Out of curiosity, do you mind me asking the reason you got it prescribed? No judgement! It's just that Im from Michigan where we were hit reallyyy hard by them, and in reality still are, but they have been prescribed much much less, and no longer offer it for wisdom teeth removal. Was just curious what it's like in other areas, because I know even doctors downstate in areas are much more liberal with prescribing them than most where I am from! ps: coming from someone who's lost a friend that was taking oxys then OD'd on Heroin shortly after, then watched my other friend months later turn purple on the floor, trying CPR to then rush 100mph home to grab narcan only for him to need NINE more, swallowing the hardest pill that ive ever taken, which was knowing that ill never be able to hangout with him again, otherwise our crutch would not create as we intended, yet destroy, leaving both of us dead... And who's uncle has been on every painkiller known to man due to >30 surgeries, yet still had the want and will to get off Oxycodone and Fentanyl patches (BOXES of them he had, no joke)... My friend who Od'd he moved to cali and is FULLY RECOVERED NOW!!! Me: I isolated myself to reset my mindset, staying home from anyone my momentous, poisonous habits could negativtely impact. My mind was replaying the visual of the scene over and over, and how sickening the horrible feeling of pain,, guilt and lifetime of unshakable dread knotted my stomach as I waited for an eternity before being carried away still unresponsive, not knowing... A feeling you wish that NO person should EVER have to feel... It was a cut so deep that if I were to run, I would bleed out. I couldn't push it away. So I let it overcome me when it came over me, because it wasn't the problem, it was reality, in which I was the problem, and it was now the teacher.. I sat, I listened, I watched, I took it as a teaching, as a chance for change and as a reminder to how bad it pained my heart, so so deep to the soul that it would bring monumental change to what I was living.for. I ended up getting the best job I couldn't ever have even imagined. Outside, detached from society,, working and connecting with the beautiful forest and wildlife surrounding me, and with each second healing me more and more, these realizations were given to me from everything around me I was connecting with, about the countless flaws in the way which society nowadays operates, I could see the hindered areas in where the line of the transfer of energy from thing to thing in society were un natural, therefor being entropied and lost. Society no longer remembers the last part of our name: "human BEING", we've become so disconnected from nature and focused on racing to and hyper fixating on an illusion of something un-feasible, and only practical to societal norms taught to us, not in reality, therefore dis-communicating us from our inner knowings that are given to us from when we are connecting with everything all of the nature around us, not some job we don't even know what the end goal is. I soon found out from an older coworker that I was connecting with nature in the same woods my grandfather used to do research, which I had never even known, driving past the wolf cage he brought in and acclimated wolves into before introducing them to the population as a research experiment. And the same woods which now hosts researchers that very frequently when I run into and introduce myself, they becomes enjoiced to realize I am his grandson, exclaiming how amazing and how proud he would be of me, and tell me just how impactful of a person he was, and the reason their interest was sparked to become biologists... such a full circle thing, I still cry thinking about not knowing how long reaching of an impact we all may make yet never see after we are gone...). ------- now I am someone who keeps a narcan with me, because you never know what future or impact might not happen with out it. Now I am someone who my struggles have given me a new opportunity and have bestowed a newfound love and fascination for chemistry. I am learning as much as I can about as much as I can in this world, in hopes to one day make a change and possibly help save lives in as many different ways and areas I possibly can. I now view the world through a completely different lens, and my mind has completely changed to view things in very different ways than I ever had before. Everywhere I look, I now see the entire chain of interactions of everything involved in it, and the outcomes of how it all affects each other. Im not working to make money, Im living to make change. Im sorry I wrote a damn book!!! But if there is anyone going through some struggles right now, know that you never can see what amazing opportunities are awaiting to be rewarded to you right around the corner! And that with time and life, one day you'll realize that the understanding of beauty in life comes from struggle! And all of a sudden without knowing, you've learned to seek it and to love it painlessly, because thats were true progress and change for this world comes from.
narcan is the most dangerous thing ever created it make you think playing russian roulet is safe with opoid it need to be made iligal so people see the reality of opiod and if they that take them let them face the danger by themself helping thosse people is a waste.
Mad props to SciShow for informing about harm reduction and, while not promoting drug use, also not having any judgment toward those who use or are suffering from addiction. I love this channel.
@@seanevertts2735 I've always wondered why people are like you are, are you mad that people are more knowledgeable than you? Don't worry I bet there is something you know or can do that @BZCSquadron can't do, it's all good.
The last time my mom was discharged from the hospital, she was given a handful of packs of Narcan along with her pain med scrips. She was very responsible with her pain meds and didn't end up using any of the Narcan, so we gave a couple to a family friend who's a known user and donated the rest to a local substance abuse clinic.
My mom was really surprised about getting the naloxone when she got her pain meds. I don't think she was quite ready for my husband and me to have a strong reaction about making sure she (or ideally my father) knew how to use them BEFORE that could arise.
I was a heroin addict for years and Subs only kept me sick. What really helped me was Vivitrol Injections once a month. Vivitrol is an opiate blocker. Couldn't get high even if I tried. Saved my life. The chemical that his video was leading up to reminds a lot like Vivitrol. You do have to be clean from opiates for 7-14 days before injection or you risk sever withdrawal symptoms. The time before the shot is the hardest part and where most people back out or go for the pill form which can easily be mistaken which then opens your receptors back up. I know a lot of rehabs offer Vivitrol before they discharge you.
Thanks. And more info: "Vivitrol is an extended release formulation of naltrexone, which is an opioid receptor antagonist." [Psychiatric Research Institute}
@@2000Peaceouttrue. I've been on vivitrol for alcohol misuse for over 4 months now and it works really well. I have no desire to drink and it's much easier on the liver than oral naltrexone
I’m a home health nurse (I specialize in geriatric care). I ALWAYS encourage my patients to have Narcan on hand because accidental overdoses happen! I’ve had patients double up on their meds, I’ve had spouses accidentally take the wrong pills, I’ve seen pain patches break open etc etc
i’m a middle school teacher and got narcan a few years ago just in case. the new school i moved to last year is in a rough neighborhood, so i taught my advisory kids what it was and why it was so amazing. i found later that a few students had family including parents who had ODd, and lived in places with a lot of drug use. a few of them told me they were able to convince someone to get some for themselves/for the kid to carry with them. some states have free distribution programs which is so amazing
I was a firefighter for 38 years. Thirty years of that time I spent many shifts working on an advanced life support ambulance. On more than one occasion we had overdosed patients that were very angry because we ruined their high by administering Narcan. Never mind that they weren't breathing when we arrived.
It doesn't only make you no longer high and then you are angry about it. It legitimately makes you angry all on its own. Think about all the feel good chemicals in your brain are suddenly gone... Yeah you're gonna be at least irritable. Sometimes people don't even know WHY they are angry and just direct it at the most obvious thing. knowing their high is gone, and they're angry, they connect the two. Not denying that there aren't assholes out there, but sometimes it's legit something a person can't help.
An old coworker once told me about his friend who crashed his car while overdosing on opioids. When the EMT arrived, he was conscious enough to say, "Don't help me. Just let me die. This is what I've always wanted," before dying shortly after. He suffered from depression and anxiety his entire life from childhood trauma. Opioids allowed him to run from the feelings that haunted him indefinitely. Some people don't want to stop dreaming.
My sister was angry at me for calling emergency services when I found her blue with a needle in her arm. The 911 operator had me blowing breaths into her mouth for what felt like forever but was probably only about five minutes. I've never been so happy to see firefighters in my life .
If you're administering Narcan as a first-line treatment for opioid overdose while working ALS, then you kinda had it coming. It's great for the public, though.
Nanoparticle drug administration is so fascinating. I went to a lecture from one of the leading researchers on the matter, and it was riveting. Great to see the tech being put to use
Hi, I'm actually a ungrad working in a lab working on kappa receptors and longer term opioid receptor antagonists. I love how you guys summarize this topic and it'll be nice to share it with people when they ask what I'm working on. Only thing I wish you guys would improve on is clearing up the references and make it clear which one you are referring to at various points. (I've seen other science communication channels put a little R1 or whatever in the corner when they mention a source). Anyway, love this channel and how it's evolved over the years. Keep being awesome. ❤
I was saved by naloxone and 3 adults beating my chest cpr.... I swear after being revived I still felt the opiates... it was laced with fentanyl.... been sober 5yrs.... kept my moral somehow... I'm very lucky and need all police to carry reversal drugs and people that know active users.
Folks like you are rare success stories. A diamond in the dirt. You ought to pursue a career in helping even if it's speaking at meetings but you may be eligible for school grants to become a counselor or even a doctor. Don't underestimate your power you are already beating the odds.
I work in a pharmacy. I noticed a pharmacist I worked with had naloxone with her, and in the last weeks, a social worker and someone else that worked in a neighborhood susceptible to overdose, come in to ask for naloxone, in case.
Depending on the circumstances, you might not want a long-acting antagonist. Naloxone has a wide acceptability among opioid addicts, precisely because it lasts such a short period of time - hopefully long enough to get them through the acute emergency, but which is going to allow your heroin, or fentanyl or whatever to start working again. If you give someone something which lasts days to weeks, you are putting them into a cold turkey, they can't be released from. Any addict is going to think twice, before doing that to their friend, maybe causing a fatal delay. The agents in the second half of the video, are addiction treatments, not really overdose treatments, at least no more than 'Just Say NO!' is an overdose treatment.
Psychedelics are just an exceptional mental health breakthrough. It's quite fascinating how effective they are against depression and anxiety. Saved my life.
Can you help with the reliable source I would really appreciate it. Many people talk about mushrooms and psychedelics but nobody talks about where to get them. Very hard to get a reliable s0urce here in Australia. Really need!
Yes, blizmyco. I have the same experience with anxiety, depression, PTSD and addiction and Mushrooms definitely made a huge huge difference to why am clean today.
I was prescribed naloxone along oxycodone after my surgery! After I was done taking the opiods, I gave one of the sprays to my friend who (unlike me) attends parties where drug use may be present.
I work in the recovery field after a lifetime of heroin addiciton - we go through a lot of naloxone and have all been worried about nitazines, fent analogues, and some rediscovered ultrapowerful opioids hitting the street. A naloxone analogue with increased potency would be ideal. Using immunity sounds great if you don't think about all the negative effects that would have on your body. You have those receptors because your body uses them to signal and carry out different processes. Blocking everything from binding to those has me very weary.
I think in this case you are adding ready-made antibodies rather than provoking the body to make them. So they would be cleared from the body, hopefully before the patient needs any pain-relief in the future for surgery or whatever.
The lack of antagonists for nitazines and adulterants like Xylazine is terrifying. As someone who is in recovery and harm reduction too, keep up the good work you are doing. It's priceless.
The main problem with buprenorphine is that only medical professions could use it because a nasal spray would be much more dangerous than current formulations to people that don't have a tolerance and it's a controlled substance. It also has a very long half life (more than 20 hours) which is the exact opposite problem of naloxone (60-90 mins). Naloxone wearing off before the drug that caused the overdose is both a plus and a minus. Precipitated withdrawal would take much longer to pass and that can cause it's own problems.
My sister is an EMT and suggests making sure you have dodge space when giving narcan. Some of the patients have been angry and combative coming back to awareness.
This is a very rare response, to be clear. I know folks who've done this work 30 years and never had someone wake up aggressive. Don't be afraid to give narcan because of this.
35 years ago, before naloxone was available, I gave CPR to someone I found in a stairwell in my block of flats. He had stopped breathing but when I pushed air out of his lungs he said "stop pushing me". I heard he died from another OD a couple of months later.
The problem with Buprenorphine is that it still acts too strongly as an agonist and can cause respiratory arrest in opioid-naive people (folks without tolerance and dependence) on its own.
@@lemonz1769an opioid dependent person has to wait 24 hours before taking buprenorphine or else they get precipitated withdrawals which is horrible. Buprenorphine has a very long half life so they’d be violently ill for upwards of twelve hours if you administer buprenorphine before the other opioids leave the receptors of an opioid dependent person.
@@twiggz1000 When Buprenorphine is carelessly used on a person with marked opioid dependence (doesn't have to be addicts, it's also a thing in pain patients), it'll catapult them into WD aswell. The proper protocol for this is tapering the original drug before switching the pt over to Buprenorphine.
@@twiggz1000 at a lower dose it will throw someone with dependence that recently used into withdrawal, but at higher doses it will act as an agonist and prevent withdrawal AND overdose from the offending agent since it has a higher affinity for the receptor than full agonist opioids/opiates.
Many years ago I and miles behind, I was working in Central Africa for The Red Cross, it was basically treat everyone they throw in front of you. Any way this bunch of American Soldiers, rushed in waking me up to treat a guy who'd stolen all the morphine sterets, in his units emergency supplies. So I got the Naloxone into the dude, who, in three or four heartbeats sits up, calls me a nasty word CZcams will take umbrage at, and tried hitting me. So I gave their unit medic a supply. And their warrant officer wrung the dude's ear until he apologised. I glad to see the back of them. I got a sense that they were lightening rods for trouble and wanted them out of my general vicinity.
yep. Narcan in high doses will shut off their high in a heartbeat, and they wake up furious. experienced people will get just enough into them to get them breathing again, until they have them in a controlled environment, where they can decide whether to leave them asleep until the opioids wear off, or give them the rude awakening.
@@kenbrown2808 One thing to remember though is the reason why they're upset. They're upset because they're in pain. Naloxone is incredibly efficient at what it does so when it's given, it resumes that painful feeling a person may have overdosed from.
Can we have a discussion about the legalities/morality of forcing long lasting opioid agonists on a patient against their will. Will that prevent them from getting potentially actually needed pain relief in the event of opioid necessary pain? Bodily autonomy?
I would love to see this research not only improve overdose reversal but also treatment protocols for addiction. It would be wonderful if we could help more people with substance use disorder before they overdose as well as those who want treatment after an overdose reversal.
Just some additional information: Naloxone is available dirt cheap as a generic - like less than 8 USD per vial(!) cheap. These fancy nasal applicators like shown in the video thumbnail are sold in cities with rampant illicit opioid use and cost distinctly more than 100 bucks - for a single dose that may not even be sufficient to reverse an overdose, depending on the receptor binding affinity or the amount of the opioid the person took. Why do they cost this much, you might ask. It's because the applicator is patented. This also means that no other company can provide the same or a similar thing in cheaper. It's absolutely disgusting how profit interests get in the way of saving lifes…
Available as a generic, but not OTC, right? Are there any cheaper OTC options available? I'd love to carry some just in case I find myself in a situation where someone needs it.
@@elisebrown5157 I'm not aware of any OTC options beside the patented nasal applicator. The cheaper options are vials and ampules for injection purposes. Arguably, one could crack open such an ampule and pour some of the contents into an unconscious person's nose to achieve a similar result. Pharmacists can sometimes hand over medicine without a prescription - depending on the legislation, it can be left to their own judgement, so maybe you'd get some ampules this way; otherwise just explain it to your physician and see if they're willing to help you out. Esp. in the U.S., I doubt that they'd hand it over together with injection equipment though, because even if it's for the purpose of saving another person's life, the phycisian/pharmacist could be held legally accountable for any damage may occur, which is just too much of a personal risk for them (people have already been sued for saving another person's life - be it civilians or professianals like nurses, EMTs and physicians…). In order to circumvent this, maybe there is a compounding pharmacy that could make a nasal spray out of the ampule contents. It'd have a limited shelf life, but that's still better than nothing.
In colorado you can ask the pharmacist to write a script for you and we can run it through insurance to help with cost. Most insurance will cover it or at least some of it.
it would be good to see an episode expanding on harm reduction and safe supply. drugs like heroin, cocaine and amphetamines are often dangerous because dosages are so inconsistent and the likelihood of other drugs being present (agonists and antagonists). safe supply is available for other recreational drugs, namely alchohol which is responsible for 100,00s of deaths yearly. it is available with safety standards and labelling that ensures anyone wishing to ingest it knows how much they are taking.
The difference is alcohol is legal. You can't expect for them to regulate/label illegal drugs. Its ridiculous that they don't even have harm reduction/needle exchanges in many states. I'm a former MA user, and I was fortunate that my state does.( Only because the overdose rate is one of the highest in the nation.) They provided clean syringes and other tools, naloxone and fentanyl test strips(which don't detect amounts, just whether or not it's present) That's about as good as anybody can get and I was lucky to have access. Which is crazy because statistically they absolutely do work. Hell Im living proof that they do. Utilizing those services helped keep me healthy and safe(well, safer)during my active use. The people that worked there were really great too. They never judged me or made me feel bad about myself, and that is something that helps tremendously. I got clean and went back to school and im currently a neuroscience major, planning on grad school after I finish my BSc. Harm reduction works.
Nothing useful comes from Heroin. Nothing. There is no safe supply, it is incredibly addictive and has zero benefits whatsoever. Opioids aren’t and should never be considered recreational. Ever. Yes, Alcohol is a dangerous substance but for all but the most grizzled alcoholic you pass out from alcohol long before you can reach toxic levels. Comparing alcohol and heroin is kinda silly.
@@ferretyluv That's absolutely false. You sound like a pompous a**, being arrogant while also being so wrong. Mexico for Tramadol, Lots of EU nations for Codeine, even in the US, you can buy certain opioids OTC, of which, loperamide, (Immodium being the brand name), is one of. While we're at it, let's talk about that one. There's a reason it's called "poor man's methadone". Doesn't mean you should go and abuse that one, though. At small doses it's fine with only peripheral nervous system activity and little to no psychoactive qualities, but the doses you need to achieve an effect in the brain, (where the intoxication comes from, starting around 50-72mg) give you a risk of cardiovascular issues, especially QTc AND QRS prolongation, syncope, ventricular tachycardia, conduction disturbances, all being more likely the higher you go. I was addicted to loperamide for a good while but thankfully got off with minimal side-effects. My normal dose was 96mg every 2 days due to the very long half-life. Not recommended. At therapeutic doses, (2mg-16mg per day), it will help with diarrhea by slowing down motility of the gut. At supratherapeutic doses, the drug has typical opioid effects like euphoria, analgesia, sedation, respiratory depression, nodding if you take enough (a state of semi-consciousness), itching, et al. Increased risk of overdose in opiate-naive patients, just like regular methadone. I hope you enjoyed my tangent, but next time, at least look something up before being so sure of yourself. You won't look as dumb.
@@impossible_planetthe temperature swings in Canada make it so carrying in the glove compartment is not advised. Too hot in the summer and too cold in the winter, so we're encouraged to carry it with us in a bag to maintain temperature stability of the naloxone.
Narcan can also safely be used on dogs! If a dog gets into opioids and is overdosing, narcan can save their lives while they’re on the way to the vet. I carry narcan for both humans and my dog, though thankfully I’ve never had to use it.
My EMT father always kept naloxone in the house and i never knew what it was until i was like 30. The gravity of the opioid crisis aside, methocinnamox is my favorite alien breakfast cereal.
I’ve been accidentally clean of opiates for a few months now. I was given Buvidal (burpenorphine), a monthly injection, until I went on holiday and wasn’t able to get it, since I was out of state. I didn’t start entering withdrawals so I kept putting it off, and fast forward three months, I’ve still not had any withdrawal symptoms. My doctor said that the last of the Buvidal will be gone by now, and that I’ve essentially weaned myself off it. I’ve lost weight so my pain is better now, too. I’m so glad to be free of the curse.
4:10 is just wrong. Tight binding does NOT automatically equate to high effect intensity. What causes downstream effects is the shape the receptor takes, once the substance is bound! When Naloxone binds, it forces the receptor into an inactive conformation (in layman's terms: "the receptor is turned off"). Btw you want antagonists with a high binding affinity, because that makes it easier for them to displace other ligands from the receptors - this is the whole point behind finding a better alternative to Naloxone.
Naloxone and anything that contains it will reverse the effects of opiates but it also causes someone to shift into immediate withdrawal called precipitated withdrawal. So some people get mad even though someone saved their life because although they will no longer die they also feel like they are going to.
Only patients that ever tried to hit me were those we had to hit with Narcan, and heatstroke patients. Oh, and one alcoholic Romanian woman who by the numbers should’ve been brain dead her blood alcohol was so high. She was awake and angry, fighting with all 100lbs of her might. Kept her for 18 hours until her BAC dropped, she was waiting for her hubs to pick her up, went outside our ED doors to smoke a cigarette, looks at the cigarette, then the police officer standing 3 feet away and launched herself Onto his back and started hitting. She got tazed, we got her back as a patient…. It was an odd night. I hope she’s doing better now.
Precipitated withdrawal entirely depends on how much narcan is administered an how much opioids are in your system, I've been narcaned a few times and most of the time a single nasal spray only gets me to wake up, but ill still be mildly high.
Hmm. I worry a little about the really long-lasting naloxone replacements. Would they not throw you instantly (and for weeks) into opioid withdrawal? And force you to cold-turkey your favored (and possibly only effective) painkiller? Those situations sound . . . not great.
Absolutely, this could result in fewer people actually calling for help. Full-blown withdrawal W/O relief from Suboxone or Methadone due to the blocking effect would be hell. Saving lives is important, but so is their quality of life during recovery if we want successful outcomes. I could see this being used as a blocker like Naltrexone after they are fully weaned off Opiates to help prevent relapse.
I feel what you're saying, but opiate withdrawal, although very uncomfortable and at the time is horrendous, compared to methadone, benzo or alcohol withdrawal, it's a walk in the park. 4-7 days max. With benzos and alcohol, withdrawal has the potential to be lethal. It can last weeks as well. I ended up using heroin again, to get off methadone! How crazy is that? Clean now due to a variety of bupeonorphine, which is administratored under the skin, called Buvidal. It works. Take care and good vibes sent your way.
@@addiegraves3 Have you heard of Buvidal? That's the name in the UK . Probably different in the US. But recent trials here have been extremely successful. Was trialed during the pandemic and since then it's offered to users, in areas lucky to get the funding, but I can speak of its life changing/saving effects personally. After decades of the usual in/out of treatment with methadone(my opinion, worse than heroin) subutex, lofexidine, only Buvidal has made any significant impact and I stopped overnight. No cravings, on top use, nothing. Imho, a wonder drug. I appreciate everyone's different but 6 months ago I never saw me being where I am now. Never. If you work in this area of social care, I have nothing but love and respect for you. Bless.
@siheard4206 Congrats on your sobriety🙂 I agree with your comment except for the length of severe Opiate withdrawal symptoms for others including myself it lasted weeks. After I entered MMT it took 6 weeks to get to a stable dose. Thankfully I was successfully able to slowly taper off Methadone and have been sober for 8 years now. Depending on the person Methadone tapering can be difficult like you mentioned. Keep up the good fight 💞
Naloxone actually can cause pulmonary edema with higher dosages and after giving it to patients who have been given it in the past. It should be only given if the patients are not breathing as it is a last resort medication.
@SciShow The 'end of video' links appear about a minute early, blocking the images in this video from being shown. Unlike subtitles, the viewer doesn't have a way to remove the links to see what is behind them.
I volunteer at a place that distributes nasal and injection naloxone. I always recommend the injection unless someone really thinks they'd freeze up if they had to poke someone. The injection gets directly to the muscle, where the nasal spray has to go through mucosal membranes first.
@@kashiichanyep, chronic pain patient here, been on some kind of opioid for nearly 20yrs, now on fentanyl patches with sevradol (morphine) tablets for breakthrough pain. Never felt any "feel good or high" feeling and I don't experience any drowsiness. I don't have the majority of withdrawal symptoms either (had a few occasions when changing meds where I had to come off 1 med 100% before trying another and times when accessing repeat prescriptions had issues). If it wasn't for my pain levels increasing I would swear opioids did nothing for me.
@@Just.A.T-Rex But you understood what they meant by it, and it got the message across so what's the point of saying that... The average layman isn't going to know the difference. I know this information as well, but I don't go around correcting everyone about it. Time and place, my guy.
it's still gonna be extremly expensive if we are still using the non injectable mechanism made by the Israeli pharmaceutical company from a $1 to over a $100 for the same dosage again it's not the meds that is patented which causes the primum price, the moral mechanism was patnented
I take bupe i had a pain specialist suggest it for me because i have severe nerve pain and was on lortab about to move up to something stronger ive been on the same dose for a decade ajd it works for me. Its very uncommon here in the states to use it for pain but i think it should be option one for long term pain patients
Im on bule too, totally different reasons lol but that makes sense it would be used as a long term pain management option. The half-life is enormous, the ceiling effecr helps prevent ODs.
In the UK bupe is preferred over other opioids. I have multiple chronic problems which cause pain. After tramadol they tried me on bupe but I had an allergic reaction to the patches so they reluctantly switched me to fentanyl patches which I've had no issues with except some brands just don't want to stick to my skin. That was over 10 years ago and my previously "moderate" dosage is now the "highest" dosage my pain management consultant can prescribe, which is insane as I knew people from the pain management course I went on who had much higher dosages than I. Lost touch with them so I don't know if they were made to reduce the dosage but I do know that I am always "encouraged" to switch to something else, like in April this year i trialed zomorph (oh the digestive issues! 15 days not passing anything, couldn't even fart! ) was begrudgingly allowed back to fentanyl patches after they cut my zomorph dosage equivalent in HALF compared to the fentanyl dosage and it still didn't make a dent in the digestive issues! Just left me in significant pain 😢 For those that bupe works for, it's great, plus patches last 5 days Vs mine only 3 days so less management needed. But for those it doesn't work for, being on fentanyl patches make all medical encounters difficult because you're treated like a junkie, despite it being prescribed by a pain management specialist and reviewed annually despite having chronic, degenerative condition (s). I had an MRI where I had to remove my patch, despite it being covered in tegaderm film/ second skin, not because of it having complications with the MRI machine but staff being nervous about potentially having to touch me if an emergency occurred. I was wearing film covering the patch that was attached to me, there was no risk and I wear my patch on my upper thigh/ hip area under my underwear that I was allowed to keep on. Id just put a new patch on that morning, so doing this wasted 3 days of meds and I had to request my new prescription early which requires explanation why, I did ensure that I was given a letter stating I had to remove the patch for the MRI to give my doctor to get my prescription earlier because they are ON IT when it comes to scheduled drugs here.
I surprised myself one day when I was really stressed going to a writing exam that I wished I could take an hydromorphone(Dilaudid) pill. I had gotten some practically one year before because I had my four wisdom teeth removed and two needed to open the gum and break the tooth piece by piece and removing the pieces.
Muscle injection sounds like a job for an epipen. It would also be more familiar as a "uh oh, something bad is in my body and this will fix it" kind of thing to people who might be less educated about this stuff.
In colorado you can ask the pharmacist to write a script for you for generic Narcan and we can run it through insurance to help with cost. No need to see a doctor and most insurance will cover it or at least some of it.
It sounds like there may could be some promise for these drugs. However, addicted individuals may continue to opt for the high at risk and choose not to use antagonists if the antagonist will prevent them from experiencing a high at the next urge, which will likely be very soon. Since the high is of significant importance a methadone alternative may be better suited to users. I hope that developers are taking use behaviours into consideration and not freely using resources in the name of science.
In many places you can get Nalaxone kits for free from pharmacies or nonprofits, along with simple training on how and when to use it. Anyone who lives or works in an area with a lot of opioid use should consider carrying it.
Even considering it was only between 1996 in 2014, and only in the United States. I am absolutely certain 26,000 people is a gross underestimate. And I am so grateful for how easily Narcan is to get now. Absolutely everybody should have at least 1 on hand.
The nasal spray method available now is not so great, best to have a backup. I was literally putting off make a batch of naloxone kits and saw this video instead. Haunting my conscience into doing that next. Glad harm prevention is becoming normalized in culture.
Watching people wake up from narcan is so trippy. One second they’re slumped and look like they’re just going to nod off next second they’re projectile vomiting before they stand up like nothing ever happened
In Quebec we can get naloxone kits for free at the pharmacy. Any time I have a party, I keep one nearby. You never know what people may be taking (and sometimes they don’t really know either - until it’s too late!) Life-saving!
Correction: narcan CAN hurt someone. Little known or advertised adverse side effects of narcan if administered incorrectly (IV slam) or in unnecessarily great quantities (i.e. the over zealous LEO that administers 16mg+ IN in 2 minutes before EMS arrives): flash pulmonary edema. Pt goes from respiratory distress/failure due to over relaxation of the sympathetic nervous system to respiratory distress/failure drowning in their own bodily fluids.
So, if it blocks the receptor for up to 28 days, does that mean an overdose reversal would mean the user can’t get high for a month? Would they still go through withdrawals at that point? Can this be used to get people off the stuff, not just reversing OD. Many addicts would rather use, than go through withdrawals.
There is a website (can't remember the name) that will send you two doses of Narcan, two fentanyl test kits, and a mouth barrier - all for free. Where I live, Narcan is available at the pharmacy but it costs money.
Yes, if there's no other options then it is useful. Someone with a low tolerance might not be a good idea in that case however. If they're a regular user of strong opioids then there shouldn't be any issues with respiratory depression getting worse with buprenorphine. You could potentially give it intranasal or intrarectal dissolved in water for faster onset. You do not need a lot of water. Naloxone will also be much more bioavailable also.
Would be cool to see you do a training block with weighted pull-ups and weighted dips. Also you could even experiment with building a decline/flat deficit weighted push-up setup with either rings or paralletes. It’s a tricky thing to set up but should be extremely effective chest exercise on paper in terms of ROM, stability (with paralletes instead of rings), stretch, and shoulder friendliness. You might have some innovative setup design if you thought about it, you seem like that type of guy. Also, considering how much you like converging chest press machines, you could try doing ring pushups with the strap hanging points much wider than shoulder width. The diagonal strap angle creates a converging force vector. I’ve never used a converging machine so I’m curious how you think it compares.
I wonder if having Naloxone alternatives that last longer are creating a significant risk of turning OD emergency into a different emergency related to detox symptoms. My assumption here is that the people (especially heavy users) would need monitoring for the entire duration the new drug is working.
God, imagine getting those antibodies to opiates that last a month and then getting in a car wreck or something a few weeks in. Everything is broken and no standard pain management is going to work (I don't think you can flood out the antibody with a high enough dose. Can you?).
I could be wrong but there's plenty other non-opiate pain treat out there. i have friends that are in recovery and have no trouble any time they go to the dentist or get other pain management and they do it all without opiates.
@@sunnyquinn3888 good question. I never understood that about the USA. In Germany, for example, it is really hard to get an opioid prescription. Only if other analgesics and/or steroids failed, or wouldn't work for specific pains, will an opioid be used.
@@lunakat__ I'm not familiar with any. I mean, there is Toradol for sure, but that can't even hold a candle to opiate relief for major stuff except in very specific situations. They may just suffer through it with just something like toradol if you can't ask them what they get.
@@lunakat__have you ever had an infected rotting nerve in your mouth? Or been in a serious car crash? Not even oxycodone really helps let alone an nsaid, the only thing that would help besides an opioid would be a dissociative, but they don't really give out ketamine for pain.
as someone with chronic pain, I really don't like the "were talking life ending pain here" comment. whether your life is actually in danger or not has nothing to do with how horrible the pain you have to endure is, and it is imperative that patients have access to pain medication that helps to alleviate that pain whether or not it is caused by something life threatening.
CVS might charge upwards of $150 for a single dose of naloxone if you're uninsured. Most insurance covers it completely, and it's also free from any harm reduction organization or at many cities' departments of social services. If you use, know someone who uses, or live in an area with a large addict population, get some, keep it handy. It has saved tens of thousands of lives, many times over for a lot of addicts. I work in a nightclub and we keep it stocked in multiple locations around the building.
How do these opiod antagonists affect the pain-relief offered by opiates, or even of our own endorphins? It seems like a shorter-lived antagonist would be better because it would block the acute side effects but still allow pain relief with subsequent doses, or for endorphins to do their job. (Assuming the reason for taking the opiate is pain relief and not just to get high.) My understanding is that one of the reasons its so difficult to wean off opiates is that they suppress our natural supply of endorphins, so we end up with nothing activating those receptors and offering even miniscule pain relief. So pain tolerance is way down, pain threshold is way down, everything hurts and feels terrible, and the symptoms of withdrawal are felt even more acutely. Would something that completely blocks these receptors (especially for days or weeks at a time) create the same side effects? I don't have any experience with it, so I'd really be interested in finding out.
I have nerve pain so severe that it's made me OD on Ibuprofen just to get it to stop. Opioids are its ultimate kill switch, which for me indicates I should NEVER take it. It sucks so much that the only medications that work for me are highly addictive. I was told at some point that cone snail venom was being investigated for a non-addictive alternative to Opioids, but... I haven't heard about it in a while. Right now my "Flare up kill switch pill" is Diazepam--I know, another highly addictive substance. But the difference is it doesn't get rid of my nerve pain entirely. It just brings it to baseline, which thus far has staved off any addictive habits. I just wish there was medicine out there that eradicated pain without such dire consequences like Opioids have. It would make such a tremendous difference in my life.
I go to a place helping me with alcohol, they treat all addiction and they gave us narcan just in case. I’m glad I’ve never had too use it but I’m glad I have it in case I run across someone who needs it.
Antibodies that bind opioids (like CSX-1004) can't directly reverse the receptor binding of an agonist, because they cannot cross the blood-brain barrier, so they still rely on the agonist leaving the binding site on its own through good ol' thermodynamic entropy. This could be problematic in substances that bind very, very strongly to the receptors, since those will take their sweet time to dissociate again. Antibodies could be very well suited for relapse prevention after the PT has had a controlled withdrawl though, as they prevent the effects of freshly ingested agonists. The greatest potential issue of these ABs are cost and the potential of acting as haptenes in combination with the opioid they bind to. Repeated ingestion of said opioid may then cause an allergic reaction (anaphylactic shock!) towards the [antibody-opioid] complex.
I have been on long release opioids for 4 years. When I was taking oral pills they never offered narcan. When I was switched to fentanyl patches the nurse brought a narcan kit. He taught me how to use the patch and then the narcan kit. It sit on my bedside desk but i have never used it.
Unless I'm misunderstanding something, this is a very poor advocacy for buprenorphine. While it for sure is an amazing drug, it is slow acting and not effective for pulling someone out of an overdose. It is odd to display it as a 1:1 to Naloxene(narcan) as their use cases are different. It takes ~1 hour or so for buprenorphine to even start working. It's use case is usually as a preventative measure if someone does use opioids. However, it is more useful for rehabs/outreach programs/doctors because it would be very difficult to convince an active addict to take a pill/patch every morning that would hinder their ability to get high and it can not be used in an emergency to pull someone out of an overdose, which is how naloxene is used.
The nanoparticles needing to be an intramuscular injection isn't really a problem, we already have the technology for people to easily and safely give an IM injection with epipens. It working 30x longer could make a big difference with fentanyl overdoses in particular.
Most people dont want to get clean because they are scared to death of withdrawls, especially with fentanyl withdrawals. We need new mediciations to help get off opiates without experiencing withdrawals. Suboxone doesnt cut it anymore for whats on the streets, having to wait up to a week to take it.
Preface, im not a doctor or anything related, but an issue i thought of (again idk, im not a doctor, i just thought of it idk if it is an actual issue in practice) is that with substances that block stuff like fentanyl for weeks or months or whatever, is the fentanyl is used in surgery all the time as part of the anasthesia because fentanyl is so fast acting, if it is blocked then issues could arise during emergancy surgerys and having to substitute drugs for (potentially less effective/appropriate) other drugs
i was kind of hoping, i would hear something about mytrangia speciosa. Kratom is pretty new to the USA, and it has been shown to act as an analgesic, and an antagonist in some efforts, but the science is super scarce.
Well, I hope that they do one thing better than Narcan, which is to make the packaging smaller. I have carried it but the box says not to remove it from packaging until you need to use it, and the boxes are large and I can only carry it when I have a tote bag. Would be much better if they made the portable nature more useful.
The primary concern with these approaches is their inability to effectively restore the regulation of opioid receptors within the brain. Consequently, patients remain vulnerable to opioid discontinuation syndrome, which can persist for an extended period, potentially lasting months or even years after cessation of opioid use. Many individuals affected by this condition report an overwhelming inability to experience joy or motivation in their lives. Essentially, it becomes challenging to revitalize the reward system in a brain that has come to rely on opioids as an integral component of daily existence. In the absence of the "pleasure/joy" stimulation triggered by opioid chemicals, patients are left with a significant void in their lives.
Now I'm curious to see what my surgeon gives me. I'm having a combined surgery on my wrist and hand this Friday. I was told I would get pain meds after it.
I was literally about to say I "wonder if we could basically make a vacinne style medicine that prevents the attachment in the first place" and lo and behold.
Yeah the "vaccine" for opioids is a bad idea, as are super long-term overdose preventions. Others have said it better, but basically, people will be made to take it for jobs, housing, etc, and that means that if they need surgery or get in an accident? Good pain killers will be useless. I understand that it'll do good, but it'll do a hell of a lot of bad, too. (Like the current opioid panic - many people with chronic pain (including terminal cancer patients) have been forcibly taken off pain killers or not been allowed in the first place. They're turning to street drugs for pain relief, because what else are they going to do? I got removed from an opioid pain program because I didn't need refills often enough. Because the govt limits how many pain patients physicians can have, so they only keep those who get them the most money. It took me three more pain clinics to find one that gives anyone besides terminal patients pain medication. I am bedridden from a herniated disc, documentedly. None of this is cut and dry.
This is fantastic. Now can we please do a video on fentanyl test kits? The science behind how to test othet recreational drugs for fentanyl contamination? We act like no one ever does any drugs for fun, but they do. But because it is all on the black market there is no quality control and so regular members of society, people who do not have any sort of drug addiction, are dying from fentanyl overdoses because some was accidentally mixed into the bag of cocaine they got
Heroin addicts told me independend of each other that in case of a OD "they" give you some horrible stuff, wich makes you unable to get high for quite some time. 1 or 2 days, i think. They had no doubt this would be to teach them a lesson because of the OD. 2 of them told me what exactly this nightmarish substanze was called: NaCl. I was first confused, but i guess that if the OD than they get also a infusion with sodium chloride solution, wich is labeled "NaCl".
1:25 morphine does not work in a "similar" way to endorphins. Morphines is literally an endorphin and this is well documented at this point. It is believed that one of the metabolites of heroin (3-monoacetylmorphine) may also play a roll as an endorphin, though this isn't as well studied due to heroin and it's metabolites falling into schedule 1, or it's equivalent in most countries (the UK being one big exception)
@scishow Your molecules of morphine and naloxone were reversed in your part of your presentation. Lots of mixed up presentations, but I like yours because they are usually accurate. Please keep being the better source (and by that I mean to just be more mindful, and then you'll be perfect).
When my doctor prescribed morphine for me, my pharmacy included two doses of Narcan. I've never needed it, but I'm glad it's there.
@@caroljo420 Sweet, if you're not using the morphine can I get it off you?
Out of curiosity, do you mind me asking the reason you got it prescribed? No judgement! It's just that Im from Michigan where we were hit reallyyy hard by them, and in reality still are, but they have been prescribed much much less, and no longer offer it for wisdom teeth removal. Was just curious what it's like in other areas, because I know even doctors downstate in areas are much more liberal with prescribing them than most where I am from!
ps: coming from someone who's lost a friend that was taking oxys then OD'd on Heroin shortly after, then watched my other friend months later turn purple on the floor, trying CPR to then rush 100mph home to grab narcan only for him to need NINE more, swallowing the hardest pill that ive ever taken, which was knowing that ill never be able to hangout with him again, otherwise our crutch would not create as we intended, yet destroy, leaving both of us dead... And who's uncle has been on every painkiller known to man due to >30 surgeries, yet still had the want and will to get off Oxycodone and Fentanyl patches (BOXES of them he had, no joke)...
My friend who Od'd he moved to cali and is FULLY RECOVERED NOW!!! Me: I isolated myself to reset my mindset, staying home from anyone my momentous, poisonous habits could negativtely impact. My mind was replaying the visual of the scene over and over, and how sickening the horrible feeling of pain,, guilt and lifetime of unshakable dread knotted my stomach as I waited for an eternity before being carried away still unresponsive, not knowing... A feeling you wish that NO person should EVER have to feel... It was a cut so deep that if I were to run, I would bleed out. I couldn't push it away. So I let it overcome me when it came over me, because it wasn't the problem, it was reality, in which I was the problem, and it was now the teacher.. I sat, I listened, I watched, I took it as a teaching, as a chance for change and as a reminder to how bad it pained my heart, so so deep to the soul that it would bring monumental change to what I was living.for. I ended up getting the best job I couldn't ever have even imagined. Outside, detached from society,, working and connecting with the beautiful forest and wildlife surrounding me, and with each second healing me more and more, these realizations were given to me from everything around me I was connecting with, about the countless flaws in the way which society nowadays operates, I could see the hindered areas in where the line of the transfer of energy from thing to thing in society were un natural, therefor being entropied and lost. Society no longer remembers the last part of our name: "human BEING", we've become so disconnected from nature and focused on racing to and hyper fixating on an illusion of something un-feasible, and only practical to societal norms taught to us, not in reality, therefore dis-communicating us from our inner knowings that are given to us from when we are connecting with everything all of the nature around us, not some job we don't even know what the end goal is. I soon found out from an older coworker that I was connecting with nature in the same woods my grandfather used to do research, which I had never even known, driving past the wolf cage he brought in and acclimated wolves into before introducing them to the population as a research experiment. And the same woods which now hosts researchers that very frequently when I run into and introduce myself, they becomes enjoiced to realize I am his grandson, exclaiming how amazing and how proud he would be of me, and tell me just how impactful of a person he was, and the reason their interest was sparked to become biologists... such a full circle thing, I still cry thinking about not knowing how long reaching of an impact we all may make yet never see after we are gone...).
------- now I am someone who keeps a narcan with me, because you never know what future or impact might not happen with out it. Now I am someone who my struggles have given me a new opportunity and have bestowed a newfound love and fascination for chemistry. I am learning as much as I can about as much as I can in this world, in hopes to one day make a change and possibly help save lives in as many different ways and areas I possibly can. I now view the world through a completely different lens, and my mind has completely changed to view things in very different ways than I ever had before. Everywhere I look, I now see the entire chain of interactions of everything involved in it, and the outcomes of how it all affects each other. Im not working to make money, Im living to make change.
Im sorry I wrote a damn book!!!
But if there is anyone going through some struggles right now, know that you never can see what amazing opportunities are awaiting to be rewarded to you right around the corner!
And that with time and life, one day you'll realize that the understanding of beauty in life comes from struggle! And all of a sudden without knowing, you've learned to seek it and to love it painlessly, because thats were true progress and change for this world comes from.
I don't take any narcotics, but I've thought bout getting Narcan just in case I stumble across someone in overdose.
@@caroljo420 That is one progressive pharmacy.
narcan is the most dangerous thing ever created it make you think playing russian roulet is safe with opoid it need to be made iligal so people see the reality of opiod and if they that take them let them face the danger by themself helping thosse people is a waste.
Mad props to SciShow for informing about harm reduction and, while not promoting drug use, also not having any judgment toward those who use or are suffering from addiction. I love this channel.
You switched the morphine and naloxone molecules at 4:00. The top one is morphine and the bottom one is naloxone.
Flex much?
@@seanevertts2735 what do you mean
nice catch!
@@seanevertts2735 I've always wondered why people are like you are, are you mad that people are more knowledgeable than you? Don't worry I bet there is something you know or can do that @BZCSquadron can't do, it's all good.
It is scientifically funny that our human editor made the same mistake as the opioid receptors, mixing up those molecules :)
The last time my mom was discharged from the hospital, she was given a handful of packs of Narcan along with her pain med scrips. She was very responsible with her pain meds and didn't end up using any of the Narcan, so we gave a couple to a family friend who's a known user and donated the rest to a local substance abuse clinic.
At least in Arizona, you can get free doses of narcan from the pharmacy (walmart for sure at least.)
My mom was really surprised about getting the naloxone when she got her pain meds. I don't think she was quite ready for my husband and me to have a strong reaction about making sure she (or ideally my father) knew how to use them BEFORE that could arise.
I was a heroin addict for years and Subs only kept me sick. What really helped me was Vivitrol Injections once a month. Vivitrol is an opiate blocker. Couldn't get high even if I tried. Saved my life. The chemical that his video was leading up to reminds a lot like Vivitrol. You do have to be clean from opiates for 7-14 days before injection or you risk sever withdrawal symptoms. The time before the shot is the hardest part and where most people back out or go for the pill form which can easily be mistaken which then opens your receptors back up. I know a lot of rehabs offer Vivitrol before they discharge you.
Precipitated withdrawals are terrible
Thanks. And more info: "Vivitrol is an extended release formulation of naltrexone, which is an opioid receptor antagonist." [Psychiatric Research Institute}
also great for alcohol addiction
@@2000Peaceouttrue. I've been on vivitrol for alcohol misuse for over 4 months now and it works really well. I have no desire to drink and it's much easier on the liver than oral naltrexone
Suboxone saved my life. My dose is 1/4 what I started at 6 years ago
I’m a home health nurse (I specialize in geriatric care). I ALWAYS encourage my patients to have Narcan on hand because accidental overdoses happen! I’ve had patients double up on their meds, I’ve had spouses accidentally take the wrong pills, I’ve seen pain patches break open etc etc
i’m a middle school teacher and got narcan a few years ago just in case. the new school i moved to last year is in a rough neighborhood, so i taught my advisory kids what it was and why it was so amazing. i found later that a few students had family including parents who had ODd, and lived in places with a lot of drug use. a few of them told me they were able to convince someone to get some for themselves/for the kid to carry with them. some states have free distribution programs which is so amazing
I believe Minnesota actually passed a bill to stock every school with atleast two doses of Narcan
I was a firefighter for 38 years. Thirty years of that time I spent many shifts working on an advanced life support ambulance. On more than one occasion we had overdosed patients that were very angry because we ruined their high by administering Narcan. Never mind that they weren't breathing when we arrived.
It doesn't only make you no longer high and then you are angry about it. It legitimately makes you angry all on its own. Think about all the feel good chemicals in your brain are suddenly gone... Yeah you're gonna be at least irritable. Sometimes people don't even know WHY they are angry and just direct it at the most obvious thing. knowing their high is gone, and they're angry, they connect the two. Not denying that there aren't assholes out there, but sometimes it's legit something a person can't help.
An old coworker once told me about his friend who crashed his car while overdosing on opioids. When the EMT arrived, he was conscious enough to say, "Don't help me. Just let me die. This is what I've always wanted," before dying shortly after.
He suffered from depression and anxiety his entire life from childhood trauma. Opioids allowed him to run from the feelings that haunted him indefinitely. Some people don't want to stop dreaming.
My sister was angry at me for calling emergency services when I found her blue with a needle in her arm. The 911 operator had me blowing breaths into her mouth for what felt like forever but was probably only about five minutes. I've never been so happy to see firefighters in my life .
If you're administering Narcan as a first-line treatment for opioid overdose while working ALS, then you kinda had it coming.
It's great for the public, though.
@@JohnnyWishbone85 What an ignorant comment
Nanoparticle drug administration is so fascinating. I went to a lecture from one of the leading researchers on the matter, and it was riveting. Great to see the tech being put to use
has it been tested for safety?
Hi, I'm actually a ungrad working in a lab working on kappa receptors and longer term opioid receptor antagonists. I love how you guys summarize this topic and it'll be nice to share it with people when they ask what I'm working on.
Only thing I wish you guys would improve on is clearing up the references and make it clear which one you are referring to at various points. (I've seen other science communication channels put a little R1 or whatever in the corner when they mention a source).
Anyway, love this channel and how it's evolved over the years. Keep being awesome. ❤
Research ibogaine. Get your company to as well.
I was saved by naloxone and 3 adults beating my chest cpr.... I swear after being revived I still felt the opiates... it was laced with fentanyl.... been sober 5yrs.... kept my moral somehow... I'm very lucky and need all police to carry reversal drugs and people that know active users.
Here's to your life remaining suitably fulfilling and you having the strength to get mental health support when it isn't.
Best wishes to you. ✊
I'm glad you're still with us and that you did yourself the best favor and got sober. I hope you are living well ❤
Folks like you are rare success stories. A diamond in the dirt. You ought to pursue a career in helping even if it's speaking at meetings but you may be eligible for school grants to become a counselor or even a doctor. Don't underestimate your power you are already beating the odds.
Congrats on 5 years, that's a lot of 24 hrs 👏 ... My sobriety date is Dec 25 2008.
Glad you got clean! Thats a lot of hard work, congratulations!
I carry narcan with me nearly everywhere i go. I am a former emt but civilian narcan training is available.
That’s really cool!
I carry narcan and a face mask as well. It’s really a necessity
I'd also carry a defibrillator everywhere I go, but they're too big to do that.
Is narcan available for free? I was thinking of carrying some but its $70 here
I work in a pharmacy. I noticed a pharmacist I worked with had naloxone with her, and in the last weeks, a social worker and someone else that worked in a neighborhood susceptible to overdose, come in to ask for naloxone, in case.
Depending on the circumstances, you might not want a long-acting antagonist. Naloxone has a wide acceptability among opioid addicts, precisely because it lasts such a short period of time - hopefully long enough to get them through the acute emergency, but which is going to allow your heroin, or fentanyl or whatever to start working again. If you give someone something which lasts days to weeks, you are putting them into a cold turkey, they can't be released from. Any addict is going to think twice, before doing that to their friend, maybe causing a fatal delay. The agents in the second half of the video, are addiction treatments, not really overdose treatments, at least no more than 'Just Say NO!' is an overdose treatment.
Psychedelics are just an exceptional mental health breakthrough. It's quite fascinating how effective they are against depression and anxiety. Saved my life.
Can you help with the reliable source I would really appreciate it. Many people talk about mushrooms and psychedelics but nobody talks about where to get them. Very hard to get a reliable s0urce here in Australia. Really need!
Yes, blizmyco. I have the same experience with anxiety, depression, PTSD and addiction and Mushrooms definitely made a huge huge difference to why am clean today.
Is he on instagram?
Yes he is. blizmyco
Microdosing helped me get out of the pit of my worst depressive episode, a three year long episode, enough to start working on my mental health.
I am glad you mentioned the buprenorphine breathing issues. It can seriously depress your breathing all on its own.
Its respiratory depressive effects have a ceiling unlike full agonists.
And it was designed to be far harder to kick than a short acting opiate creating life long customers for the big pharm.
@@lemonz1769 So its not more effective past a high enough dose? I've been wondering about that for years
It only activates the receptors to a certain degree and taking more does not stimulate them more.
@@Greger88 thanks. Its been next to impossible to get a straight answer about that.
I was prescribed naloxone along oxycodone after my surgery! After I was done taking the opiods, I gave one of the sprays to my friend who (unlike me) attends parties where drug use may be present.
I work in the recovery field after a lifetime of heroin addiciton - we go through a lot of naloxone and have all been worried about nitazines, fent analogues, and some rediscovered ultrapowerful opioids hitting the street.
A naloxone analogue with increased potency would be ideal. Using immunity sounds great if you don't think about all the negative effects that would have on your body. You have those receptors because your body uses them to signal and carry out different processes. Blocking everything from binding to those has me very weary.
I think in this case you are adding ready-made antibodies rather than provoking the body to make them. So they would be cleared from the body, hopefully before the patient needs any pain-relief in the future for surgery or whatever.
The lack of antagonists for nitazines and adulterants like Xylazine is terrifying.
As someone who is in recovery and harm reduction too, keep up the good work you are doing. It's priceless.
The main problem with buprenorphine is that only medical professions could use it because a nasal spray would be much more dangerous than current formulations to people that don't have a tolerance and it's a controlled substance. It also has a very long half life (more than 20 hours) which is the exact opposite problem of naloxone (60-90 mins). Naloxone wearing off before the drug that caused the overdose is both a plus and a minus. Precipitated withdrawal would take much longer to pass and that can cause it's own problems.
They will give it to you free at any drug store or doctors office or hospital.
@@philbert006not buprenorphine spray, that’s nalaxone spray that’s widely available
My sister is an EMT and suggests making sure you have dodge space when giving narcan. Some of the patients have been angry and combative coming back to awareness.
Yeah because you 'took away their high' don't be expecting to be treated like the hero you are if you save someone from ODing.
Stay out of the vomit splash zone aswell 😅
Also projectile vomiting 🤢
This is a very rare response, to be clear. I know folks who've done this work 30 years and never had someone wake up aggressive. Don't be afraid to give narcan because of this.
35 years ago, before naloxone was available, I gave CPR to someone I found in a stairwell in my block of flats. He had stopped breathing but when I pushed air out of his lungs he said "stop pushing me". I heard he died from another OD a couple of months later.
The problem with Buprenorphine is that it still acts too strongly as an agonist and can cause respiratory arrest in opioid-naive people (folks without tolerance and dependence) on its own.
Use naloxone in the field and buprenorphine in the ED
@@lemonz1769an opioid dependent person has to wait 24 hours before taking buprenorphine or else they get precipitated withdrawals which is horrible. Buprenorphine has a very long half life so they’d be violently ill for upwards of twelve hours if you administer buprenorphine before the other opioids leave the receptors of an opioid dependent person.
Why is no one talking about PW's? I wouldn't want to take any suboxone for at least 16 hours. Wouldn't taking it right after using f you up?
@@twiggz1000 When Buprenorphine is carelessly used on a person with marked opioid dependence (doesn't have to be addicts, it's also a thing in pain patients), it'll catapult them into WD aswell.
The proper protocol for this is tapering the original drug before switching the pt over to Buprenorphine.
@@twiggz1000 at a lower dose it will throw someone with dependence that recently used into withdrawal, but at higher doses it will act as an agonist and prevent withdrawal AND overdose from the offending agent since it has a higher affinity for the receptor than full agonist opioids/opiates.
Many years ago I and miles behind, I was working in Central Africa for The Red Cross, it was basically treat everyone they throw in front of you. Any way this bunch of American Soldiers, rushed in waking me up to treat a guy who'd stolen all the morphine sterets, in his units emergency supplies. So I got the Naloxone into the dude, who, in three or four heartbeats sits up, calls me a nasty word CZcams will take umbrage at, and tried hitting me. So I gave their unit medic a supply. And their warrant officer wrung the dude's ear until he apologised. I glad to see the back of them. I got a sense that they were lightening rods for trouble and wanted them out of my general vicinity.
Wonder what American soldiers were doing in Central Africa... lightning rods for trouble indeed.
yep. Narcan in high doses will shut off their high in a heartbeat, and they wake up furious. experienced people will get just enough into them to get them breathing again, until they have them in a controlled environment, where they can decide whether to leave them asleep until the opioids wear off, or give them the rude awakening.
@@Nwmguy Possibly providing security for medical agencies like Red Cross.
@@kenbrown2808 One thing to remember though is the reason why they're upset. They're upset because they're in pain. Naloxone is incredibly efficient at what it does so when it's given, it resumes that painful feeling a person may have overdosed from.
@ashiningsoul449 yeah, it kills the high.
4:00 the labels for Morphine and Naloxone are swapped. The top one is Mor, the bottom one is Nal.
@scishow. Thank you for tackling such subjects that Im sure most YTers would steer clear off for many reasons. Bless you guys.
Can we have a discussion about the legalities/morality of forcing long lasting opioid agonists on a patient against their will. Will that prevent them from getting potentially actually needed pain relief in the event of opioid necessary pain? Bodily autonomy?
I would love to see this research not only improve overdose reversal but also treatment protocols for addiction. It would be wonderful if we could help more people with substance use disorder before they overdose as well as those who want treatment after an overdose reversal.
Just some additional information: Naloxone is available dirt cheap as a generic - like less than 8 USD per vial(!) cheap.
These fancy nasal applicators like shown in the video thumbnail are sold in cities with rampant illicit opioid use and cost distinctly more than 100 bucks - for a single dose that may not even be sufficient to reverse an overdose, depending on the receptor binding affinity or the amount of the opioid the person took.
Why do they cost this much, you might ask. It's because the applicator is patented. This also means that no other company can provide the same or a similar thing in cheaper. It's absolutely disgusting how profit interests get in the way of saving lifes…
Available as a generic, but not OTC, right? Are there any cheaper OTC options available? I'd love to carry some just in case I find myself in a situation where someone needs it.
@@elisebrown5157 I'm not aware of any OTC options beside the patented nasal applicator. The cheaper options are vials and ampules for injection purposes.
Arguably, one could crack open such an ampule and pour some of the contents into an unconscious person's nose to achieve a similar result.
Pharmacists can sometimes hand over medicine without a prescription - depending on the legislation, it can be left to their own judgement, so maybe you'd get some ampules this way; otherwise just explain it to your physician and see if they're willing to help you out.
Esp. in the U.S., I doubt that they'd hand it over together with injection equipment though,
because even if it's for the purpose of saving another person's life, the phycisian/pharmacist could be held legally accountable for any damage may occur, which is just too much of a personal risk for them (people have already been sued for saving another person's life - be it civilians or professianals like nurses, EMTs and physicians…).
In order to circumvent this, maybe there is a compounding pharmacy that could make a nasal spray out of the ampule contents. It'd have a limited shelf life, but that's still better than nothing.
In colorado you can ask the pharmacist to write a script for you and we can run it through insurance to help with cost. Most insurance will cover it or at least some of it.
A nasal applicator is $22 if you can’t get it cheaper from a nonprofit (you prolly can)
it would be good to see an episode expanding on harm reduction and safe supply. drugs like heroin, cocaine and amphetamines are often dangerous because dosages are so inconsistent and the likelihood of other drugs being present (agonists and antagonists).
safe supply is available for other recreational drugs, namely alchohol which is responsible for 100,00s of deaths yearly. it is available with safety standards and labelling that ensures anyone wishing to ingest it knows how much they are taking.
The difference is alcohol is legal. You can't expect for them to regulate/label illegal drugs. Its ridiculous that they don't even have harm reduction/needle exchanges in many states. I'm a former MA user, and I was fortunate that my state does.( Only because the overdose rate is one of the highest in the nation.) They provided clean syringes and other tools, naloxone and fentanyl test strips(which don't detect amounts, just whether or not it's present) That's about as good as anybody can get and I was lucky to have access. Which is crazy because statistically they absolutely do work. Hell Im living proof that they do. Utilizing those services helped keep me healthy and safe(well, safer)during my active use. The people that worked there were really great too. They never judged me or made me feel bad about myself, and that is something that helps tremendously. I got clean and went back to school and im currently a neuroscience major, planning on grad school after I finish my BSc. Harm reduction works.
Nowhere on earth can you buy opioids OTC. That’s not how it works even in Portugal.
@@ferretyluv Codeine
Nothing useful comes from Heroin. Nothing. There is no safe supply, it is incredibly addictive and has zero benefits whatsoever. Opioids aren’t and should never be considered recreational. Ever. Yes, Alcohol is a dangerous substance but for all but the most grizzled alcoholic you pass out from alcohol long before you can reach toxic levels. Comparing alcohol and heroin is kinda silly.
@@ferretyluv That's absolutely false. You sound like a pompous a**, being arrogant while also being so wrong. Mexico for Tramadol, Lots of EU nations for Codeine, even in the US, you can buy certain opioids OTC, of which, loperamide, (Immodium being the brand name), is one of. While we're at it, let's talk about that one. There's a reason it's called "poor man's methadone". Doesn't mean you should go and abuse that one, though. At small doses it's fine with only peripheral nervous system activity and little to no psychoactive qualities, but the doses you need to achieve an effect in the brain, (where the intoxication comes from, starting around 50-72mg) give you a risk of cardiovascular issues, especially QTc AND QRS prolongation, syncope, ventricular tachycardia, conduction disturbances, all being more likely the higher you go.
I was addicted to loperamide for a good while but thankfully got off with minimal side-effects. My normal dose was 96mg every 2 days due to the very long half-life. Not recommended. At therapeutic doses, (2mg-16mg per day), it will help with diarrhea by slowing down motility of the gut. At supratherapeutic doses, the drug has typical opioid effects like euphoria, analgesia, sedation, respiratory depression, nodding if you take enough (a state of semi-consciousness), itching, et al. Increased risk of overdose in opiate-naive patients, just like regular methadone.
I hope you enjoyed my tangent, but next time, at least look something up before being so sure of yourself. You won't look as dumb.
In Canada we can get free kits from pharmacies, i don't do drugs but do keep one with my work 1st aid kit, luckily never had to use it.
i also recommend keeping some in your glove compartment in your car!
@@impossible_planetthe temperature swings in Canada make it so carrying in the glove compartment is not advised. Too hot in the summer and too cold in the winter, so we're encouraged to carry it with us in a bag to maintain temperature stability of the naloxone.
@@barbf5936 oh you’re so right!!! I didn’t even think about that! I live in a temperate rainforest where the temperature doesn’t fluctuate too much.
@@impossible_planetTotally wish I lived where you do - sounds fantastic. And yes, it would be nicer to keep it in the glove box! 🙂
Narcan can also safely be used on dogs! If a dog gets into opioids and is overdosing, narcan can save their lives while they’re on the way to the vet. I carry narcan for both humans and my dog, though thankfully I’ve never had to use it.
Thank you for including this info!
I love the editing on this video. Much easier to watch with out all those cuts between sentences. Great and informative!!
I lost my brother to overdose I’m glad it sounds like people still haven’t given up trying to help this epidemic.
Would love to see an episode on harm reduction! Also if you could point to any non-profits that help with harm reduction initiatives.
My EMT father always kept naloxone in the house and i never knew what it was until i was like 30. The gravity of the opioid crisis aside, methocinnamox is my favorite alien breakfast cereal.
I’ve been accidentally clean of opiates for a few months now. I was given Buvidal (burpenorphine), a monthly injection, until I went on holiday and wasn’t able to get it, since I was out of state. I didn’t start entering withdrawals so I kept putting it off, and fast forward three months, I’ve still not had any withdrawal symptoms. My doctor said that the last of the Buvidal will be gone by now, and that I’ve essentially weaned myself off it.
I’ve lost weight so my pain is better now, too. I’m so glad to be free of the curse.
i was just given narcan training for free by my workplace. very glad to have had that opportunity
4:10 is just wrong. Tight binding does NOT automatically equate to high effect intensity. What causes downstream effects is the shape the receptor takes, once the substance is bound!
When Naloxone binds, it forces the receptor into an inactive conformation (in layman's terms: "the receptor is turned off").
Btw you want antagonists with a high binding affinity, because that makes it easier for them to displace other ligands from the receptors - this is the whole point behind finding a better alternative to Naloxone.
Naloxone and anything that contains it will reverse the effects of opiates but it also causes someone to shift into immediate withdrawal called precipitated withdrawal. So some people get mad even though someone saved their life because although they will no longer die they also feel like they are going to.
Only patients that ever tried to hit me were those we had to hit with Narcan, and heatstroke patients. Oh, and one alcoholic Romanian woman who by the numbers should’ve been brain dead her blood alcohol was so high. She was awake and angry, fighting with all 100lbs of her might. Kept her for 18 hours until her BAC dropped, she was waiting for her hubs to pick her up, went outside our ED doors to smoke a cigarette, looks at the cigarette, then the police officer standing 3 feet away and launched herself
Onto his back and started hitting. She got tazed, we got her back as a patient…. It was an odd night. I hope she’s doing better now.
The only form of naloxone that doesn't do much of anything is oral form.
Precipitated withdrawal entirely depends on how much narcan is administered an how much opioids are in your system, I've been narcaned a few times and most of the time a single nasal spray only gets me to wake up, but ill still be mildly high.
Hmm. I worry a little about the really long-lasting naloxone replacements. Would they not throw you instantly (and for weeks) into opioid withdrawal? And force you to cold-turkey your favored (and possibly only effective) painkiller? Those situations sound . . . not great.
Absolutely, this could result in fewer people actually calling for help. Full-blown withdrawal W/O relief from Suboxone or Methadone due to the blocking effect would be hell. Saving lives is important, but so is their quality of life during recovery if we want successful outcomes. I could see this being used as a blocker like Naltrexone after they are fully weaned off Opiates to help prevent relapse.
I feel what you're saying, but opiate withdrawal, although very uncomfortable and at the time is horrendous, compared to methadone, benzo or alcohol withdrawal, it's a walk in the park. 4-7 days max. With benzos and alcohol, withdrawal has the potential to be lethal. It can last weeks as well. I ended up using heroin again, to get off methadone! How crazy is that? Clean now due to a variety of bupeonorphine, which is administratored under the skin, called Buvidal. It works.
Take care and good vibes sent your way.
@@addiegraves3 Have you heard of Buvidal? That's the name in the UK . Probably different in the US. But recent trials here have been extremely successful. Was trialed during the pandemic and since then it's offered to users, in areas lucky to get the funding, but I can speak of its life changing/saving effects personally. After decades of the usual in/out of treatment with methadone(my opinion, worse than heroin) subutex, lofexidine, only Buvidal has made any significant impact and I stopped overnight. No cravings, on top use, nothing. Imho, a wonder drug. I appreciate everyone's different but 6 months ago I never saw me being where I am now. Never.
If you work in this area of social care, I have nothing but love and respect for you. Bless.
@siheard4206 Congrats on your sobriety🙂
I agree with your comment except for the length of severe Opiate withdrawal symptoms for others including myself it lasted weeks. After I entered MMT it took 6 weeks to get to a stable dose. Thankfully I was successfully able to slowly taper off Methadone and have been sober for 8 years now. Depending on the person Methadone tapering can be difficult like you mentioned. Keep up the good fight 💞
Naloxone actually can cause pulmonary edema with higher dosages and after giving it to patients who have been given it in the past. It should be only given if the patients are not breathing as it is a last resort medication.
@SciShow The 'end of video' links appear about a minute early, blocking the images in this video from being shown. Unlike subtitles, the viewer doesn't have a way to remove the links to see what is behind them.
It looks like they've fixed it!
It looks like they've fixed this now! :)
I volunteer at a place that distributes nasal and injection naloxone. I always recommend the injection unless someone really thinks they'd freeze up if they had to poke someone. The injection gets directly to the muscle, where the nasal spray has to go through mucosal membranes first.
Opioids are crazy. I had morphine once in the hospital and I *immediately* understood why it's so addictive
Conversely, I've had morphine and fentanyl and oxycodone and never felt a 'high' at all. Bodies are so different; it's wild.
@@kashiichanyep, chronic pain patient here, been on some kind of opioid for nearly 20yrs, now on fentanyl patches with sevradol (morphine) tablets for breakthrough pain. Never felt any "feel good or high" feeling and I don't experience any drowsiness. I don't have the majority of withdrawal symptoms either (had a few occasions when changing meds where I had to come off 1 med 100% before trying another and times when accessing repeat prescriptions had issues). If it wasn't for my pain levels increasing I would swear opioids did nothing for me.
Morphine is an opiate not opioid
@@Just.A.T-Rex But you understood what they meant by it, and it got the message across so what's the point of saying that... The average layman isn't going to know the difference. I know this information as well, but I don't go around correcting everyone about it. Time and place, my guy.
I see you badge Stefan ✊ ❤
infinity? for poly?
@@elisebrown5157 Neurodiversity
it's still gonna be extremly expensive if we are still using the non injectable mechanism made by the Israeli pharmaceutical company from a $1 to over a $100 for the same dosage again it's not the meds that is patented which causes the primum price, the moral mechanism was patnented
I take bupe i had a pain specialist suggest it for me because i have severe nerve pain and was on lortab about to move up to something stronger ive been on the same dose for a decade ajd it works for me. Its very uncommon here in the states to use it for pain but i think it should be option one for long term pain patients
Im on bule too, totally different reasons lol but that makes sense it would be used as a long term pain management option. The half-life is enormous, the ceiling effecr helps prevent ODs.
In the UK bupe is preferred over other opioids. I have multiple chronic problems which cause pain. After tramadol they tried me on bupe but I had an allergic reaction to the patches so they reluctantly switched me to fentanyl patches which I've had no issues with except some brands just don't want to stick to my skin. That was over 10 years ago and my previously "moderate" dosage is now the "highest" dosage my pain management consultant can prescribe, which is insane as I knew people from the pain management course I went on who had much higher dosages than I. Lost touch with them so I don't know if they were made to reduce the dosage but I do know that I am always "encouraged" to switch to something else, like in April this year i trialed zomorph (oh the digestive issues! 15 days not passing anything, couldn't even fart! ) was begrudgingly allowed back to fentanyl patches after they cut my zomorph dosage equivalent in HALF compared to the fentanyl dosage and it still didn't make a dent in the digestive issues! Just left me in significant pain 😢
For those that bupe works for, it's great, plus patches last 5 days Vs mine only 3 days so less management needed. But for those it doesn't work for, being on fentanyl patches make all medical encounters difficult because you're treated like a junkie, despite it being prescribed by a pain management specialist and reviewed annually despite having chronic, degenerative condition (s). I had an MRI where I had to remove my patch, despite it being covered in tegaderm film/ second skin, not because of it having complications with the MRI machine but staff being nervous about potentially having to touch me if an emergency occurred. I was wearing film covering the patch that was attached to me, there was no risk and I wear my patch on my upper thigh/ hip area under my underwear that I was allowed to keep on. Id just put a new patch on that morning, so doing this wasted 3 days of meds and I had to request my new prescription early which requires explanation why, I did ensure that I was given a letter stating I had to remove the patch for the MRI to give my doctor to get my prescription earlier because they are ON IT when it comes to scheduled drugs here.
I surprised myself one day when I was really stressed going to a writing exam that I wished I could take an hydromorphone(Dilaudid) pill. I had gotten some practically one year before because I had my four wisdom teeth removed and two needed to open the gum and break the tooth piece by piece and removing the pieces.
Muscle injection sounds like a job for an epipen. It would also be more familiar as a "uh oh, something bad is in my body and this will fix it" kind of thing to people who might be less educated about this stuff.
In colorado you can ask the pharmacist to write a script for you for generic Narcan and we can run it through insurance to help with cost. No need to see a doctor and most insurance will cover it or at least some of it.
It sounds like there may could be some promise for these drugs. However, addicted individuals may continue to opt for the high at risk and choose not to use antagonists if the antagonist will prevent them from experiencing a high at the next urge, which will likely be very soon. Since the high is of significant importance a methadone alternative may be better suited to users. I hope that developers are taking use behaviours into consideration and not freely using resources in the name of science.
Narcan vending machines are becoming more common in pharmacies. I wish it wasn't necessary but I'm grateful for it.
In many places you can get Nalaxone kits for free from pharmacies or nonprofits, along with simple training on how and when to use it. Anyone who lives or works in an area with a lot of opioid use should consider carrying it.
Even considering it was only between 1996 in 2014, and only in the United States. I am absolutely certain 26,000 people is a gross underestimate. And I am so grateful for how easily Narcan is to get now. Absolutely everybody should have at least 1 on hand.
The nasal spray method available now is not so great, best to have a backup.
I was literally putting off make a batch of naloxone kits and saw this video instead. Haunting my conscience into doing that next.
Glad harm prevention is becoming normalized in culture.
Hello SciShow team, just wanted to say thank you for making me interested in science! Without you, my life would be very different.
Watching people wake up from narcan is so trippy. One second they’re slumped and look like they’re just going to nod off next second they’re projectile vomiting before they stand up like nothing ever happened
In Quebec we can get naloxone kits for free at the pharmacy. Any time I have a party, I keep one nearby. You never know what people may be taking (and sometimes they don’t really know either - until it’s too late!) Life-saving!
Ive had friends overdose on fent before and we didnt have narcan and gave them bupe and it worked thankfully
Correction: narcan CAN hurt someone. Little known or advertised adverse side effects of narcan if administered incorrectly (IV slam) or in unnecessarily great quantities (i.e. the over zealous LEO that administers 16mg+ IN in 2 minutes before EMS arrives): flash pulmonary edema. Pt goes from respiratory distress/failure due to over relaxation of the sympathetic nervous system to respiratory distress/failure drowning in their own bodily fluids.
Thank u..
I have cousins who are recovering from heroin and fentanyl addictions. They suffered a few overdoes in the past.
So, if it blocks the receptor for up to 28 days, does that mean an overdose reversal would mean the user can’t get high for a month? Would they still go through withdrawals at that point? Can this be used to get people off the stuff, not just reversing OD. Many addicts would rather use, than go through withdrawals.
Nahh, it’s called the Crusader’s Crossbow
There is a website (can't remember the name) that will send you two doses of Narcan, two fentanyl test kits, and a mouth barrier - all for free. Where I live, Narcan is available at the pharmacy but it costs money.
So if someone were suffering from an opioid overdose, would administering suboxone (bupenorphine and naloxone) be effective at reversing the effects?
Yes, if there's no other options then it is useful. Someone with a low tolerance might not be a good idea in that case however. If they're a regular user of strong opioids then there shouldn't be any issues with respiratory depression getting worse with buprenorphine. You could potentially give it intranasal or intrarectal dissolved in water for faster onset. You do not need a lot of water. Naloxone will also be much more bioavailable also.
Thank god someone is working on this. I needs available to those can’t or won’t get it in advance.
Would be cool to see you do a training block with weighted pull-ups and weighted dips. Also you could even experiment with building a decline/flat deficit weighted push-up setup with either rings or paralletes. It’s a tricky thing to set up but should be extremely effective chest exercise on paper in terms of ROM, stability (with paralletes instead of rings), stretch, and shoulder friendliness. You might have some innovative setup design if you thought about it, you seem like that type of guy.
Also, considering how much you like converging chest press machines, you could try doing ring pushups with the strap hanging points much wider than shoulder width. The diagonal strap angle creates a converging force vector. I’ve never used a converging machine so I’m curious how you think it compares.
I wonder if having Naloxone alternatives that last longer are creating a significant risk of turning OD emergency into a different emergency related to detox symptoms. My assumption here is that the people (especially heavy users) would need monitoring for the entire duration the new drug is working.
You should do a video on SR-17018, it apparently reduces opioid tolerance.
God, imagine getting those antibodies to opiates that last a month and then getting in a car wreck or something a few weeks in. Everything is broken and no standard pain management is going to work (I don't think you can flood out the antibody with a high enough dose. Can you?).
I could be wrong but there's plenty other non-opiate pain treat out there. i have friends that are in recovery and have no trouble any time they go to the dentist or get other pain management and they do it all without opiates.
Then why do any doctors ever prescribe opioids to anyone for anything?
@@sunnyquinn3888 good question. I never understood that about the USA. In Germany, for example, it is really hard to get an opioid prescription. Only if other analgesics and/or steroids failed, or wouldn't work for specific pains, will an opioid be used.
@@lunakat__ I'm not familiar with any. I mean, there is Toradol for sure, but that can't even hold a candle to opiate relief for major stuff except in very specific situations. They may just suffer through it with just something like toradol if you can't ask them what they get.
@@lunakat__have you ever had an infected rotting nerve in your mouth? Or been in a serious car crash? Not even oxycodone really helps let alone an nsaid, the only thing that would help besides an opioid would be a dissociative, but they don't really give out ketamine for pain.
As a substance use provider. Buprenorphine is the greatest drug ever made.
Opioid are also prescribed for chronic pain not just broken bones and dying
as someone with chronic pain, I really don't like the "were talking life ending pain here" comment. whether your life is actually in danger or not has nothing to do with how horrible the pain you have to endure is, and it is imperative that patients have access to pain medication that helps to alleviate that pain whether or not it is caused by something life threatening.
CVS might charge upwards of $150 for a single dose of naloxone if you're uninsured. Most insurance covers it completely, and it's also free from any harm reduction organization or at many cities' departments of social services. If you use, know someone who uses, or live in an area with a large addict population, get some, keep it handy. It has saved tens of thousands of lives, many times over for a lot of addicts. I work in a nightclub and we keep it stocked in multiple locations around the building.
How do these opiod antagonists affect the pain-relief offered by opiates, or even of our own endorphins? It seems like a shorter-lived antagonist would be better because it would block the acute side effects but still allow pain relief with subsequent doses, or for endorphins to do their job. (Assuming the reason for taking the opiate is pain relief and not just to get high.) My understanding is that one of the reasons its so difficult to wean off opiates is that they suppress our natural supply of endorphins, so we end up with nothing activating those receptors and offering even miniscule pain relief. So pain tolerance is way down, pain threshold is way down, everything hurts and feels terrible, and the symptoms of withdrawal are felt even more acutely. Would something that completely blocks these receptors (especially for days or weeks at a time) create the same side effects? I don't have any experience with it, so I'd really be interested in finding out.
Yes
I have nerve pain so severe that it's made me OD on Ibuprofen just to get it to stop. Opioids are its ultimate kill switch, which for me indicates I should NEVER take it. It sucks so much that the only medications that work for me are highly addictive. I was told at some point that cone snail venom was being investigated for a non-addictive alternative to Opioids, but... I haven't heard about it in a while.
Right now my "Flare up kill switch pill" is Diazepam--I know, another highly addictive substance. But the difference is it doesn't get rid of my nerve pain entirely. It just brings it to baseline, which thus far has staved off any addictive habits. I just wish there was medicine out there that eradicated pain without such dire consequences like Opioids have. It would make such a tremendous difference in my life.
I go to a place helping me with alcohol, they treat all addiction and they gave us narcan just in case. I’m glad I’ve never had too use it but I’m glad I have it in case I run across someone who needs it.
Do an episode on ibogaine. I'd be glad to help.
We've got benzo reversents. Had them for years.
Interesting. Are they NAMs?
What are they?
@@BobSacamano666 I've been retired too long, to retrieve that quickly! Give me a few minutes.
Problem is you give them to someone addicted to Benzos and give them instant withdraws and seizures.
Antibodies that bind opioids (like CSX-1004) can't directly reverse the receptor binding of an agonist, because they cannot cross the blood-brain barrier, so they still rely on the agonist leaving the binding site on its own through good ol' thermodynamic entropy.
This could be problematic in substances that bind very, very strongly to the receptors, since those will take their sweet time to dissociate again. Antibodies could be very well suited for relapse prevention after the PT has had a controlled withdrawl though, as they prevent the effects of freshly ingested agonists.
The greatest potential issue of these ABs are cost and the potential of acting as haptenes in combination with the opioid they bind to. Repeated ingestion of said opioid may then cause an allergic reaction (anaphylactic shock!) towards the [antibody-opioid] complex.
I was prescribed this with my opioids through the VA, so federally it's already mandatory. I keep it in my medical bag just in case.
I have been on long release opioids for 4 years. When I was taking oral pills they never offered narcan. When I was switched to fentanyl patches the nurse brought a narcan kit. He taught me how to use the patch and then the narcan kit. It sit on my bedside desk but i have never used it.
I carry both injectable naloxone and the inhalant. I've been clean for 9 years but other people still struggle
Unless I'm misunderstanding something, this is a very poor advocacy for buprenorphine. While it for sure is an amazing drug, it is slow acting and not effective for pulling someone out of an overdose. It is odd to display it as a 1:1 to Naloxene(narcan) as their use cases are different. It takes ~1 hour or so for buprenorphine to even start working. It's use case is usually as a preventative measure if someone does use opioids. However, it is more useful for rehabs/outreach programs/doctors because it would be very difficult to convince an active addict to take a pill/patch every morning that would hinder their ability to get high and it can not be used in an emergency to pull someone out of an overdose, which is how naloxene is used.
The nanoparticles needing to be an intramuscular injection isn't really a problem, we already have the technology for people to easily and safely give an IM injection with epipens. It working 30x longer could make a big difference with fentanyl overdoses in particular.
Most people dont want to get clean because they are scared to death of withdrawls, especially with fentanyl withdrawals. We need new mediciations to help get off opiates without experiencing withdrawals. Suboxone doesnt cut it anymore for whats on the streets, having to wait up to a week to take it.
C'mon SciShow, don't use clickbait. Your content is already great. There's no need for that.
Preface, im not a doctor or anything related, but an issue i thought of (again idk, im not a doctor, i just thought of it idk if it is an actual issue in practice) is that with substances that block stuff like fentanyl for weeks or months or whatever, is the fentanyl is used in surgery all the time as part of the anasthesia because fentanyl is so fast acting, if it is blocked then issues could arise during emergancy surgerys and having to substitute drugs for (potentially less effective/appropriate) other drugs
i was kind of hoping, i would hear something about mytrangia speciosa. Kratom is pretty new to the USA, and it has been shown to act as an analgesic, and an antagonist in some efforts, but the science is super scarce.
Well, I hope that they do one thing better than Narcan, which is to make the packaging smaller. I have carried it but the box says not to remove it from packaging until you need to use it, and the boxes are large and I can only carry it when I have a tote bag. Would be much better if they made the portable nature more useful.
The primary concern with these approaches is their inability to effectively restore the regulation of opioid receptors within the brain. Consequently, patients remain vulnerable to opioid discontinuation syndrome, which can persist for an extended period, potentially lasting months or even years after cessation of opioid use. Many individuals affected by this condition report an overwhelming inability to experience joy or motivation in their lives. Essentially, it becomes challenging to revitalize the reward system in a brain that has come to rely on opioids as an integral component of daily existence. In the absence of the "pleasure/joy" stimulation triggered by opioid chemicals, patients are left with a significant void in their lives.
2:01 Tell me about it
Now I'm curious to see what my surgeon gives me. I'm having a combined surgery on my wrist and hand this Friday. I was told I would get pain meds after it.
If my experience is correct oxynorm and oxycodon enough for 3 days. If its a day surgery.
4:00 There’s an error here. The top one is morphine and the bottom one is naloxone.
I was literally about to say I "wonder if we could basically make a vacinne style medicine that prevents the attachment in the first place" and lo and behold.
Yeah the "vaccine" for opioids is a bad idea, as are super long-term overdose preventions. Others have said it better, but basically, people will be made to take it for jobs, housing, etc, and that means that if they need surgery or get in an accident? Good pain killers will be useless.
I understand that it'll do good, but it'll do a hell of a lot of bad, too. (Like the current opioid panic - many people with chronic pain (including terminal cancer patients) have been forcibly taken off pain killers or not been allowed in the first place. They're turning to street drugs for pain relief, because what else are they going to do?
I got removed from an opioid pain program because I didn't need refills often enough. Because the govt limits how many pain patients physicians can have, so they only keep those who get them the most money.
It took me three more pain clinics to find one that gives anyone besides terminal patients pain medication. I am bedridden from a herniated disc, documentedly.
None of this is cut and dry.
Naloxone has a negative effective on the liver in longer term use. I myself had issues with it.
This is fantastic. Now can we please do a video on fentanyl test kits? The science behind how to test othet recreational drugs for fentanyl contamination? We act like no one ever does any drugs for fun, but they do. But because it is all on the black market there is no quality control and so regular members of society, people who do not have any sort of drug addiction, are dying from fentanyl overdoses because some was accidentally mixed into the bag of cocaine they got
Heroin addicts told me independend of each other that in case of a OD "they" give you some horrible stuff, wich makes you unable to get high for quite some time. 1 or 2 days, i think.
They had no doubt this would be to teach them a lesson because of the OD. 2 of them told me what exactly this nightmarish substanze was called: NaCl.
I was first confused, but i guess that if the OD than they get also a infusion with sodium chloride solution, wich is labeled "NaCl".
1:25 morphine does not work in a "similar" way to endorphins. Morphines is literally an endorphin and this is well documented at this point. It is believed that one of the metabolites of heroin (3-monoacetylmorphine) may also play a roll as an endorphin, though this isn't as well studied due to heroin and it's metabolites falling into schedule 1, or it's equivalent in most countries (the UK being one big exception)
@scishow
Your molecules of morphine and naloxone were reversed in your part of your presentation.
Lots of mixed up presentations, but I like yours because they are usually accurate.
Please keep being the better source (and by that I mean to just be more mindful, and then you'll be perfect).
i < 3 Buprenorphine and Naloxone.