Naloxone, often sold under the brand name Narcan, is a lifesaving medication that stops the effects of opioids in people who are overdosing. Experts attribute the recent decline in overdose deaths to the accessibility of naloxone, which became available over the counter in 2023.
Unfortunately, myths that naloxone is not effective against all opioids, such as fentanyl, may stop some people from administering this medication when it’s needed most.
Read on to learn more about what naloxone is, how it reverses overdoses caused by different types of opioids, and how you can use naloxone to save lives.
What is naloxone?
When a person takes opioids, the drug attaches to receptors in the brain to produce its effects. Naloxone is an opioid antagonist, which means it binds to those same receptors and blocks opioids from causing overdose symptoms. When a person’s breathing has slowed or stopped due to an overdose, naloxone can help them breathe normally within minutes and keep them stable until emergency services arrive.
It’s typically administered as a nasal spray (as in the case of Narcan), but sometimes the medication is administered as an injectable (similar to an EpiPen). Multiple doses may be required in order for naloxone to be effective.
Which drugs is naloxone effective against?
Naloxone reverses overdoses caused by prescription opioids and opioid street drugs. These include natural opioids that come from plants, such as codeine and morphine; synthetic opioids that are made in a lab like fentanyl and isotonitaze (“iso”); semi-synthetic opioids like heroin and oxycodone; and opioid-containing substances like krokodil, which is typically made of codeine mixed with additives like gasoline or paint thinner.
Naloxone cannot reverse an overdose caused by non-opioid drugs like cocaine, benzodiazepines, or alcohol. However, naloxone should be administered any time someone shows signs of an overdose, even when you don’t know if they’ve taken opioids. Street drugs are often laced with opioids—especially fentanyl—which increases the risk of overdose.
Naloxone will not harm a person who is not overdosing on opioids.
If someone has overdosed on synthetic opioids, they may need multiple doses of naloxone. If you administer naloxone and overdose signs do not resolve, give additional doses every two to three minutes until the person begins to breathe normally or until medical help arrives.
When should I administer naloxone?
If you believe someone is overdosing, call 911 and then administer naloxone. Signs of an overdose may include:
- Shallow or slow breathing
- Loss of consciousness
- Slurred speech
- Limp body
- Cold, clammy skin
- Blue lips, nose, or nails
- Abnormally small pupils
- Choking or gurgling sounds
Stay with the person until medical help arrives, and provide additional doses of naloxone—which is typically sold in packs of two doses—if needed. Most states have Good Samaritan laws that protect people who are overdosing and those assisting them from some legal consequences.
Where can I learn how to use naloxone?
All naloxone products have step-by-step instructions printed on them. However, it’s helpful to know how it works before you have to administer it. Learn how to use naloxone from the American Medical Association, or sign up for a free online training.
Where can I get naloxone?
You can get naloxone for free from local harm reduction programs and some community centers and public libraries. You can also purchase over-the-counter naloxone without a prescription at pharmacies, grocery and convenience stores, and other retailers. A pack of two doses costs around $50.
Learn about other harm reduction services that prevent overdose deaths from the National Harm Reduction Coalition.