Thank you Josey; I appreciate the response as well as the additional background in the mechanism such a medication uses to combat the OD scenario. I was unaware of the action of both the narcotic and the "remedy" on the binding sites. I may need to do a little more research, as SRC had suggested. I suspect it will only further validate my opinion of the value ZIMHI should have.
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66, I’m not certain. I’ve been out of the prehospital arena since 2010, but within that timeframe I was a paramedic, I had almost always seen a single dose of Narcan work well. But that was mostly oxycodone and heroine ODs.
That said, my medic time was before the current epidemic street use of fentanyl and doping of other drugs with Remifentanyl. Those two drugs could perhaps create the situation you mention, as narcan is a Competitive Antagonist. Essentially Narcan (naloxone) competes for binding sites with opioids. An extra dose of opioids (or in this case, perhaps a stronger opioid) has a greater chance of overwhelming the Narcan.
As an aside, a non-competitive antagonist for Benzos (Valium, etc) is Romazicon. You could dump benzos in after, but they cannot bind.
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