Does Narcan Work On Cocaine?

Narcan does not work on cocaine, as cocaine is a stimulant and Narcan is an opioid antagonist. Narcan only reverses overdoses caused by opioid drugs. Cocaine overdose symptoms such as increased body temperature, elevated blood pressure, and abnormal heart rhythm require medical attention. It’s important to call 911 when you spot your loved one overdosing to have professional help.

There have been 57,497 overdose deaths from stimulants (including cocaine) in America, according to the NIDA’s latest report. Reach out to ChoicePoint to take immediate action and prevent an overdose.

CALL NOW FOR FREE SCREENING

Highlights

• Narcan (aka Naloxone) and cocaine work on different sites of the brain 
• Overdose from cocaine becomes fatal when there is an involvement of polydrug abuse
• Calling an emergency department or a cocaine rehab is important to prevent fatalities from overdose
• Make sure you get your loved one admitted to an addiction treatment center to help them recover fully

Why Doesn’t Narcan Work on Cocaine?

Narcan does not work on cocaine because cocaine is a non-opioid drug and Narcan is an opioid antagonist. The answer to this question can be further understood by knowing how Narcan/naloxone, and cocaine work.

Narcan (Naloxone) Mechanism of Action

• Naloxone rapidly enters your bloodstream
• It then moves to the brain where it binds to the opioid receptors
• Narcan has more affinity for opioid receptors than opioid drugs (codeine, morphine, or heroin)
• It displaces opioid drugs from these receptors
• Narcan binds to the receptors and deactivates them to restore breathing from overdose

Cocaine’s Mechanism of Action

Cocaine (crack), being a stimulant, excites the brain, giving a very quick yet intense euphoria. 

• Within the brain, cocaine acts on the reward system 
• It blocks the absorption of excess dopamine
• This increases the dopamine levels in the brain 
• The increased dopamine give you pleasure and quick euphoria

Since the mechanism of action of cocaine and Naloxone is different, Narcan does not work on reversing the cocaine overdose. 

Co-occurring Cocaine and Opioid Use Disorders         

However, most cocaine overdose cases also include opioids, and if this is the case, Narcan can help you. Research reports that cocaine-related overdose deaths involving opioids drastically increased from 29.4% in 2000 to 63.4% in 2015. The two commonly abused opioids with crack are:

• Fentanyl: Synthetic fentanyl increases the risk of cocaine overdose deaths
• Heroin: Pink cocaine use is often the driving force in people inclined towards heroin abuse 

What Are the Cocaine Reversal Agents?

Although Narcan does not work on cocaine, certain medications can reverse the overdose effects of cocaine including abnormal heart rate, elevated blood pressure, and chest pain. Some of these medications are discussed below: 

1) Benzodiazepines

They can be used to treat the abnormal heart rate resulting from cocaine overdose. Examples include: Midazolam, lorazepam, and diazepam

2) Calcium Channel Blockers

They are recommended medications for reducing chest pain and hypertension. Examples include: Isradipine, and Nifedipine.

3) Blood Vessel Dilators

They can improve the symptoms of chest pain. Example include: Nitroglycerin 

4) Alpha-1 blockers

It may help overcome hypertension and improve blood flow. Example include: phentolamine

5) Antipsychotic

To overcome the agitation and psychosis. Examples include: Haloperidol and Aripiprazole. 

These medications may or may not work for you. So, remember to follow the advice of your doctor and never use any of them without a prescription. 

What to Do When You Suspect a Cocaine Overdose?

Here are some of the practical tips you can use to help your loved one when you spot an overdose:

1. Call 911
2. Administer Naloxone if you suspect co-occurring cocaine and opioid use disorder
3. Use a wet cloth to bring down the body temperature of your loved one
4. In case of slowed breathing, perform CPR or rescue breathing
5. Get your loved one admitted to a cocaine rehab near you to have comprehensive addiction treatment.  

Get Help for Cocaine Addiction 

If Narcan does not work on cocaine, it does not mean you can’t get over cocaine use disorder. Reaching out to addiction treatment centers can help you get sober from cocaine and improve your negative behavior relating to cocaine abuse. Here are three services rehabs (such as ChoicePoint) may offer for reversing cocaine disorder:

a) Flush Cocaine Out

One of the important aspects of sobering from cocaine is to get cocaine out of your system faster. It’s important to flush crack through a medical detox under the supervision of addiction specialists so you can get help in tapering off rather than quitting cocaine abruptly. Your doctor will also help to manage withdrawal symptoms, which otherwise could be hard to manage.

b) Use Medication-Assisted Treatment 

Although there is no specific FDA-approved medication for cocaine abuse, you can be prescribed a few pills to reduce the intensity of withdrawal symptoms. However, with the co-existence of opioid and cocaine use disorder, you can be given the following FDA-approved meds to help with opioid addiction:

• Suboxone 415 orange round pill
• Subutex orange oblong pill 153
• Naltrexone 50 mg Film-Coated Tablets
• Vivitrol
• Brixadi injectable Buprenorphine

c) Opt For Contingency Management

Contingency management (CM) is the first line of treatment for maintaining abstinence from crack. It involves incentives to motivate cocaine users to keep abstaining from the drug. These incentives compete with cocaine to influence your brain’s reward system and ultimately help release dopamine without you smoking coke, or snorting coke.

d) Engage In Behavior Therapies

Other than contingency management, cognitive and dialectical behavior techniques are also effective in providing strategies to cope with drug cravings and prevent a relapse. Behavior therapists will lead these sessions in groups or individually as per your need to:

• Educate you on the adverse effects of addiction
• Help you recognize the triggers
• Learn the coping skills
• Resolve family conflicts
• Control aggression and manage stress

The techniques learned during CBT group exercises will allow you to develop social skills and return to your normal life. 

Does Narcan Work On Cocaine? Summing It Up

No, Narcan will not work on cocaine, but it can help restore consciousness when there is a case of co-occurring opioid and cocaine disorder. Narcan is an over-the-counter medication and anyone can carry it. However, overdose reversal is a temporary solution, and can not help you flush coke out of your system. Contacting an addiction treatment center to achieve long-lasting sobriety is important. 

More Info On Narcan And Cocaine

Learn how co-occurring use of Narcan to get its benefits and tips to manage cocaine addiction.

Will Narcan work on stimulants?

Narcan is an opioid antagonist and binds to the opioid receptors to reverse an opioid overdose. Stimulants work around the androgenic receptors to excite the brain chemicals giving you the high. As Narcan cannot bind to the excitatory receptor, it does not reverse the effects of stimulants.

What Does Narcan Do If You Are Sober?

Narcan does not work on people who are sober or have non-opioid drugs in their system. It only activates when you have opioids in the body. It does no harm if you have administered Naloxone for a non-opioid drug or when you are sober. 

What Are Cocaine Withdrawal Symptoms?

Cocaine withdrawal occurs when you reduce the cocaine or completely stop taking it all of a sudden after you have become dependent on it. Although the withdrawal symptoms vary between individuals some of these are common that every cocaine user is expected to experience, including:

• Agitation
• Nausea
• Vomiting
• Unpleasant dreams
• Suspicions
• Change in appetite
• Drowsiness

What Counteracts Cocaine?

There is no FDA-approved medication that will reverse the overdose from cocaine, but emergency doctors or addiction medicine specialists can certainly prescribe you a few medications to restore your breathing, lower your blood pressure, or bring your heart rate to normal. However, the evidence-based effective treatment for cocaine use disorder is contingency management, which involves incentivizing the cocaine user in the form of money, gift cards, or discount vouchers. 

Additional Resources

How to Get Cocaine Out of Your System Fast

How Much Cocaine Does It Take to Overdose

Mixing Xanax and Cocaine

Outpatient Detox NJ

Do Detox Drinks for Drugs Work

IOP For Cocaine Addiction Treatment

Cocaine Detox Program

Pink Cocaine

References

1. National Institute On Drug Abuse. Drug Overdose Deaths: Facts and Figures
   https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates
2. American Journal of Public Health. 2017. Recent Increases in Cocaine-Related Overdose Deaths and the Role of Opioids
   https://pubmed.ncbi.nlm.nih.gov/28177817/
3. Clinical Toxicology. 2016. Treatment of cocaine cardiovascular toxicity: a systematic review
   https://pubmed.ncbi.nlm.nih.gov/26919414/
4. Therapeutic Advances in Drug Safety. 2017. Naloxone dosage for opioid reversal: current evidence and clinical implications
   https://pmc.ncbi.nlm.nih.gov/articles/PMC5753997/
5. JAMA Network Open. 2021. Comparison of Treatments for Cocaine Use Disorder Among Adults
   https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2779686