By Max Blau,

ATLANTA — Dr. Nora Volkow has heard a frightening scenario play out around the country. People are administering naloxone to synthetic opioid drug users who have overdosed. But the antidote doesn’t work well. So they give another dose. And it’s only after multiple doses — four, five, even six times — that drug users finally come to their senses.

Naloxone is the only widely available drug to reverse opioid overdoses. But anecdotal reports of its limitations against synthetic opioids are on the rise. Spurred by that public health threat — as well as a booming commercial market for the antidote — drug companies, researchers, and health officials are eagerly eyeing the development of new treatments to augment the use of naloxone or, in some cases, potentially replace it.

“The strategies we’ve done in the past for reversing overdoses may not be sufficient,” Volkow, director of the National Institute for Drug Abuse, said in a recent speech at the 2018 National Rx Drug Abuse and Heroin Summit. “We need to develop alternatives solutions to reversing overdoses.”

Those alternatives are taking a variety of forms. One biotech company is studying a drug with similar mode of action as naloxone — an opioid antagonist — but one that lasts roughly four times longer. Some addiction medicine specialists are hopeful that a different drug, buprenorphine, presently used to treat opioid addiction, could also be tweaked to reverse an overdose. Meanwhile, the National Institutes of Health hopes to pursue research into drugs that wouldn’t counteract the opioids directly but rather keep the patient breathing — the thing that causes so many overdoses to be fatal.