We interrupt this usual blog post for an important commercial announcement.  Please buy this product!!!  I hesitate to tell anyone to do what I’ve done (because I’m so often unable to follow through on things and don’t want to be a hypocrite),  but, please, in this case, I’m strongly hoping you do, because it just may save a life.  Last Monday the FDA made an important step and allowed Naloxone (brand name  NARCAN) to be purchased over the counter.  I bought a two dose pack for myself and each of my daughters to have on hand.  I pray we never have to use it, but I’m so grateful that we have it just in case.  And now, a quick description of what naloxone is, how it works, and how to use it to reverse a potentially tragic overdose.

Naloxone is a medication that can reverse an overdose from opioids, including fentanyl, heroin, and prescription medications by blocking the effects of opioids on the brain and restoring breathing.  A person can’t get high from naloxone and it’s been shown to be safe for practically anyone to use.  Most often the drug is sprayed into the nose and takes only two to three minutes to work.  If someone doesn’t  wake up in three minutes, a second dose can and should be given.  Naloxone won’t work for an overdose on drugs other than opiates, but it’s safe to administer.  If given to someone who isn’t on opioids, it’ll simply make them uncomfortable, so you don’t have to worry.  It’s also non-addictive.

In order to feel comfortable using Narcan, the first step is to know the potential signs of an opioid overdose.  Typically, someone who is experiencing an opioid overdose will have small constricted pupils, be falling asleep or losing consciousness, be slow, weak, or have no breathing, a limp body, cold clammy skin, discolored skin (especially the lips and nails), and may be making choking or gurgling sounds, vomiting, or having a slow or erratic pulse.  If you’re not sure if someone is experiencing an overdose, it’s best to go ahead and give the Narcan, as it can save their life if they are, but won’t harm them if they aren’t.

Once you become aware of someone exhibiting these symptoms, call 911 immediately.  If they’re not breathing, administer rescue breathing by moving them onto their back, tilting their head back, lifting their chin, and breathing two normal breaths into their mouth.  Next, administer the Narcan spray into their nostril.  Continue rescue breathing if needed, giving one breath every five seconds until they begin breathing on their own.  Try to keep the person awake and lay the person on their side to prevent choking.  Stay with the person until help arrives.

In 2021 there were nearly 108,000 overdoses from opioid drugs according to the CDC.  In more than one in three of these overdose situations, studies found a bystander was present.  Equipping people with Narcan will, and has, saved lives.  The goal of distributing naloxone is a public safety measure in order to educate and equip people to prevent these deaths from happening.  And for anyone concerned about increasing opioid abuse with the availability of naloxone can feel reassured that studies have found that making naloxone available did not encourage people to use opioids at any increased rate.

In fact, professionals are hoping to de-stigmatize the conversation around naloxone and to make it a part of any first aid preparation kit.  Even people who don’t use drugs or opioids should keep it in their purse or in their car for the chance they may need it.  Parents of teenagers are encouraged to have it at home and educate their child on how to use it.  According to the CDC, carrying naloxone is no different than carrying an Epi-pen for someone with an allergic reaction.  “It simply provides an extra layer of protection for those at higher risk of potential overdose.”(CDC website)

For years, medical professionals have been advocating to make Narcan an over the counter medication so that anyone can have it available.  Relying on people using drugs to ask their doctor for a prescription was not an effective approach to prevention.  “There was no medical or moral reason to keep this medication behind the counter,” argued Dr. Bobby Mukkamala, the chair of the American Medicine Association’s Substance Abuse and Pain Task force.  And it seems to me, there is no medical or moral reason why we all shouldn’t buy it now that it’s finally available.

Just as I was reviewing this post for edits, a story in the news caught my attention.  At a daycare center in NY, four children, ages 8 months to 2 years, were found to be unresponsive and showing symptoms of having come into contact with fentanyl.  “Tragedy struck the daycare on Friday when a 1-year-old baby boy died.  Three other children were taken to a hospital where Narcan, a medicine that rapidly reverses an opioid overdose, was used to revive them” (News Nation, NY).  I can’t help but think of that little baby boy who might also have been saved if someone had a dose of Narcan on site.

I know it‘s become a cliché for people to say “the only constant in life is change,” but when the Greek philosopher Heraclitus made this famous observation about change, it was 535 BC.  And while his understanding of the universality of change has held up well with the test of time (better than his fashion sense), what he and most all of us could never have predicted is the rapid acceleration, especially in recent times, in the rate of change.  In responding to the ever increasing pressures of new technologies and information overload, scientists are now adapting their models of coping with change and recommending an approach that is even more reliant on our adaptability as a key to mental wellness.

Previous models of change tended to rely on the concept of homeostasis, the idea that we have a status quo, experience something disruptive, and adapt in order to bring ourselves back to the status quo.  More recently, a shift to a concept called allostasis has been taking favor.  Allostasis is based on the idea that our healthy baseline is a moving target.  While both processes strive for stability, in homeostasis the goal is a return to a baseline that is the same as before.  Whereas in allostasis, the stability achieved would be a new baseline.  As author Brad Stalberg writes in his book, Master of Change: How to Excel When Everything Is Changing, homeostasis involves moving from X to Y and back to X, whereas, allostasis is thought of as X to Y to Z.  He writes, “The way to stay stable through the process of change is by changing, at least to some extent.  If you want to hold your footing, you’ve got to keep moving.”  Allostasis is defined as stability through change.

An allostatic approach acknowledges that the goal of mature adulthood is not to avoid, fight or try to control change, but rather, to skillfully engage with it.  Via this shift, change is seen as something that doesn’t happen to you, but as something you’re working with, an ongoing process of adaptation.  As Sterburg describes it, it’s about balancing acceptance with problem solving to move on to a new normal.  Overcoming pain, for example, either psychological or physical, is not about resistance, or trying to get back to how you were, but rather involves acceptance and growth.  In fact, as we learn about neuroplasticity, the truth is that our brain is at its best when it is constantly rewiring itself and making new connections.  In this way, change becomes a normal and healthy process rather than something to be feared.

As I have seen in my own work with people and as documented throughout the world, anxiety is at epidemic proportions.  I do think it is related to this fear of change and is emerging so intensely at this time specifically because the rate of change has become so rapid.  Information is coming at us at unprecedented rates, through news, social media, and ever changing sources of information.  We have more access to goods and services (Amazon, for example, can give you access to most anything at any time) and more choices about what and how we engage in the world.  Our climate is changing quickly with ore storms and cycles, and our technology is ever increasing in its ability and ways of engagement.  We are bombarded with a constant supply of new information and are asked to perform in ever increasingly complex environments (self check out, anyone?)  No wonder we’re overwhelmed.  Anxiety, simply put, appears in direct proportion to our perceived sense of threat in relation to our sense that we can handle that threat.  As we watch the news and are so inundated with the facts and images of our changing world, it’s easy to feel unsafe.  In response, we as a society have tended to become more cautious, which only fuels our experience of the world as being a scary place.  A classic phenomena of anxiety is that the more we avoid what makes us anxious, the more power it has over us.  As we feel threatened by change and try to resist it, we withdraw and become overwhelmed by it.  

I believe the concept of allostasis will be an important focus in addressing anxiety and helping us to be more resilient in the face of rapid change.  Science does point to there being strong evidence that we can become stronger and grow from change and that much of how we navigate change can, in fact, be developed and practiced.  There is much new research supporting the idea that how well we cope with change is directly related to our life satisfaction.  Our psychological approach to change must involve both an ability to be tough and determined by sticking to our core values while simultaneously adapting, consciously responding to changing conditions and bending without breaking.  As Bradberg describes it, “equal parts ruggedness and flexibility.”

For myself, and in thinking about how to be of help to others in this age of rapid change, applying an allostatic perspective (that’s a mouthful), I can see the importance of becoming more fluid in my expectations, becoming more comfortable with uncertainty, and expanding  meaning and purpose through growth. I imagine myself as a modern Heraclitus, standing at the water and noting “no one ever steps in the same river twice,” except today I’ve gotten to the river driving an electric car, using google maps, hoping I’ve applied the right UV protection sunscreen, wearing my Athleta swim outfit, all while listening to the latest ESPN Daily podcast.   In other words…stay tuned.  There’s a lot more material I’m going to need to cover!