The opioid-reversal drug Narcan (naloxone) can now be sold over the counter, the Food and Drug Administration (FDA) announced Wednesday.
“Naloxone it’s really easy to give. It’s life-saving,” saidRobert Baillieu, MD, MPH, a physician and senior advisor at the Center for Substance Abuse Treatment at the Substance Abuse and Mental Health Services Administration. “It’s really important. It means anyone who uses substances, or anyone who knows someone who uses substances, particularly friends or family members, has access to a life-saving medication.”
How Can You Tell If Someone Is Overdosing?
A person may be experiencing an overdose if:
If you suspect someone has overdosed, call their name or nudge them to see if they are responsive. If you can no longer see their chest rise and fall, they may be overdosing. You can also do a “sternum grind,” saidJose Martinez, a harm reduction associate with the National Harm Reduction Coalition. Use your knuckle and rub it in the middle of their chest, across their breastbone, and see if they respond.
You may also notice discoloration of the person’s skin, depending on their race. For instance, a Black person may have a grayish tint to their skin while a white person may start to appear blue or purple.
When in doubt, it may make sense to administer Narcan. Baillieu said Narcan is a “really safe” medication, even when given to someone who hasn’t overdosed on opioids.
Should You Call 911 Before Administering Narcan?
If you have Narcan available, use the spray first. The sooner Narcan is administered after a person shows signs of overdose, the more likely the person is to survive. Then you can call 911.
Narcan won’t permanently reverse an overdose. The person will likely need more naloxone and other medical care to fully recover, so you should call emergency services, even if the person wakes up.
Nearly every U.S. state and territory has good Samaritan laws, which protect people from criminal penalties if they call 911 to help someone who has overdosed.
How Should You Use Narcan?
Step 1
Peel off the back of the Narcan package and remove the device. Hold the device in one hand. Place your thumb on the bottom of the plunger and your index and middle fingers on the base of either side of the nozzle.
Step 2
Lay the person on their back, face up. Make sure their head is straight. Support their head with your hand.
Step 3
Place the tip of the nozzle into one nostril until your fingers touch the bottom of the person’s nose. Hold the device steady, firmly press the plunger with your thumb. This will release a spray of the medication into the person’s nose.
Step 4
Wait two to three minutes for the medicine to work. If you haven’t yet called 911, this is a good time to do so. Put the person in a “recovery position.” Roll them on their side, with their head resting on their hands and one knee bent out to the side to prevent them from rolling onto their stomach.
Until the person is breathing normally or EMS arrives, you can give them “rescue breaths.” Lay them on their back, tilt their chin up, and pinch their nose. Place your mouth on theirs to make a seal and give them two slow breaths. Repeat this every five seconds.
If the person’s breathing does not return to normal, or they continue to have difficulty breathing, they may need another dose. You may need to repeat this every two to three minutes until breathing returns to normal.
Stay near the person and closely watch them until medical help arrives. Dispose the Narcan device in an area away from children.
What Should You Do After Giving Narcan?
Narcancan reversean overdose for 30 to 90 minutes, but opioids can stay in the body longer than that. During this time, the patient should not use additional drugs.
When the patient revives, it’s important to keep them calm and help them understand what happened, Martinez said. They may become agitated and need some time to get coordinated again.
People who are opioid dependent can experience symptoms of withdrawal within minutes of receiving Narcan. These may include:
Emergency medical responders may suggest that the patient goes to the emergency room or gets treatment for opioid use disorder after the overdose is reversed.
“Sometimes, people who use drugs don’t really have either a good relationship with or history with those kinds of environments, so that’s why we give them the option to go to the ER or not,” Martinez said.
How Does Narcan Work?
Should You Get Narcan Before It’s Available OTC?
In most cases, a prescription is required for someone to access Narcan. In many states,providers will mailit to your home. In others, you can pick it up at vending machines.
Baillieu said SAMHSA has spent more than $1 billion in grants to support states’ efforts to curb overdose, including distributing naloxone. A simple Google search can tell you how to access Narcan in your state.
The FDA said it may later approve other brand-name naloxone nasal sprays and encouraged other manufacturers to apply for over-the-counter status for their products.
Martinez said that many people still stigmatize drug users. Making naloxone widely available could encourage more people to see the benefits of harm-reduction tools.
“It’s one thing to say, ‘you should carry X number of doses,’ and another to make it easy,” Martinez said. “This decision to make naloxone over the counter is really important so that people can access it easily. It helps with broader issues around communities’ involvement in looking after individuals who misuse substances, too.”
Ease of access to naloxone can be life-saving not only for persistent opioid users, but for those who unwittingly consume fentanyl and other opioids, too. Baillieu said there have been instances of marijuana being laced with these drugs.
Baillieu applauded the move to make naloxone more accessible to everyone. Still, the overdose crisis is multi-faceted and addressing it will require interventions from many angles, he said.
“Naloxone is one part of the puzzle. Decreasing opioid overdose is more than just treating overdose. It’s looking at the social determinants of health that lead to substance misuse. It’s looking at access to treatment. It’s looking at addiction counseling. It’s looking at all of those things that can help an individual and communities.”
What This Means For YouAnyone seeking treatment options for substance use or mental health disorders can call the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 800-662-HELP (4357) or visitfindtreatment.gov.
What This Means For You
Anyone seeking treatment options for substance use or mental health disorders can call the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 800-662-HELP (4357) or visitfindtreatment.gov.
4 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute on Drug Abuse.Drug overdose death rates.Substance Abuse and Mental Health Services Administration.SAMHSA opioid overdose prevention toolkit: safety advice for patients & family members.U.S. Government Accountability Office.Drug misuse: most states have Good Samaritan laws and research indicates they may have positive effects.National Library of Medicine: DailyMed.Narcan—naloxone hydrochloride spray[drug label].
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute on Drug Abuse.Drug overdose death rates.Substance Abuse and Mental Health Services Administration.SAMHSA opioid overdose prevention toolkit: safety advice for patients & family members.U.S. Government Accountability Office.Drug misuse: most states have Good Samaritan laws and research indicates they may have positive effects.National Library of Medicine: DailyMed.Narcan—naloxone hydrochloride spray[drug label].
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Institute on Drug Abuse.Drug overdose death rates.Substance Abuse and Mental Health Services Administration.SAMHSA opioid overdose prevention toolkit: safety advice for patients & family members.U.S. Government Accountability Office.Drug misuse: most states have Good Samaritan laws and research indicates they may have positive effects.National Library of Medicine: DailyMed.Narcan—naloxone hydrochloride spray[drug label].
National Institute on Drug Abuse.Drug overdose death rates.
Substance Abuse and Mental Health Services Administration.SAMHSA opioid overdose prevention toolkit: safety advice for patients & family members.
U.S. Government Accountability Office.Drug misuse: most states have Good Samaritan laws and research indicates they may have positive effects.
National Library of Medicine: DailyMed.Narcan—naloxone hydrochloride spray[drug label].
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