Naloxone (Narcan®) for Emergency Use

Author: Miranda Hetrick, PharmD
Last Reviewed: February 28, 2024

Opioids are a class of medications that treat severe pain – oxycodone, fentanyl, hydromorphone, morphine, hydrocodone, etc. You can overdose on opioids if you take too much, which can happen on purpose or not on purpose. When someone overdoses on an opioid, their breathing slows down or stops, which can lead to death.

What is naloxone?

Naloxone is a medication that reverses opioid overdose. It can reverse an overdose of opioids like fentanyl, morphine, oxycodone, heroin, and hydromorphone. Naloxone, also called Narcan®, can come in a nasal spray or an injectable form (given with a needle). The injectable form is not often prescribed but the nasal form is widely used. Narcan® is the most prescribed form of naloxone and it is easy to carry and use – it can save lives!

When opioids are taken as prescribed, there is very little chance of overdose. Some people are at a higher risk of opioid overdose. You should keep Narcan® nearby if you:

  • Take opioids to manage pain.
  • Have a history of breathing problems such as sleep apnea or chronic obstructive pulmonary disease (COPD).
  • Have a history of an opioid overdose.
  • Are diagnosed with substance use disorder.
  • Have recently had a period of time when they were not taking an opioid but in the past took opioids consistently.

If you think you are at risk of an overdose, talk to your provider.

How does naloxone work?

Naloxone attaches to the opioid receptors in your body. Naloxone will remove opioid medications from the opioid receptors and stop them from working.

What are the signs of an opioid overdose?

Signs of an opioid overdose include:

  • Changes in your breathing. It can be slow, shallow, or even stop. Some may even be gasping for air.
  • The person won’t wake up even if you shake them or say their name.
  • Gurgling or choking noises.
  • Blue-colored hand lips or fingertips.
  • Pale or ashy skin that is cool to the touch.
  • Small, constricted pupils.

If the person is still awake, but showing signs of overdose, ask them what medication they have taken and how much. You can also ask them what other health problems they have. Signs of opioid overdose can also be signs of other health issues.

If naloxone is given to someone who is not overdosing on opioids, it will not hurt them. You can give someone naloxone if they are showing signs of an opioid overdose, even if you are not sure that they took an opioid.

How is nasal spray naloxone given?

To give nasal spray naloxone, follow the directions below:

  1. Check for signs of overdose (as stated above).
  2. Remove Narcan® nasal spray from the cartridge by peeling back the paper tab.
  3. Tilt the person’s head back and provide support under their neck with your hand.
  4. Insert the nozzle (top part) of the nasal spray into the person’s nose and press the plunger (bottom part).
  5. Move the person to be lying on their side (this is to stop them from choking on vomit).
  6. Call 911.
  7. In 2-3 minutes, if the person has not woken up, another dose of Narcan® may be given. Narcan® is a temporary treatment and the person may need more than 1 dose. This is more common in people who overdose on fentanyl or long-acting opioids.

There are instructions about how to give Narcan® inside a cardboard flap on the box. the instructions include written directions and also pictures to help guide you.

When should you contact emergency services?

If naloxone is given for an opioid overdose, always call emergency services by dialing 911. A person having an opioid overdose must be seen by a medical professional.

What are the side effects of naloxone?

Naloxone can cause opioid withdrawal symptoms after it is given. Withdrawal is an unpleasant feeling or physical reaction when a person stops taking a substance their body is dependent on (used to having). Opioid withdrawal symptoms include:

  •  Intense pain.
  • Shaking.
  • Sweating.
  • Nausea and vomiting.
  • Headache.
  • Restlessness.
  • Fast heart rate.
  • Fever.

Who should carry naloxone?

Anyone can carry naloxone. Often, emergency service workers and law enforcement officers carry it. It may also be on hand at schools and other public areas.

How can you get naloxone?

Narcan® can be purchased over the counter at most pharmacies for $40 to $50. It includes 2 nasal sprays in the box. You can also ask your provider to write a prescription for Narcan®. Many insurance companies will cover all or most of the cost of Narcan®. In some cases, people who are prescribed opioids are also prescribed naloxone as a safety precaution.

If you take opioids to help manage pain, ask your provider if you should also be prescribed Narcan®. When used correctly in the case of an overdose, Naloxone can help reverse the effects of overdose. Talk to your provider or pharmacist if you have any questions.

Lifesaving Naloxone. CDC. Updated April 2023. Accessed February 2024.

Overdose Prevention. CDC. Updated October 2021. Accessed February 2024. Naloxone Fact Sheets. CDC. Updated February 2022. Accessed February 2024.

Frequently Asked Questions About Naloxone. CDC. Updated January 2023. Accessed February 2024.

Narcan Patient Information. Plymouth Meeting, PA: Emergent BioSolutions. June 2023.

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