The Naloxone Yo-Yo Effect

It could easily be argued that naloxone, the lifesaving overdose reversal drug sold under the brand name Narcan, is one of the most important drugs ever produced. If it's administered in a timely manner, the life of an opioid addict can be spared from what would have otherwise resulted in an overdose death.

In the United States, practically every first-responder has been trained to administer the drug, in response to the staggering overdose death rates linked to the epidemic plaguing America. Additionally, a number of states have taken certain actions, making it much easier for addicts and their families to acquire the ever important drug—in many cases a prescription is not required for obtaining the miracle drug.

While the United States has the highest overdose death rates in the world, after decades of over prescribing painkillers and a burgeoning heroin market, our neighbors from the North have hardly been spared. In fact, between November 17-23, there were nearly 500 overdoses that required paramedics in the greater British Columbia (B.C.) area, CTV reports. Situations that would usually be considered routine, involving naloxone treatment. However, it turns out that addicts have begun mixing naloxone with their heroin in an attempt to protect oneself from an overdose.

Obviously, the method is far from the right course of action. The act of using an opioid, followed by naloxone, is being called “yo-yoing” or the “yo-yo” effect, according to the article. Heroin causes feelings of euphoria; naloxone reverses those effects by essentially starting a process of drug withdrawal—a real up and down experience. One that is far from pain-free.

In B.C. paramedics are arriving at the scene of overdoses and seeing empty vials of the overdose reversal drug, the article reports. Addicts are getting a false sense of safety from yo-yoing, but Paramedic Sophia Parkinson says that a person who uses naloxone needs to be followed up with by medical personnel, as the effects of the antidote can be fleeting.

Please take a moment to watch a short video on the Yo-Yo Effect:


If you are having trouble watching, please click here.

Fentanyl Salesmen Arrested for Kickback to Doctors

An aspect of the prescription opioid epidemic that is often ignored is the role of pharmaceutical salesmen. These are people who are employed by pharmaceutical companies to travel around the country enticing doctors to prescribe their medical product. Now, it stands to reason that a physician's willingness to prescribe a drug should be based off of the drug's effectiveness at treating a specific condition—and in a perfect world that may be the case. However, doctors are often times given huge incentives to prescribe one medication over another, a practice which surely had a hand in the rampant over prescribing of drugs like OxyContin (oxycodone).

In the wake of the beloved pop star Prince’s death, attention has been redirected back to the powerful opioid analgesic fentanyl. Many Americans may have never heard of fentanyl as the drug is not commonly used outside of hospital settings. Those who had heard of the drug before may have been unaware that fentanyl is 100 time more potent than morphine. Fentanyl, while fast acting and highly effective, can cause severe respiratory depression that can be fatal; this is why it should be scarcely used except under the close supervision of doctors and nurses.

In an attempt to stem the tide of irresponsible prescribing practices, law enforcement has begun to set their sights on pharmaceutical salesmen. Recently, two former pharmaceutical salesmen were arrested from charges stemming from paying doctors to prescribe a form of fentanyl, USA Today reports. The two salesmen, who worked for Insys Therapeutics, allegedly paid two doctors in the New York-area $259,000 in kickbacks to prescribe Subsys.

Most fentanyl prescribed for take home use comes in the form a transdermal patch. The patches are adhered to one’s skin—slowly releasing the drug throughout the course of the day. Subsys, on the other hand, is sprayed under the tongue, according to the article. The spray version of fentanyl works quickly, relieving pain in just five minutes.

"You have this hyper-powerful drug marketed intensely, aggressively and shamelessly without any sense of the addictive and lethal power of what is being sold," said Arthur Caplan, the director of medical ethics at NYU Langone Medical Center in New York.

We will continue to follow the fentanyl story. Stay tuned. 

Draconian Drug-Induced Homicide Laws

Last week we wrote about caution to heroin dealers from prosecutors. If you sell heroin to someone which results in a fatal overdose you may be looking at a over 20 years in prison. It turns out that you may not have to be a heroin dealer to receive a life sentence after all. A man in Louisiana was given a life sentence for injecting his girlfriend with heroin that resulted in an overdose death, Fox19 reports. The stiff sentence raises a lot of questions about culpability.

The case of Jarret McCasland, 27, is not simple. While the man has a history of selling drugs, he did not sell the heroin that resulted in the death of his girlfriend Flavia Cardenas, 19. Nevertheless, 19th Judicial District Judge Don Johnson gave McCasland the maximum sentence possible for a second degree murder charge.

"There are two consenting adults who were using drugs,” said McCasland's attorney, J. Rodney Messina. “this thing could have flip-flopped. He could have been the one that's six feet under, and then they would be prosecuting Miss Cardenas." 

We know for act that treating addiction with jails and prison is not effective in deterring drug use, and it certainly does not cure addiction. In recent years, in the wake of the American opioid epidemic, we have seen a dramatic change in how lawmakers look at addiction. Many of which now believe that treatment is the most effective weapon for fighting addiction. Apparently, lawmakers in some parts of the country did not receive the memo. A drug policy reformist at Roosevelt University, Kathie Kane-Willis, contends that draconian drug-induced homicide laws need to be changed, according to The Fix.

 “It may seem like a kinder gentler war on drugs and perhaps for folks in urban areas that is the case,” said Kane-Willis. “In the Midwest and the South that is not the case at all, in fact we are seeing really disturbing trends in the ways that these cases are being handled.”

Keep in mind, If you or a loved one is battling opioid addiction, please contact Celebrate Hope at Hope by The Sea. We can help you learn how to live free from addiction and begin your journey of recovery.