d'd . It causes rapi detoxification. She'll probablly feel so bad after it she'd had rather much just go on ahead with the cold turkey "kickin". I mean personally I wouldn't do it.

[teddybearpicnics]

swim dissagrees with anyone who says turkey it out...even a week of using high grade dope will make someone sick. swim has been low on funds and using one bag of shit a day and wakes up with w.d.'s. granted swim was using about 8-10 bags a day about 3 weeks ago. but you get the idea.

like uni said...narcan is used for o.d.'s and can be used in VERY small doses against w.d.'s but it should be combined with something else like bupe. i would say fuck the narcan and try and find your girlie some subs.