Over the Counter (OTC) Narcan Nasal Spray: Should You Get It?

Have you heard of Narcan? That’s a brand name for a drug called naloxone — and it’s a real lifesaver. Literally. It can block and reverse the effects of an opioid overdose and make the difference between life and death.

The FDA approved over-the-counter (OTC) sales of naloxone nasal spray last week. As pharmacies, grocery stores and even gas stations prepare room for naloxone nasal spray on their shelves alongside other first-aid products, here’s some information on the life-saving medication — and why you should have it.

What is Narcan?

Naloxone (sold under the brand names Narcan, Evzio and Zimhi) is what’s called an opioid antagonist. That means it attaches to the opioid receptors in your body and blocks the effects of opioids on the brain. Opioids are drugs like heroin, oxycodone, hydrocodone, codeine, morphine and fentanyl.

How does Narcan work?

Narcan, or any naloxone nasal spray, rapidly restores normal breathing to a person who may have stopped breathing or is breathing very slowly because of an opioid overdose.

Naloxone can be delivered in two ways: by injection or pre-packaged nasal spray. Only the nasal spray is currently approved for OTC sales.

Why should you have Narcan?

Opioid overdoses are more common than you may think. More than 130 people in the U.S. die from an opioid overdose every day — and it happens to people from all walks of life. You might think you’d never see this happen, but what if you do? If you have naloxone on you, you might be able to help. And it is possible: 8 out of 10 opioid overdoses happen in a home, and 4 out of 10 opioid overdoses have bystanders present.

The potential at-risk population includes teenagers, people who are prescribed opioids to manage chronic pain, people who have substance-use disorders or those who have been treated in the past for substance-use disorders.

Does Narcan have side effects?

The medication is considered safe and has no effect on someone who does not have opioids in their system. Although naloxone won’t work for non-opioid overdoses, such as those caused by cocaine or methamphetamines, it won’t harm anyone either. The CDC recommends using naloxone anytime someone witnesses a person experiencing the symptoms of overdose, even if the drug that caused it is unknown. Overdose symptoms include pinpoint-sized pupils, faint heartbeat, difficulty speaking, unconsciousness, vomiting, cold or bluish skin, or stopped or slowed breathing, sometimes with gurgling sounds.

Allergic reactions to naloxone are rare, and the risk of dying from an overdose is higher

than the risk of an allergic reaction. Signs of an allergic reaction include hives or swelling in the face, lips or throat. Anyone experiencing these symptoms should seek medical help immediately.

If a person is dependent on opioids, they may experience withdrawal symptoms after receiving naloxone. These symptoms are usually not life-threatening and may include headaches, blood pressure changes, heart rate changes, sweating, nausea and tremors.

How do you give someone Narcan nasal spray?

To administer a dose of the nasal spray, tilt back the head of the person who appears to have overdosed and spray the prefilled device into one nostril. Be sure to push the plunger all the way to give the person the entire dose. It works in two to three minutes. If the person has not woken up after 3 minutes, another dose of naloxone may be required.

Call 911 immediately after giving the medicine, and stay with the person until emergency help arrives. Try to keep them awake — without slapping or hitting them — and keep them on their side to prevent choking.

How long does Narcan block opiates?

Naloxone works to reverse the overdose for 30 to 90 minutes. Since opioids can remain in the body longer than that, a person may go back into an overdose after the naloxone wears off.

Where can I get Narcan and how much does Narcan cost? 

Narcan is available in all 50 states, D.C. and Puerto Rico. Prices range from $24-$129. Some health insurance providers and prescription discount programs cover the medication.

It may take months for Narcan to be readily available OTC nationwide. In the meantime, every state has laws that allow people to access naloxone. There are also community naloxone distribution programs in most states that allow people to order the drug for free online and have it delivered by mail.

Check with your healthcare provider or local pharmacist to find out how to get Narcan now.

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