If you or someone you know is in crisis right now: call or text 988 (Suicide & Crisis Lifeline). For a possible overdose or any medical emergency, call 911. For help finding treatment, the SAMHSA National Helpline is free and open 24/7 at 1-800-662-4357.
The short answer
Naloxone (Narcan) is a medicine that can quickly reverse an opioid overdose. It is available over the counter at pharmacies and many stores, and it is often free through health departments and community programs. If you think someone is overdosing, give naloxone and call 911. It will not harm someone who is not overdosing on opioids.
What is naloxone?
Naloxone blocks opioids in the brain and can restore breathing within minutes. The FDA approved Narcan nasal spray for over-the-counter sale in March 2023, and it reached shelves in September 2023. The nasal spray is easy to use and needs no medical training, and several brands are now available.
When to use it
Use it if you think someone may be overdosing on an opioid, such as fentanyl, heroin or prescription painkillers. Signs include:
- Unresponsive or cannot be woken
- Slow, shallow or stopped breathing, or gurgling or snoring sounds
- Blue or gray lips and fingertips
- Very small pupils
- Limp body
If you are not sure, use it. CDC advises that naloxone will not harm a person who is overdosing on something other than opioids.
How to use naloxone nasal spray
- Call 911 (or have someone else call). Always call, even if the person wakes up, since they may need more doses and medical care.
- Lay the person on their back and tilt their head back.
- Peel back the package and hold the device with your thumb on the plunger. Do not test it first.
- Insert the tip into one nostril until your fingers touch the nose, then press the plunger firmly to give the full dose.
- Stay with the person. Turn them on their side in the recovery position once they are breathing.
- If there is no response after 2 to 3 minutes, give a second dose in the other nostril, using a new device.
- If they are not breathing, give rescue breaths if you know how, while you wait for help.
- Stay until help arrives. The effects of naloxone can wear off before the opioid does, so the person can slip back into overdose.
After waking, the person may feel sick, agitated or in withdrawal. Encourage them not to use more drugs, and stay with them.
Where to get naloxone
- Pharmacies, grocery stores and many retail stores. A two-dose package cost just under $45 at launch, and prices vary.
- With a prescription or from a pharmacist. With insurance, copays are often much lower. Over-the-counter coverage varies, so ask your plan.
- Free from community programs. Health departments, clinics, syringe services and harm reduction organizations often give it away, and some mail it for free. Mail programs, such as NEXT Distro, can be discreet.
- Treatment programs and hospitals often provide it, and SAMHSA grants fund distribution in many places. (See [Free and Low-Cost Rehab Options Without Insurance].)
- Schools, libraries and some public buildings keep it on hand in some states.
Search for your local health department’s naloxone program or call the SAMHSA helpline (1-800-662-4357).
Naloxone and the law
Naloxone is legal to carry and use in all 50 states, and many states have Good Samaritan laws that protect people who call 911 to help during an overdose. Check your state’s rules.
Keep it ready
- Keep it where you can find it quickly, such as at home, in a bag or in a car.
- Store at room temperature, away from extreme heat and cold.
- Check the expiration date and replace as needed.
- Tell others where it is and teach them how to use it.
Who should carry it?
Anyone who uses opioids or knows someone who does, people on prescribed opioids, families, friends, coworkers and community members.
What naloxone does not do
- It does not reverse sedatives, alcohol or stimulants on their own. It still helps if opioids are involved.
- It does not treat addiction. After an overdose, help is available. (See [Opioid Addiction Treatment: Buprenorphine, Methadone and Naltrexone Compared] and [How to Get Into Rehab Fast: Same-Day and Next-Day Admission Options].)
If you are a family member
Get naloxone before you need it, practice reading the steps and talk to your loved one about where it is kept. Do not wait for a crisis. (See [Fentanyl Addiction: Treatment Options and Why Naloxone Matters].)
Frequently asked questions
Is Narcan over the counter?
Yes. Narcan and other naloxone nasal sprays are sold without a prescription.
Can naloxone hurt someone who isn’t overdosing?
No. It will not harm a person who is not overdosing on opioids.
Do I still call 911 after giving naloxone?
Yes. The person needs medical care, and the effects can wear off.
How many doses might it take?
Sometimes more than one. If there is no response after 2 to 3 minutes, give another dose in the other nostril.
Where can I get naloxone for free?
Health departments, clinics, harm reduction programs and some mail-order programs.
Does naloxone work on fentanyl?
Yes, though more than one dose may be needed.
Sources
- U.S. Food and Drug Administration. FDA approves first over-the-counter naloxone nasal spray. fda.gov
- SAMHSA. Naloxone and Opioid Overdose Prevention Toolkit. samhsa.gov
- CDC. Naloxone and Overdose Prevention. cdc.gov
This article is for general information only and is not medical advice. In an emergency, call 911 immediately.