Pubdate: Sun, 07 Aug 2016
Source: New York Times (NY)
Copyright: 2016 The New York Times Company
Contact: http://www.nytimes.com/ref/membercenter/help/lettertoeditor.html
Website: http://www.nytimes.com/
Details: http://www.mapinc.org/media/298
Author: Charlotte Bell
Referenced: http://www.mapinc.org/drugnews/v16/n517/a07.html

TREATING HEROIN ADDICTS

Naloxone saves lives after a heroin overdose, but does it also 
encourage addiction?

To the Editor: You say naloxone "carries no health risk; it cannot be 
abused and, if given mistakenly to someone who has not overdosed on 
opioids, does no harm." In fact, like most drugs, naloxone can have 
adverse effects, most of which are mild, but some, such as severe 
hypertension, decreased platelet function, coma and death, are very 
significant. Severe hypertension and tachycardia can likely be 
exacerbated in patients who have taken amphetamines or cocaine in 
addition to opioids, causing heart attack or stroke. Fortunately, 
most overdoses treated with naloxone occur in young patients who 
tolerate side effects. However, I am concerned about propagating the 
myth that this drug is completely safe and thereby inadvertently 
adding a new game to the highs of addiction - get high, push the 
experience to near death, make sure naloxone is handy for reversal, 
and repeat. We may indeed see more complications if patients are 
using multiple rounds of opioids and naloxone.

CHARLOTTE BELL

Milford, Conn.

The writer is an anesthesiologist.
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MAP posted-by: Jay Bergstrom