What you need to know

  • Naloxone is a lifesaving medication that reverses opioid overdoses.
  • People who are or know someone who takes prescription opioids, uses illicit drugs, or is in recovery should carry naloxone.
  • Naloxone is easy to use and can be acquired by anyone without a prescription.  

For over a decade, the U.S. has been battling a worsening drug overdose epidemic fueled by the increased presence of synthetic opioids like fentanyl. In 2021, overdose deaths surpassed 100,000 for the first time in history. Around three-quarters of those deaths were from opioids, and, of those, over 94 percent were preventable, according to the National Safety Council. Most solutions to the overdose crisis are systemic, but carrying the opioid overdose-reversing drug naloxone can empower individuals to reduce opioid overdose deaths. 

Naloxone is an FDA-approved medication that rapidly reverses overdoses caused by any opioid, including prescription and synthetic opioids. The most well-known form of naloxone is the nasal spray Narcan. The drug also comes in an injectable form. When administered to a person who has overdosed, naloxone temporarily blocks the effects of opioids on the body. Naloxone should be used at the first sign of an opioid overdose and won’t harm someone who isn’t experiencing an opioid overdose. 

This article is meant for informational purposes and is not a substitute for professional medical advice.

Signs of opioid overdose

Opioid overdoses occur when a person intentionally or accidentally consumes a higher dose of opioids than their body can tolerate. The drug slows your body down, resulting in the following symptoms:

  • Shallow or slow breathing
  • Drowsiness or loss of consciousness
  • Slurred speech
  • Cold, clammy skin
  • Blue lips, nose, or nails
  • Abnormally small pupils

Overdoses are emergencies that require immediate medical attention. You should always call 911 if you believe someone is overdosing. Most states have Good Samaritan laws that protect people who seek medical care for overdose victims. Naloxone is only a temporary overdose treatment and is not a substitute for emergency medical care. The medication is only effective on opioid overdoses and cannot reverse non-opioid overdoses. Although some widely circulated videos claiming to show fentanyl overdose feature hyperventilating, elevated heartbeat, sweating, and nervousness, none of these are symptoms of an opioid overdose.

Who should carry naloxone?

You should carry naloxone and be trained in its use if:

  • You or someone you know takes high-dose or slow-release opioids for pain.
  • You or someone you know uses opioids or other drugs that could be laced with opioids.
  • You or someone you know is in recovery for opioid use disorder.
  • You participate in activities with recreational drug use, including music festivals and large parties.

Anyone can carry naloxone, but some people are at higher risk for opioid overdose. The following can increase opioid overdose risk: 

  • Recent release from a substance use treatment facility. 
  • Mixing opioids with other drugs, including alcohol and stimulants.
  • Taking unidentified drugs.
  • Taking an unknown or higher than recommended opioid dose.
  • Having an underlying heart, liver, or lung condition. 

It’s not possible to self-administer naloxone during an overdose, so it’s important to have at least one nearby person able to administer the medication if needed. Naloxone is available without a prescription at most pharmacies. NEXT Distro and the National Harm Reduction Coalition have resources to help you find free or low-cost naloxone near you.

When and how to use naloxone

Naloxone should be administered at the first sign of opioid overdose. It’s safe to use on someone who isn’t overdosing. The naloxone you are most likely to use comes in two forms: nasal spray and auto-injector. All naloxone products have clear step-by-step instructions printed on them. The auto-injector device also has voice instructions. This short American Medical Association video has step-by-step instructions for using all types of naloxone. You can also sign up for a free online training to learn how to use naloxone. 

When administering naloxone, you should first identify signs of opioid overdose, then call 911 if you believe they are experiencing an overdose or other medical emergency. Monitor breathing after administering naloxone, and repeat the dose after two to three minutes if there’s no response. Stay with the person who has overdosed until emergency personnel arrives. 

How to use Narcan nasal spray  

  1. Place the nozzle completely inside either nostril.
  2. Pointing the nozzle sideways inside the nostril, press the plunger firmly to release.
  3. If there’s no response after 2-3 minutes, administer a second dose.

How to use intranasal naloxone (yellow cap)

  1. Remove the yellow caps from the syringe and the red cap from the naloxone vial.
  2. Screw the vial into the syringe, but don’t press down. Screw the white cone on top of the syringe.
  3. Insert the cone into either nostril and push the vial firmly to release half its contents. Repeat in the second nostril.
  4. If there’s no response after 2-3 minutes, administer a second dose.

How to use auto-injectable naloxone 

  1. Remove the auto-injector from its case. 
  2. Pull off the red safety guard, being careful not to touch the black end.
  3. Press the black end against the outside of the thigh, over clothing if necessary. 
  4. Press firmly on the auto-injector until you hear a “click,” then hold for 5 seconds.  
  5. If there’s no response after 2-3 minutes, administer a second dose.