Research reveals potential advantages of naloxone in opioid-associated cardiac arrest

Sufferers who overdose on opioids and have a pulse are sometimes given naloxone (Narcan) by first responders, a standard life-saving measure.

Nevertheless, emergency medical service (EMS) companies have completely different protocols for administering naloxone, so there’s little proof to assist its use in sufferers with no pulse who skilled opioid-associated out of hospital cardiac arrest (OHCA).

A latest examine by UC Davis Well being researchers got down to assess the results of giving naloxone administration by paramedics to sufferers with OHCA. 

The examine, printed in Jama Community Open, concluded there was an affiliation between naloxone administration, and each return of spontaneous circulation and survival to hospital discharge.

“The incidence of drug-related cardiac arrests has skyrocketed up to now twenty years, and there’s an pressing want for proof to information doable naloxone use on this circumstance,” stated David Dillon, assistant professor of Emergency Drugs and one of many examine’s authors.

What’s naloxone?

Naloxone is a drugs that quickly reverses an opioid overdose. It’s an antagonist -; that means it attaches to opioid receptors and reverses and blocks the results of different opioids. Naloxone can rapidly restore regular respiratory to an individual whose respiratory has slowed or stopped due to an opioid overdose. Researchers hypothesize that naloxone might also assist sufferers who’re experiencing opioid-related cardiac arrest.

Naloxone has no impact on somebody who doesn’t have opioids of their system, nor does it hurt them, and it isn’t a therapy for opioid use dysfunction.

Opioid-associated cardiac arrests

Cardiac arrest happens when the guts instantly stops beating. Roughly 350,000 cardiac arrests happen exterior the hospital every year, based on the American Coronary heart Affiliation. Nearly all of these are because of coronary heart assaults or electrical points with the guts, however opioid overdose-related cardiac arrests are a serious reason for demise for adults 25 to 64 years previous.

Latest research estimate 17.6% of all OHCA, and 34% of OHCA in these underneath 60 years of age, are the results of opioid toxicity.

Research outcomes

For this retrospective examine, researchers collected information from San Francisco, Sacramento and Yolo county EMS companies between 2015-2023. In complete, 8,195 sufferers with OHCA have been handled by the three companies.

The outcomes confirmed EMS administration of naloxone was related to considerably improved outcomes. The quantity wanted to deal with with naloxone, which represents the variety of sufferers that have to be given naloxone to watch one further constructive consequence, was 9 sufferers for return of spontaneous circulation and 26 sufferers who survived and have been discharged from the hospital.

Surprisingly, our findings confirmed that naloxone was related to improved medical outcomes in each drug-related cardiac arrests and non-drug associated cardiac arrests. That is necessary as a result of it provides to our understanding in regards to the effectiveness of naloxone for drug associated out of hospital cardiac arrest.”

David Dillon, Assistant Professor, Emergency Drugs, College of California – Davis Well being

The researchers famous that these discovering warrant additional investigation, given the rising opioid epidemic in the US and the potential advantages of naloxone as a part of cardiac arrest care.