Toxicology Sessions - Naloxone Autoinjector

00:00
05:43
Sign in or subscribe to listen

No me gusta!

The flash player was unable to start. If you have a flash blocker then try unblocking the flash content - it should be visible below.

Nurses Edition Commentary

Mel Herbert, MD MBBS FAAEM, Lisa Chavez, RN, and Kathy Garvin, RN
00:00
02:00

No me gusta!

The flash player was unable to start. If you have a flash blocker then try unblocking the flash content - it should be visible below.

Jan H. -

The song's just priceless. Thanks for that. :D

Sean G., M.D. -

Not sure if my initial comment will pass the filters but I feel the need to express further. This drug is not going to be dispensed to a reasonable "compliant" pt population like an epi pen for example. Ie the recommendations as I sure there will be to "go to the ER if you have used this medication or to "call 911" are unlikely to be followed. This is a pt population that often illegally obtains large rx's of oxy IR and the like, even then they do not take the dose as prescribed often doubling/tripling etc(my ex fiance I mentioned in my first comment would take 50 percs at a time then end up in the ED with hepatitis). Not only do these people take more then prescribed, they crush them and snort them or melt them and shoot them...and you think they will use this drug correctly? Really? Why would they suddenly do that? This drug will leave them with the false sense of security that they can do MORE heroin or oxy's etc, the segment here with the THC dealers and the joking about them being high while packaging the medical marijuana...that was funny...this is not. These people are worse then that. I can just see a group getting together with their narcan with a designated sober person....how do u think that will work out? When we give it in the ED we either tie the person down first or give incremental doses to avoid the resp depression because the full dose would lead to the unrestrained pt ripping out their iv and running out of the ED to chase their next high...what do u think they will do if they take it at home? If the parent gives it? Do u really believe they will understand and respect the pharmokinetics of the drug they used and the narcan? Seriously this idea belongs on David Letterman's "stupid human tricks". I am quite sure this drugs end result would be more deaths due to OD not less. Please. Some common sense would go real well here.

Timothy R. W., M.D. -

Sean G,
The data is pretty clear that home naloxone saves lives. Do a bit of a search on the topic focusing on Boston - NOMAD and OEND, North carolina Project Lazarus, Dan Biggs data out of Chicago, expanded access to naloxone, etc. Communiteis in Massachusetts that have implemented these layperson programs have a decrease or flattening in opioid related deaths whereas nearby communities without these programs show the curve all of us are seeing of increased deaths. While this population can make our jobs less enjoyable are we really capable of making the moral judgement of a life worth living or saving and if so are we willing then to not help them based on our percieved superior human qualities and values? Maybe a deep breath and some compassion are better than contempt. It might interest you that ACEP is now behind layperson and BLS naloxone and behind prescription naloxone for high risk populations - IM, IN, whatever works to HELP these suffering humans. BTW - before making uninformed statements about a "false sense of security" that these people will get and the probability "they can just do more" drugs maybe you should read some of the literature on the topic so you do not spread misinformation. Try Seal J Urban Health 2005, Galea Addict Behav 2006, Wagner Int J Drug Policy 2010 and 2014, Doe-Simkins BMC Public Health 2014 (you can get most of those on open access if you search Google Scholar). The conclusions of all these articles are different than you might suspect - this type of therapy (they were using either IM or IN naloxone as laypersons rescuing others) often leads to an increased sense of value and a higher standing in their peer community. The result is more pride and often LESS risky behavior, but not increased opioid use. Not once have these studies shown an increase in opioid use due to a false sense of security.

Sean G., M.D. -

Tmothy R I responded to u but I guess the debate is not encouraged. I disagree with u and your interpretation of the literature...wholeheartedly. I also have no clue how you surmised I made some moral judgement on who's lives were worthy of saving????You might want to check yourself before you "read minds" cause I certainly did no such thing. I disagree with the availability of nalaxone otc likely to save lives and believe it more likely to cause more deaths. All the research alluded to refers to educational programs that involve getting whole communities together, they are required to pass tests regarding CPR Naloxone opioid toxicity recognizing an OD etc, they are not simply handed naloxone, as was suggested by Sean and Stu when they commented, "This should even be available otc" No I do not expect Rx substance abusers to take this one Rx as directed, and all others however they feel...call that a moral judgement on my part I call it common sense. Sometimes modern medicine is really lacking in common sense....ie lets all get our cholesterols to 50....we will NEVER DIE!!!!!! the foolishness of this mindset was commented on this month, and IMO the foolishness is evident in naloxone otc.

To join the conversation, you need to subscribe.

Sign up today for full access to all episodes and to join the conversation.

To download files, you need to subscribe.

Sign up today for full access to all episodes.
Episode 158 Full episode audio for MD edition 286:28 min - 268 MB - M4AEM:RAP 2014 November Canadian Edition Canadian 31:41 min - 44 MB - MP3EM:RAP 2014 Noviembre Resumen Español Español 89:01 min - 123 MB - MP3EM:RAP 2014 Novembre Résumé en Francais Français 84:05 min - 116 MB - MP3EM:RAP 2014 November Aussie Edition Australian 55:07 min - 76 MB - MP3EM:RAP 2014 November MP3 364 MB - ZIPEM:RAP 2014 November Summary 1 MB - PDFEM:RAP November 2014 Board Review Answers 379 KB - PDFEM:RAP November 2014 Board Review Questions 380 KB - PDFResumen escrito noviembre en español 691 KB - PDF