What Is Narcan (Naloxone HCL)?

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Narcan is a brand name for naloxone, a medication used to reverse overdose effects in those who’ve taken opioids. This includes prescription painkillers such as oxycodone and hydrocodone and illicit drugs such as heroin and fentanyl. Narcan is considered a vital tool in combating the opioid epidemic. Using opioids in excess is extremely dangerous, and those who engage in misuse are at significant risk of developing a substance use disorder and experiencing a life-threatening overdose.

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Naloxone’s History & Development

Naloxone was first developed by Dr. Jack Fishman and Dr. Mozes Lewenstein in 1961. (1) It was approved for use by the U.S. Food and Drug Administration (FDA) in 1971. Initially, it was intended for use in medical settings to reverse the effects of opioid overdose rapidly. In response to the growing opioid epidemic, efforts were made to increase access to naloxone for people who use opioids, their loved ones, and first responders.

How Does Narcan Work To Counteract an Overdose?

Opioids attach to specific brain receptors responsible for pain relief and pleasure. Taking these drugs in excess can overwhelm the receptors, leading to respiratory depression and possibly death. Narcan works by binding to the same receptors and blocking opioids from attaching, reversing central nervous system depression and returning a person’s breathing to normal.

Narcan can be injected into veins, muscles, or under the skin in clinical settings or by trained medical professionals. (2) In addition, nasal spray and auto-injection methods can be used by laypersons with no medical training. (3)(4)

Importantly, Narcan is specifically designed to counteract the effects of opioids and is ineffective for treating other drug overdoses, including benzodiazepines, alcohol, or cocaine.

How Long Do Reversal Effects Last?

Narcan’s reversal effects typically begin within 2-3 minutes of administration and last approximately 30-90 minutes. (5)(6) This can vary depending on individual factors, including the amount and type of opioid(s) ingested. Unfortunately, the effects of opioids can persist for longer than Narcan. For this reason, individuals who have received Narcan may need more than one dose and should be closely monitored and transported to a medical facility for treatment.

How Do You Know When To Administer Narcan?

Several signs and symptoms can identify an opioid overdose. You must be able to recognize these symptoms so you can intervene promptly.

Signs of Opioid Overdose Include:

  • Slow or shallow breathing.
  • Unresponsiveness.
  • Bluish or pale skin, especially around the lips and fingertips.
  • Pinpoint pupils.
  • A gurgling or snoring sound while breathing.

If you witness the above signs in a person whose used opioids, administer Narcan promptly while following the enclosed instructions. Remember to seek medical attention by calling 911 or visiting the nearest emergency department immediately, as Narcan is not a substitute for emergency care. After administering Narcan, monitor the individual closely for any changes in breathing or consciousness. If the individual’s breathing or consciousness does not improve, administer another dose.

Narcan is generally considered safe and has no significant adverse effects if given to a person without opioids in their system. Moreover, if you’re unsure whether a person having an overdose used opioids, it may be crucial to administer Narcan just in case.

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How Long Does Someone Have During an Overdose To Receive Narcan?

The time frame for administering Narcan during an overdose varies depending on several factors, including the amount and type of drug taken, the individual’s health status, and breathing rate. Sometimes it can take hours after using opioids for overdose symptoms to manifest. Regardless, the earlier Narcan is administered, the better the likelihood of a successful outcome.

It’s important to remember there is no limit to the number of times Narcan can be administered for an overdose. In cases of highly potent opioids, such as fentanyl, multiple doses may be needed to reverse the overdose fully.

Can You Administer Narcan to Someone Without a Pulse?

Naloxone is designed to reverse respiratory depression occurring during an opioid overdose. It is typically administered to individuals still breathing, but it will still work on individuals who have slowed or stopped respiration. However, if an individual has no pulse or is not breathing, perform cardiopulmonary resuscitation (CPR) immediately after administering Narcan if possible. (7) This will circulate the blood, allowing the Narcan to begin working.

Can You Give Yourself Narcan?

It is technically possible for someone to administer Narcan to themselves. Still, it can be challenging to do so effectively during an opioid overdose. Typically, if someone is experiencing an opioid overdose, they may be unresponsive, making it impossible for them to self-administer Narcan.

How Does Narcan Make You Feel?

Narcan produces neither euphoria nor pleasurable effects nor causes sedation or respiratory depression. Narcan’s common side effects, usually mild, include nausea, vomiting, sweating, tremors, and a rapid heart rate. Drugs that may interact with Narcan include opioids, buprenorphine, benzodiazepines, barbiturates, and tricyclic antidepressants. When a person has one or more of these drugs in their system, side effects can vary and be unpredictable.

Can Narcan Cause Withdrawal Symptoms?

Because Narcan detaches opioids from receptors, it can, in fact, precipitate withdrawal symptoms in opioid-dependent individuals. These symptoms may include agitation, irritability, sweating, nausea, vomiting, and diarrhea. Still, these symptoms are much less dangerous than opioid overdose, so the pros of Narcan vastly outweigh the cons.

Narcan Availability & Cost

In the United States, many pharmacies offer Narcan without a prescription. The cost of Narcan varies depending on the brand and administration method. The most commonly used form of Narcan is nasal spray, typically costing $140 on average for a two-dose package without insurance. (8) The injectable form may be less expensive, with a single-dose vial typically costing $20-$30.

Many states have implemented programs to make Narcan less costly and available to individuals at risk of opioid overdose or their loved ones. Similarly, some community-based organizations distribute Narcan, and healthcare providers may offer it to their patients for free or at a lower price.

Many insurance plans cover Narcan, including Medicare under Part D, a prescription drug benefit program. However, coverage and cost-sharing for Narcan may vary depending on the specific Medicare plan and the form of Narcan prescribed.

What Impact Has Narcan Had on the Opioid Epidemic?

Narcan has significantly impacted the opioid epidemic by saving countless lives and helping to prevent overdose deaths. (9) The widespread distribution and availability of Narcan have been credited with reducing the number of opioid overdose deaths in many communities. In addition, overdose deaths have decreased significantly in some areas since implementing Narcan distribution programs.

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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.

(1)https://www.mass.gov/service-details/naloxone-facts-and-formulations (2)https://www.mayoclinic.org/drugs-supplements/naloxone-injection-route/proper-use/drg-20095285 (3)https://www.mayoclinic.org/drugs-supplements/naloxone-nasal-route/proper-use/drg-20165181 (4)https://naloxoneautoinjector.com/ (5)https://www.cdc.gov/stopoverdose/naloxone/index.html (6)https://nida.nih.gov/publications/drugfacts/naloxone#:~:text=Naloxone%20only%20works%20in%20the,is%20in%20a%20person’s%20system. (7)https://www.redcross.org/take-a-class/cpr/performing-cpr/cpr-steps (8)https://www.drugs.com/price-guide/narcan (9)https://www.cdc.gov/opioids/overdoseprevention/reverse-od.html

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Reviewed professionally for accuracy by:

Ryan Soave

L.M.H.C.

Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

Cayla Clark

Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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