Narcan (Naloxone) Drug Overdose Treatment

Part of the complete guide to understanding addiction

Since then, Narcan has saved over 26,000 American lives. It is now distributed across many states through the free Narcan kit programs. Research has shown that in states where naloxone access laws have been formed, a 14% decrease in overdose deaths was observed. Using statistical modeling, it is estimated that with a high distribution of naloxone, there could be a 21% decrease in overdose deaths. Forty-six states have also passed Good Samaritan laws to protect those who administer Narcan from being prosecuted by the law. The hope is that the more available and accessible Narcan is, the more lives can be saved. It must be noted that Narcan is a life saving emergency measure. Once the patient is stabilized, it is imperative to direct him or her to a proper drug rehab treatment center. Drug detox followed by inpatient rehab and eventually outpatient rehab is the best path to lasting sobriety and addiction recovery.

How Does Narcan Work?

Narcan is an FDA-approved medication used for the treatment of opioid overdoses. Generically known as Naloxone, Narcan reverses the effects of opioids in the body. It is an emergency treatment that is not meant to be used over a prolonged period. It is safe to use amongst people of all ages.

Scientists are not fully aware of why Narcan works to reverse opioid overdoses. However, when Naloxone enters the body, it will bind to opioid receptors preventing other opioid effects. Narcan will awaken the brain and prevent opioids from slowing down spinal cord and brain systems. One of the common effects it reverses is restricted breathing which is often fatal in overdoses.

Who Is Given Narcan?

Doctors will prescribe Narcan to patients at risk for an opioid overdose.

• Patients who are taking high doses of opioids for chronic pain.
• Patients who are receiving rotating opioid regimens.
• Patients who had opioid poisoning or intoxication.
• Patients who take extended-release or long-acting opioid medications.
• Patients who have had a period of abstinence are at risk for relapse.

Narcan is also available to the public in many states through the free Narcan kit programs.

What Drugs Can Narcan Reverse?

Narcan is only effective on opioids, such as.

• Morphine
• Heroin
• Codeine
• Fentanyl
• Hydrocodone
• Methadone
• Oxycodone

When Can a Drug Overdose Occur?

An overdose can occur from many scenarios involving opioids.

These are some of the common causes of opioid overdoses.

• A patient accidentally takes an extra dose or deliberately misuses a prescription.
• Illicit drug use.
• Opioid medication is mixed with other substances.

Signs of an Overdose

The symptoms and signs of an overdose can differ. However, relatives and caregivers of those taking opioids should be familiar with the signs of a possible overdose.

These are some of the symptoms an opioid overdose can include.

• Slow or shallow breathing
• Vomiting
• Unconsciousness
• Faint heartbeat
• Unusual sleepiness
• Rapid heart rate
• Tiny (pinpoint) pupils
• Low blood pressure
• Inability to speak
• Limp arms and legs
• Purple lips and fingernails
• Pale skin

Who can give a patient Narcan?

If someone is affected by an opioid overdose, Narcan is usually given by a caregiver or loved one. Opioids can stay in the body longer than Narcan so that patients may return to their overdose condition. Therefore, once Narcan is administered, 911 should be phoned right away, so they receive professional medical attention immediately.

How To Administer Narcan

A doctor or healthcare provider will provide Narcan training. The Narcan website also gives detailed descriptions of how to administer Narcan.

These are the basic instructions for administering Narcan.

Ensure that the person is lying on their back with their head tilted and supported while administering.

1. Hold the nasal spray and use your thumb on the bottom of the plunger and your first and middle fingers on either side of the nozzle.
2. The nozzle should be inserted gently into one of the person’s nostrils.
3. Press the plunger firmly, giving the total dose of Narcan, and then remove the nasal spray from their nostril.
4. Call 911 immediately after.

After administration, place the person in a recovery position on their side. This will prevent them from choking if they vomit. It is also essential to stay with the person after giving them the first dose of Narcan. If they are not breathing after two to three minutes, give them a second dose. If a double dose is administered, it should be done in the opposite nostril. Keep repeating doses every 2-3 minutes until the person is responsive or medical help is there.

Narcan and Drug Overdose FAQs

1. How Much Narcan Should Be Given?

The dose for Narcan is one dose in one nostril. It is the same for adults and infants. However, Narcan can be administered every 2-3 minutes until responsive.

2. What are Possible Side Effects of Narcan?

These are some of the possible side effects of Narcan.

• Headache
• Nasal dryness
• Nasal congestion and fluid
• Nasal inflammation
• Increased blood pressure
• Muscle aches and pains
• Changes in blood pressure
• Irregular heartbeat
• Difficult or labored breathing
• Pulmonary edema (fluid in the lungs)
• Heart attack

3. Are there any Risks of Narcan?

The main risk of Narcan use is that the patient may relapse into an overdose. This can occur since the opioid active remains active in the body longer than Narcan. Therefore, a patient needs to be monitored after the administration of Narcan by medical professionals. Additionally, acute withdrawal symptoms can begin immediately after Narcan administration, which can be dangerous. Especially in infants, the risk of acute withdrawal symptoms onset is higher. Therefore, it is essential that professional medical help be sought right after Narcan is given.

Acute drug abuse withdrawal symptoms can include.

• Fever
• Body aches
• Tachycardia (fast heartbeat)
• Nausea/vomiting
• Abdominal cramps
• Diarrhea
• Runny nose/sneezing
• Goosebumps
• Restlessness
• Irritability
• Nervousness
• Increased blood pressure
• Sweating
• Shivering/trembling
• Weakness

4. How Long Does Narcan Last?

Narcan is a short-term, emergency medication. It begins to work within 2-3 minutes after the first dose, although sometimes additional amounts are needed. It is not supposed to be used regularly or over a prolonged period.

5. Where Can I Get Narcan?

In the United States, it is possible to purchase Narcan at all major pharmacies. It is not available over the counter but can be purchased directly from a pharmacist without a prescription. It is advisable to speak to one’s doctor about having Narcan on hand if taking an opioid medication.  

6. How Does Narcan Look?

The FDA has approved three forms of Naloxone.

• Narcan nasal spray
• injectable
• auto-injectable (Evzio)

Narcan is the most common form since it’s easiest for families and caregivers or nonmedical personnel to administer.

6. How Much Does Narcan Cost?

The cost of Narcan can vary, but most insurance plans generally cover it. GoodRx also offers updated discounted prices for Narcan based on areas.

7. Is Narcan in Place of Drug Rehab and Detox?

A common misconception about Narcan is that the effects of opioid use will be over once it is administered. However, Narcan is just the start of recovering from an opioid use disorder. It will not detox the body, which is the first step in healing. Therefore, once one has recovered from an opioid overdose, one should pursue a detox protocol and substance use treatment.

8. Is Narcan Addictive?

Narcan is not addictive at all. It has a Schedule II classification, like all opioids but does not share its addictive quality.

Addiction Treatment and Drug Rehab After an Opioid Overdose

Although Narcan effectively reverses the immediate effects of opioid use, it does not provide long-term treatment. If the cause of the opioid overdose was opioid misuse, a person must receive drug rehab treatment to prevent future overdoses and relapses. This will usually include tapering off a substance, medication, and therapy to address addictive behaviors.  Long-term medications can be used with treatment to recover from an opioid use disorder. Inpatient rehabs as well as outpatient rehab options should be explored. At a drug treatment center, clients enter the track to addiction recovery with drug detox. Once the detox from drugs is completed, inpatient drug treatment begins. The important thing is that the condition is addressed. Addiction rehab saves lives.

Using Narcan to Save Lives

The motto of Narcan is, “Be the one before 911.” As opioid use continues to climb in the USA, with over 100,000 opioid overdoses in the past year, awareness of this medication is vital. If a loved one has a history of substance use, treatment can often begin with this medication. Keep it readily available. The hope is that with measures to fix the opioid crisis and the widespread distribution of Narcan, the rate of opioid overdoses will dramatically decline.

Sources

Narcan Prices and Narcan Coupons – GoodRx
NARCAN_USPI_Aug2020_A1135.pdf
NARCAN® (naloxone HCl) Nasal Spray – Be the One When it Counts
Naloxone | SAMHSA
Narcan (naloxone): Dosage, uses, side effects, and more (medicalnewstoday.com)
Lifesaving Naloxone (cdc.gov)
Narcan Nasal Spray: Uses, Dosage, Side Effects – Drugs.com
Narcan: How It’s Given, How It Works, Uses, and More (healthline.com)
Narcan (Naloxone Hydrochloride Injection): Uses, Dosage, Side Effects, Interactions, Warning (rxlist.com)
Drug Overdose Deaths in the U.S. Top 100,000 Annually (cdc.gov)
Drug Overdose Death Statistics [2022]: Opioids, Fentanyl & More (drugabusestatistics.org)
The History of Naloxone – Cordant Health Solutions (cordantsolutions.com)