From someone who has administered Narcan dozens of times. There is no decision - you use it to save a life. What balderdash. Who would counsel delay to decide re: withdrawal....vs withdrawal from life.
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From what I understand, most of the patients who need it are not even conscious enough to decline care so it falls under assume consent anyway. Am I right?
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ALL patients who need it are incapapable of communicating assent or dissent by definition of opioid overdose.
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How can someone—who isn’t conscious—refuse something?
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In EMS or an ER, we give just enough naloxone (eg 0.4mg) to restart breathing, not induce withdrawal. Home rescue kits have larger doses (2-4mg) so that it will work on first try, which saves lives. If awake enough to refuse, the patient doesn’t need. This case is more complex.
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But more importantly, understand that persons addicted to opioids have brain chemistry and reward system hijacked, such that risking death to avoid withdrawal seems rational. Empathy starts with acknowledging that people make decisions that make sense from their viewpoint.
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0.4mg can absolutely still induce withdrawal. If the patient is unconscious and not breathing, this is still worth doing, and you can always give repeat doses.
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However, in less severe cases involving decreased responsiveness or still breathing with known or suspected opioid use, you can dilute and give smaller amounts or you can nebulize the 2mg and the patient essentially will self-titrate, taking off the mask once awake enough.
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if you can refuse narcan you dont need narcan
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The information here is good but to be clear the patient was not the one trying to refuse the naloxone, her friend was trying to refuse on her behalf. If you can refuse it yourself you don’t need it.
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You realize that if someone is overdosing, they are unresponsive and therefore consent is implied. They are unable to provide expressed consent, nor can they refuse.
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Yes, I can't imagine why someone who is literally in the middle of dying from an overdose might make a poor decision about their overdose-inspired death
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Dear
@npr - if a person is alert enough and capable of refusing naloxone, it’s generally not indicated.Thanks. Twitter will use this to make your timeline better. UndoUndo
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Your coverage on opiates, including this, has been horrifically bad. You've promoted misinformation and even information that is damaging to people who use drugs and those who love them. I'm disappointed and disgusted with
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But like it also could like save your life too man
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Happy to provide a medical toxicology consult to the usually reliable
@NPR as they’ve completely misfired on this entire issue.Thanks. Twitter will use this to make your timeline better. UndoUndo
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Your refusal to correct this ridiculous story has ended a literal lifetime of NPR listenership and donations.
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I agree. It helps to understand how it works. The writer of this title clearly doesn’t.
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