Recovery experts warn that Narcan freezes when temperatures near zero
Narcan is stocked and ready in a cabinet outside Sammy’s Avenue Eatery. Photo by David Pierini
By David Pierini, Editor
With an alarming spike in deaths from opioids came a wave of good Samaritans seeking the training to administer the antidote Naloxone, which can reverse the lethal effects of an overdose.
As a deep winter freeze approaches the Twin Cities, recovery experts warn Naloxone can freeze, making it impossible to administer. It freezes at around five degrees Fahrenheit, according to a study published in Harm Reduction Journal, and local overnight temperatures are expected to dip below zero this weekend.
There are “harm reduction stations” outside in North Minneapolis stocked with Narcan, a Naloxone nasal spray. Outreach workers carry kits and leave them in their cars. Others bring supplies of Naloxone to homeless encampments.
Naloxone kits are easy to protect from temperature extremes. And there are some tricks to thaw out frozen vials when encountering a person in the throes of an opioid overdose.
Jordan Abhold, the opioid and harm reduction team lead for Neighborhood Health Source, said important first steps include calling 9-1-1 and starting rescue breaths if the person is not breathing.
If the Naloxone is frozen, tuck the vial under the armpit or groin, warm spots on the body that could thaw out in a few minutes. Continue rescue breaths.
“Narcan is magic,” said Abhold, who is based at the Fremont Avenue clinic and leads community training across the city. “If you’re wrong (about an overdose), there’s no harm. If you’re right, you save a life. So Narcan is magic, but it’s also fragile magic.
“Direct exposure to sun can cause it to break down. (Repeated) freezing and thawing or heating and cooling can also break down in efficacy. It’s extremely abundant, so I tell people to grab a couple of kits.”
Abhold has one kit in his car and one in the inside pocket of his coat during winter months. He said he would like to see the outdoor Naloxone stations have some sort of insulation from temperature extremes.
Seneca Krueger, community partnership manager for Community Medical Services on West Broadway Avenue, likes to carry kits with injectable Naloxone because she has a foolproof way of thawing a vial that freezes.
“We’ve done our own little science experiments so that we know the easiest way to thaw it out,” she said. “Intramuscular Naloxone, because it is in a clear vial, you can tell when it is frozen. The easiest way (to thaw it) is to throw it in your cheek for about 20 seconds and then give it a shake.
“Most people get kind of scared of drawing it up through a syringe. Unfortunately, nasal Naloxone is not in a clear vial so you can’t tell when it is frozen. So, what we tell people in encampments is to keep it close to your body even when you are sleeping. Sometimes, I will give them (a dose of NARCAN) in a Styrofoam cup with a hand warmer.”
Krueger said her office does not want to waste nasal Narcan on thawing experiments because of the cost.
Audua Pugh, the executive director of the Jordan Area Community Council, recently received an old newspaper vending machine that was converted into a Naloxone storage station.
She said it was a blessing for her organization, which regularly hosts Naloxone training sessions.
Pugh placed the box outside JACC’s office on Lowry Avenue North. After one day, she brought the box inside.
“It was brought to my attention that Narcan can freeze,” Pugh said. “What will happen? Is JACC responsible? There should be some type of campaign around how to get it thawed. We need to know. People carry it in their cars, people have it in the encampments. This is Minnesota.”