Narcan (Naloxone)

What Is Narcan?

Narcan is a brand name for the drug naloxone, a life-saving medication used to quickly reverse the effects of an opioid overdose.

Narcan was the first of its kind, but now other formulations and brand names exist (such as Kloxxado®).

Available forms of naloxone include:

• Intranasal sprays
• Subcutaneous injection (under the skin)
• Intramuscular injection (into the muscle)
• Intravenous injection (directly into a vein)

Naloxone nasal sprays typically contain a single pre-measured dose of naloxone, while injections must usually be measured from a vial using a syringe to determine dosage.

In March of 2023, the US Food and Drug Administration announced that Narcan nasal spray will become available over the counter (OTC) for anyone to purchase.

While Narcan is an emergency medication designed to prevent opioid overdose deaths, it is NOT a complete treatment for opioid use disorder.

How Does Narcan Work?

Narcan is an opioid antagonist, so it is used to quickly reverse overdoses from opioid use. It binds to the brain’s opioid receptors to almost immediately cancel out the effects of opioids in the body for a short window of time.

Narcan will only work for 30-90 minutes, so the victim may go back into an overdose state after the Narcan wears off.

They might also not know what happened and could wake up feeling scared and disoriented. They may also experience opioid withdrawal symptoms, such as muscle aches, chills, and nausea, shortly after gaining consciousness.

Therefore, you should always stay with the overdose victim until first responders arrive to provide additional medical care. Good Samaritan laws protect you and the overdose victim when calling for help.

Is Narcan Safe?

Yes, Narcan is safe to use whether the victim has taken opioids or not.

If you suspect an overdose but aren’t sure what the victim has taken, it will not hurt them to administer Narcan. However, Narcan will also not revive the victim unless they are experiencing an opioid overdose.

It’s worth noting that once a dose of Narcan is administered, the individual may experience opioid withdrawal symptoms since the Narcan has paused the opioid’s effects.

The side effects of opioid withdrawal (such as headache, changes in blood pressure, sweating, tremors, or vomiting) are uncomfortable but rarely life-threatening.

Importance of Narcan in Saving Lives

The entire purpose of Narcan is to prevent overdose deaths in individuals who have taken too many opioids, be they illicit (i.e., heroin) or prescription opioids (i.e., Oxycodone).

Synthetic opioids (especially fentanyl) are the driving force behind the deadly opioid epidemic currently plaguing the United States. This public health crisis spiked in the early 2000s but remains an ongoing struggle.

In 2020, an average of 44 people died daily from a prescription opioid-related overdose. The US Centers for Disease Control and Prevention (CDC) also reports that 75% of all drug overdose deaths in 2020 involved an opioid.

Now, even individuals who are using other substances—perhaps even for the first time—are at risk of experiencing an opioid overdose without knowing it.

Having Narcan readily available is even more important now, as reports of other drugs laced with fentanyl or other illicit opioids continue to increase.

Narcan offers a significant tool in opioid overdose prevention by stopping the opioid’s effects long enough for medical personnel to intervene, potentially saving countless lives.

Harm Reduction Concerns

While evidence suggests that Narcan is extremely helpful in preventing fatal overdoses, some remain concerned that the availability of Narcan encourages substance use.

Arguably, some insist that the availability of a life-saving medication should be the priority. However, others would argue that Narcan makes it easy for opioid addicts to justify their substance abuse to themselves or others.

Ultimately, the topic of harm reduction is still a gray area.

Evidence suggests that harm reduction techniques, including having Narcan widely available, help prevent fatal overdoses long enough for many people to eventually get help—but the topic remains somewhat debated.

Signs of an Opioid Overdose That Narcan Might Help

An opioid overdose is extremely dangerous and can be fatal. If you suspect someone is experiencing an opioid overdose, call 911 immediately and stay with the victim until help arrives.

Key signs of an opioid overdose include one or more of the following:

• Slowed or stopped breathing
• Pinpoint pupils
• Blue-tinged lips or fingertips
• Slowed or stopped heart rate
• Unconsciousness
• Cold, clammy skin
• Rattling or gurgling noises when breathing
• Vomiting, especially while unconscious/unresponsive

If you can, administer Narcan to pause the effects of opioids in their system.

Please note that in many states, Good Samaritan Laws protect the caller and the victim from any legal trouble when 911 calls for an overdose.

Where Can You Get Narcan?

With the rise of fatal opioid overdoses and the ongoing opioid epidemic, many individuals choose to carry naloxone with them—even if they don’t use opioids themselves.

As of March 2023, Narcan nasal spray (distributed by Emergent Biosolutions) received FDA approval for over-the-counter purchases through their local pharmacies.

If you want to join those dedicated to harm reduction and opioid overdose prevention, you can get Narcan from your local pharmacy.

You can still speak with your prescribing doctor or get in touch with a community health department to receive a Narcan prescription and receive additional information.

Treatment Options for Opioid Use Disorder

Narcan is an emergency medication designed to reverse overdoses in opioid users. Narcan is NOT a treatment for opioid use disorder.

Therefore, after an opioid overdose, a person dealing with opioid use disorder may require additional treatment for their substance abuse.

Treatment for opioid use disorder may include one or more of the following:

• Detox: After an opioid overdose, especially for someone that has been using opioids long-term, medical detox may be the first step in addiction treatment. Medical detox can occur at home (outpatient) for average cases or at a facility (inpatient) for more severe situations.
• Rehab: Rehab for opioid abuse and addiction is available at different levels of care, starting with outpatient options (i.e., Intensive Outpatient and Partial Hospitalization programs) and moving up to inpatient options, such as residential treatment.
• Therapy: Psychotherapy helps individuals with substance use concerns to pinpoint the triggers that led them to abuse opioids in the first place. Any rehab (both inpatient and outpatient) will provide access to mental health services, including group and individual counseling sessions. However, the person may also consider seeking therapy after the initial treatment has finished.
• Medication-Assisted Treatment (MAT): Your healthcare provider may recommend prescription medication to help the individual during and/or after treatment. Specific drugs (such as buprenorphine) can alleviate cravings and decrease the risk of relapse. Notably, the CDC generally recommends that doctors prescribe Narcan to the individual in recovery or a trusted family member in case of relapse.

Resources for Battling Opioid Addiction

If you or a loved one is dealing with an addiction to opioids, you can contact the SAMHSA treatment hotline by calling (800) 662-4357 (HELP) or by visiting their online treatment locator.

They can help you locate resources in your area, from addiction counselors and detox centers to full rehab treatment programs.

Additionally, if you want to carry Narcan nasal spray for yourself, a loved one, or as a general service to your community, speak to your doctor or local community outreach program.

Visit www.narcan.com to sign up for special updates regarding the release of Narcan nasal spray to the public for OTC purchases.