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The Miracle Drug That Has Pulled Thousands of Overdose Victims Back from the Brink

“It really is the most incredible drug on the planet.”


This story is part of our special report on the private tragedies and public toll of our injection drug epidemic. Read more of the City in Pain here.


Naloxone, which reverses opioid overdoses, has pulled thousands of San Franciscans back from the brink of death. Also known by the brand names Narcan and Evzio, the drug has been used by first responders for half a century. But beginning in 2003, San Francisco became the first city in the country to distribute it widely, in partnership with the Drug Overdose Prevention Education project.

In 2010, the drug was used a reported 62 times by civilians trying to reverse overdoses. By 2016, the number of self-reported reversals had soared to 877. “It really is the most incredible drug on the planet,” says Hannah Cohen, syringe access coordinator at Glide.

Naloxone reverses overdoses by temporarily knocking opioids like heroin and fentanyl off the brain’s opioid receptors, allowing users’ respiratory systems to kick back in. The drug has no negative side effects—although it can send people into a rapid and uncomfortable withdrawal and immediately kills a heroin high—and no effect on people without opioids in their systems.

Starting in 2010, the city began allowing trained harm reduction workers to hand over blank-check prescriptions for naloxone to anyone, including people who use drugs, who can now obtain it through syringe exchanges and other programs, often for free.

Naloxone can be injected directly into a person’s upper thigh or glute. Although it’s the most eff ective way to prevent an overdose, it’s possible to save a life without it. Cohen emphasizes the importance of performing rescue breathing on all overdose victims: laying the person on her back, tipping her head back to open the windpipe, checking her mouth for any objects that she could choke on, and then plugging her nose and breathing into her mouth either directly or through the barrier of a T-shirt or hand, starting with two large breaths, followed by one breath approximately every three seconds. Acting as an outside set of lungs can prevent brain damage due to oxygen deprivation and can keep a person alive until paramedics arrive or until the opioids leave the body.


Originally published in the October issue of San Francisco

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