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Narcan Nasal Spray

Narcan is the brand-name formulation of naloxone, an opioid antagonist that can help to reverse an opioid overdose in an emergency.

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Narcan Nasal Spray is used to reverse an opioid overdose.

Almost 70,000 people died from an opioid overdose in 2020. Opioids are central nervous system depressants that can cause life-sustaining functions like breathing and heart rate to drop dangerously low very quickly, especially when opioids are misused. 

Narcan Nasal Spray is one of two formulations; the other form of Narcan is injectable. Narcan Nasal Spray is often available at your local pharmacy. In many areas, there are Narcan programs that offer the lifesaving medication for free. 

What Is Narcan Nasal Spray?

Narcan Nasal Spray is a potentially lifesaving medication that is designed to reverse the effects of an opioid overdose within two to three minutes. It is the most dispensed naloxone brand

It is dispensed in a two-pack of 4 mg doses each. It does not require needles or to be inhaled, and it is easy to administer without specialized training. It is a prescription medication, but it is regularly available directly from a pharmacist or through a Narcan program without a prescription to anyone who needs it.  

An opioid overdose can be fatal. It is a medical emergency with the following symptoms:

  • Trouble breathing
  • Extreme drowsiness or loss of consciousness
  • Mental confusion
  • Slow heart rate and blood pressure
  • Limp muscles and weakness
  • Cool, clammy skin that has a bluish tint
  • Pinpoint pupils

Narcan Nasal Spray can reverse an opioid overdose, restore breathing and consciousness, and be a lifesaving tool.

Key Statistics About Narcan

  • Narcan is a lifesaving medication. Access to it is improving with a 106 percent increase in naloxone prescriptions from 2017 to 2018 from retail pharmacies alone.
  • Bystanders are present in more than one out of three opioid overdoses. A bystander carrying Narcan Nasal Spray has the ability to save a life in this situation.
  • Naloxone distribution programs and higher rates of naloxone prescriptions have the potential to save nearly a quarter of lives lost to opioid overdose deaths.
  • Naloxone is effective in reversing an opioid overdose and saving lives nearly 94 percent of the time.

How Does It Work?

Naloxone, the active substance in Narcan Nasal Spray, is an opioid antagonist, which means that it blocks opioid drugs from binding to the opioid receptors in the brain. When dispensed when opioids are already present, it kicks these drugs off the opioid receptors. Since these drugs are acting to suppress the central nervous system, it stops that action.

An opioid overdose commonly causes breathing issues and loss of consciousness. Narcan Nasal Spray can effectively restore breathing and consciousness within a few minutes of being administered. 

How Do You Administer Narcan Nasal Spray?

Narcan Nasal Spray is quick and easy to administer. Follow the instructions contained in the prescribing information and instructions for use, which are as follows:

  1. As soon as you recognize any sign of an opioid overdose, act quickly to administer Narcan Nasal Spray as every minute counts.
  2. Lay the person flat on their back.
  3. Peel back the packaging and remove the device.
  4. Hold the device with your thumb on the bottom of the red plunger and your first and third fingers on either side of the nozzle.
  5. Tilt the person’s head back, and support the back of the head with your other hand.
  6. Put the tip of the nozzle into either nostril, and insert it up to the point where your fingers touch the bottom of the person’s nose.
  7. Press the plunger firmly to release the entire dose at once into the person’s nose.
  8. Remove the device.
  9. Move them onto their side into the recovery position.
  10.  Call 911 if you have not already.
  11.  If they do not respond within a few minutes, repeat steps 2 through 8. Additional doses can be administered every 2 to 3 minutes as needed.
  12.  Properly disposed of used Narcan Nasal Spray.

What Are the Possible Side Effects?

Narcan Nasal Spray is a safe and effective medication for opioid overdose reversal, but it can cause opioid withdrawal side effects to start, especially in people who have been using opioids regularly and have developed a physical dependence on these drugs. These withdrawal side effects can include the following:

  • Body aches
  • Nausea and vomiting
  • Diarrhea
  • Fever
  • Runny nose 
  • Teary eyes
  • Irregular heart rate
  • Stomach cramps
  • Weakness
  • Nervousness
  • Goosebumps
  • Sweating
  • Shivering 
  • Restlessness
  • Irritability
  • Heightened blood pressure

How Long Does Narcan Stay in Your System?

Narcan Nasal Spray will stay in the body for about 30 to 90 minutes. Many opioid drugs can remain active in the system for much longer than this, which can mean that multiple doses of Narcan will be necessary. 

It is important to still seek professional medical care even after a successful opioid overdose reversal with Narcan Nasal Spray. The person can then be monitored for long enough to ensure that their breathing remains stable and regulated. 

Medical care is also important at this point because opioid withdrawal symptoms can start within minutes of receiving Narcan. Emergency medical professionals are capable of helping manage these side effects right away. They can also provide referrals to treatment for long-term withdrawal management.

Where Can You Find Narcan Nasal Spray?

Naloxone is available in all 50 states. In most states, you can get Narcan Nasal Spray directly from your local pharmacist at just about any retail pharmacy location with or without a prescription. If you or a loved one is prescribed high-dose opioids, ask about a prescription of Narcan Nasal Spray to accompany it. 

Many states also have community-based programs where you can get Narcan Nasal Spray, often for free, to have on hand if you fear that someone you love may suffer from an opioid overdose at some point.

Does Narcan Nasal Spray Work on All Drugs?

Narcan Nasal Spray is specifically an opioid antagonist medication, which means that it will not be effective in reversing overdoses from other drugs. Narcan Nasal Spray will work to reverse an overdose on narcotic prescription pain medications containing opioids, such as OxyContin (oxycodone) and Vicodin (hydrocodone/acetaminophen) as well as on illicit opioids like heroin and fentanyl. 

Narcan Nasal Spray will not be effective on benzodiazepines or barbiturates, even though these drugs are also central nervous system depressant substances. Narcan Nasal Spray will not usually further harm someone if they are overdosing on a drug that is not an opioid, however. If you are not sure what substance is involved, you can always administer Narcan Nasal Spray after calling 911 just in case an opioid might be involved.

Updated April 23, 2023
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  2. Narcan. (2022). Emergent Devices Inc.
  3. Vital Signs: Pharmacy-Based Naloxone Dispensing – United States, 2012-2018. (August 2019). Centers for Disease Control and Prevention.
  4. Lifesaving Naloxone. (September 2022). Centers for Disease Control and Prevention.
  5. Naloxone for Opioid Overdose: Life-Saving Science. (June 2021). National Institute on Drug Abuse.
  6. Naloxone Reverses 93% of Overdoses, But Many Recipients Don’t Survive a Year. (October 2017). CNN.
  7. Instructions for Use. (August 2020). Adapt Pharma, Inc.
  8. Naloxone DrugFacts. (January 2022). National Institute on Drug Abuse.
  9. NEXT Distro. (2022). Next Harm Reduction, Inc.
  10. Intranasal Naloxone and Related Strategies for Opioid Overdose Intervention by Nonmedical Personnel: A Review. (October 2017). Substance Abuse and Rehabilitation.
  11. Effect of Intranasal vs Intramuscular Naloxone on Opioid Overdose A Randomized Clinical Trial. (November 2019). JAMA.
  12. Use of Naloxone Nasal Spray 4 mg in the Community Setting: A Survey of Use by Community Organizations. (April 2017). Current Medical Research and Opinion.
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