Narcan

What Is Narcan?

Narcan is a brand name for the drug naloxone, a life-saving medication used to quickly halt the effects of an opioid overdose. The effects of Narcan last for up to 90 minutes.

Narcan was the first of its kind, but now other formulations and brand names exist (such as Kloxxado®).

Available forms of naloxone include:

• Intranasal sprays
• Subcutaneous injection (under the skin)
• Intramuscular injection (into the muscle)
• Intravenous injection (directly into a vein)

Naloxone nasal sprays typically contain a single pre-measured dose of naloxone, while injections must usually be measured from a vial using a syringe to determine dosage.

In 2023, the US Food and Drug Administration (FDA) made Narcan nasal spray available for anyone to purchase over the counter (OTC) without needing a prescription.

People can find Narcan at their local pharmacies or through local, community-based programs that give it out for free.

While Narcan is an emergency medication designed to prevent opioid overdose deaths, it is NOT a complete treatment for opioid use disorder.

How Does Narcan Work?

Narcan is an opioid antagonist, so it is used to quickly stop overdoses from opioid use for up to 90 minutes. It binds to the brain’s opioid receptors to almost immediately cancel out the effects of opioids in the body for a short window of time.

Narcan will only work for 30-90 minutes, so the victim can go back into overdose after the Narcan wears off.

They might also not know what happened and could wake up feeling scared and disoriented. They may also experience opioid withdrawal symptoms shortly after gaining consciousness, such as muscle aches, chills, and nausea.

Therefore, you should always stay with the overdose victim until first responders arrive to provide additional medical care. Good Samaritan laws protect you and the overdose victim when calling for help.

Is Narcan Safe?

Yes, Narcan is safe to use whether the victim has taken opioids or not.

If you suspect an overdose but aren’t sure what the victim has taken, it will not hurt them to administer Narcan. However, Narcan will also not revive the victim unless they are experiencing an opioid overdose.

It’s worth noting that once a dose of Narcan is administered, the individual may experience opioid withdrawal symptoms since the Narcan has paused the opioid’s effects.

The side effects of opioid withdrawal (such as headache, changes in blood pressure, sweating, tremors, or vomiting) are uncomfortable but rarely life-threatening.

Importance of Narcan in Saving Lives

The entire purpose of Narcan is to prevent overdose deaths in individuals who have taken too many opioids, be they illicit (i.e., heroin) or prescription opioids (i.e., Oxycodone).

Synthetic opioids (especially fentanyl) are the driving force behind the deadly opioid epidemic currently plaguing the United States. This public health crisis spiked in the early 2000s, but it remains an ongoing problem.

In 2020, an average of 44 people died every day from a prescription opioid-related overdose. The US Centers for Disease Control and Prevention (CDC) also reports that 75% of all drug overdose deaths in 2020 involved opioids.

Now, even individuals who are using other substances—perhaps even for the first time—are at risk of experiencing an opioid overdose without knowing it.

Having Narcan readily available is even more important now, as reports of other drugs laced with fentanyl or other illicit opioids continue to increase.

Narcan offers a significant tool in opioid overdose prevention by stopping the opioid’s effects long enough for medical personnel to intervene, potentially saving countless lives.

Harm Reduction Concerns

While evidence suggests that Narcan is extremely helpful in preventing fatal overdoses, some remain concerned that the availability of Narcan encourages substance use.

Arguably, some insist that the availability of a life-saving medication should be the priority. However, others would argue that Narcan makes it easy for opioid addicts to justify their substance abuse to themselves or others.

Ultimately, the topic of harm reduction is still a gray area.

The evidence certainly suggests that harm reduction techniques, including having Narcan widely available, do help prevent fatal overdoses long enough for many people to get help eventually—but the topic remains somewhat debated.

Signs of an Opioid Overdose

An opioid overdose is hazardous and can be fatal. If you suspect someone is experiencing an opioid overdose, call 911 immediately and stay with the victim until help arrives.

Key signs of an opioid overdose include one or more of the following:

• Slowed or stopped breathing
• Pinpoint pupils
• Blue-tinged lips or fingertips
• Slowed or stopped heart rate
• Unconsciousness
• Cold, clammy skin
• Rattling or gurgling noises when breathing
• Vomiting, especially while unconscious/unresponsive

If you can, administer Narcan to pause the effects of opioids in their system.

Please note that in many states, Good Samaritan Laws protect both the caller and the victim from any legal trouble when 911 is called for an overdose.

Where Can You Get Narcan?

With the rise of fatal opioid overdoses and the ongoing opioid epidemic, many individuals choose to carry naloxone with them—even if they don’t use opioids themselves.

As of March 2023, Narcan nasal spray (distributed by Emergent Biosolutions) received FDA approval for over-the-counter purchase through their local pharmacies.

If you would like to join those who are dedicated to harm reduction and opioid overdose prevention, you can get Narcan from your local pharmacy.

You can still speak with your prescribing doctor or get in touch with a community health department to receive a Narcan prescription and receive additional information.

Treatment Options for Opioid Use Disorder

Narcan is an emergency medication designed to reverse overdoses in opioid users. It is NOT a treatment for opioid use disorder.

Therefore, after an opioid overdose, a person dealing with opioid use disorder may require additional treatment for their drug abuse.

Treatment for opioid use disorder may include one or more of the following:

• Detox: After an opioid overdose, especially for someone who has been using opioids long-term, medical detox may be the first step in addiction treatment.
  Medical detox can occur at home (outpatient) for average cases or at a facility (inpatient) for more severe situations.
• Rehab: Rehab for opioid abuse and addiction is available at different levels of care, starting with outpatient options (i.e., Intensive Outpatient and Partial Hospitalization programs) and moving up to inpatient options, such as residential treatment.
• Therapy: Psychotherapy (like cognitive-behavioral therapy) helps individuals with substance use concerns to pinpoint the triggers that led them to abuse opioids in the first place.
  Any rehab (both inpatient and outpatient) will provide access to mental health services, including group and individual counseling sessions. However, the person may also consider seeking therapy after the initial treatment has finished.
• Medication-Assisted Treatment (MAT): Your healthcare provider may recommend prescription medication that can help the individual during and/or after the treatment process. Specific drugs (such as buprenorphine) can alleviate cravings and decrease the risk of relapse.
  Notably, the CDC generally recommends that doctors or healthcare professionals prescribe Narcan to the addict in recovery, a primary caregiver, or a trusted family member in case of relapse.

Find Resources for Battling Opioid Addiction

If you or a loved one is dealing with an addiction to opioid medications or illicit opiates, you can contact the SAMHSA treatment hotline by calling 1-877-726-4727 (HELP) or by visiting their online treatment locator.

They can help you locate resources in your area, from addiction counselors and detox centers to full rehab treatment programs.

Additionally, if you are interested in carrying Narcan nasal spray for yourself, a loved one, or as a general service to your community, speak to your doctor or local community outreach program. Many community programs offer free, confidential Narcan and naloxone distribution.