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What is Narcan & How Does it Work?

 Narcan is a brand name for naloxone, a life-saving medication that blocks the effects of opioids during an opioid overdose. It’s an easy-to-use nasal spray that a bystander or first responder can administer. It rapidly reverses the effects of an overdose on opioids, such as Vicodin, OxyContin, Percocet, codeine, heroin, and fentanyl. After using Narcan, call 911 immediately and wait for medical personnel to arrive.

7 Minute Read | Published Oct 06 2023 | Updated Mar 11 2024 Expert Verified
Emma Collins
Written by
Dameisha Gibson
Reviewed by
Emma Collins
Written by
Dameisha Gibson
Reviewed by

What is Narcan Used For?

Narcan is an emergency medication approved by the Food and Drug Administration (FDA) to treat the life-threatening effects of an opioid overdose. Unfortunately, 50,000 died from opioid overdoses in 2019 alone.With Narcan, people can combat the fatal effects of an overdose and save lives amidst the national opioid overdose crisis.

Narcan and naloxone come in nasal spray and injectable formulations—both FDA-approved. First responders and medical personnel use the nasal spray or injection to resume breathing in someone whose respiration has slowed or stopped. However, Narcan is only a temporary antidote, and the overdosing person must be taken to the hospital for additional treatment and monitoring.

Narcan nasal spray is the most common form of naloxone and is readily available to everyone. Any bystander can use it to save the life of someone overdosing on opioids. Bystanders may also use naloxone intramuscular injections; just make sure to follow the instructions carefully and to inject in a large muscle, such as the thigh or shoulder. Conversely, naloxone intravenous injections are typically only used by trained professionals.

How Does Narcan Work?

The greatest threat to someone who has overdosed on opioids is a lack of oxygen. Narcan is an opioid antagonist. This means it helps a person resume breathing by attaching to opioid receptors in the brain and blocking the effects of opioids—effectively reversing the overdose. But unfortunately, it is not effective against other overdoses that don’t involve opioids, such as overdoses on cocainebenzodiazepinesbarbiturates, or alcohol.

Narcan is only a short-term treatment for an opioid overdose. It can wear off 30-90 minutes after administration, but many opioids of abuse last longer than that. Because of the long-lasting effects of some opioid drugs, a person could resume overdosing after the Narcan wears off. In the event that this happens, you can administer another Narcan dose.

Additionally, in the case of stronger, more potent opioids, like fentanyl, one Narcan dose may not be enough to initially reverse the effects of an opioid overdose—you may need to administer another dose after 2-3 minutes. Increased responsiveness and regular breathing are signs that the Narcan is working. If the person doesn’t respond in that timeframe, you will know that another dose of Narcan is necessary.

But regardless of what happens, you must call 911 immediately after realizing someone has overdosed. They require professional medical attention and care. This may be especially true if the person is dependent on opioids, as Narcan will send them into opioid withdrawal, which can be unpleasant and distressing.

Where to Buy Narcan

Anyone who uses opioids or has opioids in their home should also have Narcan if an overdose occurs. Narcan nasal spray is readily available at all major pharmacies, such as:

  • CVS
  • Walgreens
  • Rite Aid

However, naloxone injections aren’t as readily available, as they require knowledge of dosage and administering an injection. Most medical professions and hospitals use intravenous injections, while households use Narcan nasal spray and occasionally naloxone intramuscular injection (which is much easier to administer than an intravenous naloxone dose).

Narcan access laws differ from state to state. Some have a standing order law, which means pharmacists can dispense Narcan to people who are at risk of an opioid overdose even if they haven’t been seen by a doctor.

Other states allow doctors to prescribe and pharmacists to dispense Narcan to someone who is not directly at risk for an opioid overdose. These individuals typically know someone who abuses opioids and wants to keep them safe. Currently, 24 states allow you to obtain Narcan for someone you know, including:

  • California
  • Colorado
  • Connecticut
  • Delaware
  • Georgia
  • Indiana
  • Kentucky
  • Maine
  • Maryland
  • Massachusetts
  • New Jersey
  • New Mexico
  • North Carolina
  • Ohio
  • Oklahoma
  • Oregon
  • Pennsylvania
  • Rhode Island
  • Tennessee
  • Utah
  • Vermont
  • Virginia
  • Washington
  • Wisconsin
  • District of Columbia

Additionally, some states allow you to obtain Narcan without a prescription. All you need to do is go to the pharmacy counter and request it and they will dispense it for you. Narcan is available without a prescription in the following states:

  • California
  • Kentucky
  • New Hampshire
  • New Mexico
  • New York
  • Rhode Island
  • Vermont
  • Washington

Narcan Shelf Life

Narcan’s shelf life is about 24-36 months. After that time, you should replace your Narcan with a new box to ensure the nasal spray is at optimal strength if an emergency occurs. There’s a chance that expired Narcan may not be as effective, although if all you have is expired Narcan, you should still use it—it is safe to administer and won’t hurt a person. Moreover, recent research indicates that Narcan may be effective long past its listed expiration date—even up to 30 years in some cases.

How Much Does It Cost?

Over 97% of insurance policies cover the cost of Narcan nasal spray, in part or entirely. About 76% of insured patients are required to pay a co-pay of $20 or less, while nearly 50% of patients don’t owe any co-pay.

Typically, a box of two Narcan nasal sprays costs about $140 without insurance. This cost varies from pharmacy to pharmacy and depends on your insurance coverage.

Recognizing the Signs of an Opioid Overdose

An opioid overdose can occur in a number of ways, such as:

  • Using too much of an opioid
  • Relapsing after a period of abstinence in which your tolerance was reduced
  • Combining an opioid with another drug or alcohol
  • Unknowingly using an opioid cut with fentanyl

Once an opioid overdose occurs, you only have a short time to react to save a life. Knowing the signs of an opioid overdose helps bystanders treat a person faster and heightens their survival rate. Here are the signs and symptoms of an opioid overdose:

  • Slow or irregular heartbeat
  • Slow or irregular breathing
  • Unresponsiveness
  • Discolored, pale or blue skin and lips
  • Small (dilated) pupils
  • Low blood pressure

Knowing the signs of an overdose helps bystanders treat a person faster and heightens their survival rate. If you suspect someone has overdosed, you should administer Narcan. As soon as you give the first dose, call 911 for medical assistance.

How to Administer Narcan

If you notice any of the symptoms of an opioid overdose, follow these steps to administer Narcan nasal spray:

  1. Remove Narcan from the packaging and hold it with two fingers on the nozzle and a thumb on the plunger.
  2. Insert the nozzle into the patient’s nostril far enough for your fingers to touch their nose.
  3. Press the red plunger all the way to release the medication, then remove the plunger from their nostril.
  4. Narcan is not a substitute for medical intervention. Always call 911.
  5. Administer rescue breathing over the next 2-3 minutes. If the patient does not respond, repeat steps 1-3 with the opposite nostril.
  6. If the patient does respond, monitor their breathing for signs of distress and continue administering rescue breathing and Narcan doses as needed until medical help arrives.

Transitioning to Opioid Addiction Treatment After an Overdose

An opioid overdose can be a sign that someone is struggling with an opioid addiction. However, if you or a loved one has overdosed on opioids, you can find support to overcome and treat the addiction once you or they have been stabilized.

Your medical staff at the hospital can refer you to medical detox services and opioid addiction treatment services. That way, you can transition straight into an opioid abuse program that can help you address the underlying issues that influenced your opioid abuse in the first place. These programs include services like individual counseling, group therapy, family therapy, and support group meetings.

There’s no better time to start on the road to recovery. And we are here to help you find the treatment you need. Give us a call at (800) 429-7690 and we will help you find an opioid rehab program in your area.

Resources

bullet National Institute on Drug Abuse (2021)
"Opioid overdose crisis"
Retrieved on October 05, 2021
bullet Substance Abuse and Mental Health Services Administration (n.d.)
"Naloxone"
Retrieved on October 05, 2021
bullet National Institute on Drug Abuse (2021)
"Naloxone DrugFacts"
Retrieved on October 05, 2021
bullet Education Development Center (n.d.)
"State Naloxone Access Laws"
Retrieved on October 05, 2021
bullet Pruyn, S., Frey, J., Baker, B., Brodeur, M., Graichen, C., Long, H., Zheng, H., & Dailey, M. W. (2019)
"Quality Assessment of Expired Naloxone Products from First-Responders’ Supplies. Prehospital emergency care: official journal of the National Association of EMS Physicians and the National Association of State EMS Directors, 23(5), 647–653"
Retrieved on October 05, 2021
bullet Narcan (n.d.)
"Getting Narcan is Simple"
Retrieved on October 05, 2021
bullet Narcan (n.d.)
"What is Narcan Nasal Spray?"
Retrieved on October 05, 2021
bullet Narcan (n.d.)
"Key Steps to Administering Narcan Nasal Spray"
Retrieved on October 05, 2021
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