Narcan: OTC Opioid Overdose Reversal Medication

April 7, 2023

an image of Narcan (naloxone) an opioid overdose reversal medication and nasal spray

Narcan is a prescription nasal spray that rapidly reverses the effects of opioid overdose.

The FDA (U.S. Food and Drug Administration) recently announced that Narcan can be sold over-the-counter. Data from CDC (Centers for Disease Control and Prevention) show that more than 100,000 U.S. adults died from drug overdoses in each of the past two years. Public health officials and addiction specialists hope that improving access to Narcan may reduce the alarmingly high rates of drug fatality in the United States.

Narcan is expected to be sold in supermarkets, convenience stores, and big-box chains by the end of the summer. The opioid overdose antidote may even be for sale in vending machines by late 2023.

Today you can discover what does Narcan do, what is Narcan used for, and how to get Narcan without a prescription.

What is Narcan?

Narcan (stylized as NARCAN®) is the first nasal formulation of naloxone. Narcan is FDA-approved for treating opioid overdose or suspected overdose.

The most prescribed nasal form of naloxone, Narcan is designed for use in the community needle-free.

Naloxone is an opioid antagonist. Like naltrexone – approved by the FDA for treating opioid use disorder and alcohol use disorder – naloxone binds to the same mu-opioid receptors in the brain as heroin, fentanyl, and prescription opioids.

If Narcan is administered properly, the medication can swiftly reverse the effects of opioid overdose, restoring consciousness and normalizing breathing in those overdosing on any type of opioids.

Narcan is available as an injectable or as a nasal spray. The nasal spray is available in many U.S. communities without a supporting prescription.

In 1983, WHO (World Health Organization) added Narcan (naloxone) to its model lists of essential medicines.

How Does Narcan Work?

Opioids are analgesic agents – painkillers – that bind to MOP receptors (mu-opioid receptors), acting as antagonists, agonists, or partial agonists. When opioids attach to these MOP receptors in the brain and body, this simultaneously triggers pain relief and euphoria. At the same time, opioids may slow or stop breathing, potentially leading to life-threatening overdose.

Narcan rapidly binds to MOP receptors in the brain, displacing opioids and countering their effects, serving to reverse the effects of respiratory depression. Normal breathing and consciousness will be restored.

For best results, Narcan should be administered as quickly as possible after an opioid overdose. The effects of naloxone set in within minutes, blocking the effects of other opioids in the system for 30 to 90 minutes.

Does Narcan Work on Fentanyl?

Narcan can be effective in reversing the effects of an overdose caused by fentanyl. Fentanyl is a synthetic opioid that is many magnitudes more potent than heroin, and it can cause rapid, severe, and life-threatening respiratory depression. With more and more street drugs now becoming tainted by fentanyl, there is no downside to administering Narcan in the event of any suspected drug overdose.

Like other opioids, fentanyl works by binding to specific MOP receptors in the brain and body, which can lead to decreased pain and feelings of euphoria. That said, fentanyl can also slow or stop breathing like all opioids. This can be fatal in an overdose.

When Narcan is administered, it quickly competes with fentanyl for the same MOP receptors, displacing them and reversing the effects of the fentanyl, at the same time as restoring normal breathing and consciousness.

Note that fentanyl is much more potent than other opioids, so higher doses of Narcan may be required. Additionally, since fentanyl can be more potent than some forms of Narcan, multiple doses of Narcan may be necessary to completely reverse the effects of the overdose. It is crucial to seek medical attention immediately if someone has overdosed on fentanyl, even if they have already been given Narcan.

How to Administer Narcan

Narcan is a needle-free device that was developed for home use in those without medical training.

You should call 911 immediately when administering Narcan. Naloxone is not intended as a substitute for medical care.

  • Remove the Narcan spray from its packaging.
  • Hold the spray device. Place your thumb on the bottom, resting your first and middle fingers on each side of the spray’s nozzle.
  • Tilt the person’s head and support their neck with your hand.
  • Gently slide the nozzle into one nostril. Your fingers should be positioned against the bottom of the person’s nose.
  • Push down firmly on the plunger. This will release a metered dose of Narcan.
  • Remove the nozzle from the person’s nostril.
  • If they do not respond within 2 or 3 minutes, administer another dose of Narcan in the other nostril.

Where to Get Narcan

Narcan gained FDA approval in 2015 as a prescription medication. Following a process to change the drug’s status, Narcan has be demonstrated to be safe and effective for use as directed. Resultantly, Narcan nasal spray has been approved for marketing without a prescription.

Until now, access laws in every U.S. state have allowed pharmacists to have standing prescriptions enabling them to administer Narcan or naloxone in generic form to anyone who requests the medication. Regrettably, many pharmacists have declined to engage those who abuse illicit drugs – in 2021, 17 million doses of naloxone were distributed, with only 2.6 million doses obtained from pharmacies.

By late summer, Emergent BioSolutions (the manufacturer of Narcan) intends to make Narcan available nationwide at online retailers and on store shelves. Until Narcan becomes available over-the-counter, the medication remains available through pharmacies or community distribution.

Opioid Addiction Treatment at Gratitude Lodge

If you have been abusing prescription opioid painkillers, heroin, or fentanyl, we can help you reclaim your life from opioid use disorder at Gratitude Lodge in Southern California.

Engage with our supervised medical detox program to ensure that opioid withdrawal is as safe and comfortable as possible. After a week of detox, you will be ready to move directly into one of our opioid addiction treatment programs at Long Beach or Newport Beach in Southern California.

We offer treatment programs for opioid addiction at all levels of intensity, from residential rehab to intensive outpatient treatment. We also specialize in the dual diagnosis treatment of addictions co-occurring with mental health conditions like depression, anxiety, and PTSD.

All Gratitude Lodge treatment programs are delivered in pet-friendly settings and offer personalized opioid addiction treatment that combines science-backed therapies and holistic treatments that include:

  • MAT (medication-assisted treatment
  • Psychotherapy (talk therapy)
  • Group therapy
  • Family therapy
  • Individual counseling
  • Holistic interventions
  • Aftercare

When you are ready to move beyond opioid addiction, reach out to Gratitude Lodge by calling 888-861-1658 today.


Help for you or a loved one is only one call away.

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Jenni Bussi

Jenni Russe MS, LPCC

Jenni Busse MS, LPSS is the Clinical Director at Gratitude Lodge. Jenni oversees the clinical program and the clinical team at Gratitude Lodge as a whole. Jenni has worked in treatment for almost 14 years. Her background as a licensed therapist and her passion for helping others intersected with addiction recovery when she started working primarily in detox residential treatment.
Joe Gilmore

Joseph Gilmore

Joseph Gilmore has been working in the addiction industry for half a decade and has been writing about addiction and substance abuse treatment during that time. He has experience working for facilities all across the country. Connect with Joe on LinkedIn.

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