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EMS News in Focus
by Arthur Hsieh

Narcan in public hands can save lives

Widespread distribution is medically safe, but moral concerns over drug abuse cloud the issue

By Arthur Hsieh

The concept of pre-arrival naloxone use by the public continues to evolve. As Maine considers a bill that would make it available by prescription to families and caretakers of drug addicts, the controversy over its use by the public during episodes of narcotic overdoses is centered over the moral aspects of drug abuse, rather than any medical concerns.

Narcan is safe, with a specific focus of treatment, and little interaction with the body outside of that interaction. It should be a fairly straightforward argument for its use, but public misperceptions of addiction and drug abuse cloud the issues. The recent death of actor Philip Seymour Hoffman brings those issues back into focus.

Drug addiction is an insidious illness. For many, it begins as an escape from environmental or psychological issues. It is both a physical and psychological burden — your body needs it, and your mind refuses to believe that it can go on without it. Receptors change within your brain, and it’ll take a monumental effort to overcome those changes.

Those who are in recovery are like patients who have experienced cancer — there really isn’t a “cure.” They live with the daily understanding that at any given moment, the illness may reappear, and with a vengeance.

Opioids injected into the bloodstream represent an especially dangerous level of addiction. The diseases associated with intravenous drug use, the infections that are created with poor technique, and the rapidity of onset combine to make this process especially unnerving.

EMS often sees the results of this process, ranging from patients who are not breathing or simply dead from the rapid absorption, to those with chronic illnesses or facing early death. We might not be able to minimize all of IV drug use consequences, but supporting pre-arrival use of naloxone can at least reduce the chances of sudden death, and give someone an opportunity to live another day and perhaps overcome addiction.

I don’t think it will promote greater drug abuse, nor do I think it condones the practice. If it contributes to our mission of reducing death and disability in our communities, then I’m all for it.

About the author

EMS1 Editorial Advisor Art Hsieh, MA, NREMT-P currently teaches at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. Since 1982, Art has worked as a line medic and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook author, has presented at conferences nationwide, and continues to provide patient care at an EMS service in Northern California. Contact Art at
The comments below are member-generated and do not necessarily reflect the opinions of or its staff. If you cannot see comments, try disabling privacy and ad blocking plugins in your browser. All comments must comply with our Member Commenting Policy.
Derek Hunt Derek Hunt Thursday, February 13, 2014 4:50:49 PM Ask River Pheonix if narcan is safe.
Claudia Whelchel Burrows Claudia Whelchel Burrows Thursday, February 13, 2014 8:53:22 PM Indianapolis Police Department will be using it soon.
Michael Schubert Michael Schubert Friday, February 14, 2014 9:47:29 AM Narcan should ONLY be for the field. Hospitals should intubate & monitor. No sense in waking them up if they are stable, and usually by the time the patient gets to the hospital, the street opiate's effects have peaked. Intubate & monitor. As for out in the field, the worst thing you could do is to "use Narcan just because you have Narcan". If the patient is stable and breathing is ok, no sense in waking up a patient and having an extremely difficult patient all the way to the hospital. Narcan is a life saver and should be used in life threatening situations. Just because the patient is unconscious & unresponsive shouldn't automatically get Narcan. Most experienced paramedics I've worked with always know when it's needed, and when it's not needed they have it at the ready
Gary Saffer Gary Saffer Monday, May 05, 2014 12:57:37 PM Yes, because intubation is a benign procedure that never has complications or results in death. It's much safer to do an invasive procedure that ties up resources in the field and in the hospital than it is to reverse the effects of narcotics in the field. /sarcasm

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