Naloxone is an emergency medication that can temporarily reverse the effects of an opioid overdose. Narcan is one familiar brand name, but naloxone is available under other brand names and as generic products. Some nasal-spray products are sold over the counter, which means they can be purchased without a prescription.
Keeping naloxone nearby is a practical safety measure for families, friends, employers, and others who may be present during an opioid emergency. It is not an accusation and it is not a substitute for treatment. It is a way to be prepared for a situation in which minutes matter.
What naloxone does
Opioids can slow or stop breathing. Naloxone blocks opioid effects for a limited period and may restore normal breathing when it is given in time. It can be used when an overdose is known or suspected, including an overdose involving fentanyl, heroin, or prescription opioid medication.
Naloxone only works on opioids. It will not reverse an overdose caused solely by alcohol, benzodiazepines, stimulants, or another non-opioid substance. However, people do not always know what a substance contains, and fentanyl may be present unexpectedly. According to the CDC, naloxone will not harm someone if opioids are not responsible for the emergency. When an opioid overdose is possible, give naloxone and call 911.
Warning signs of a possible opioid overdose
Signs may include:
- The person cannot be awakened or does not respond to voice or touch.
- Breathing is slow, irregular, very shallow, or has stopped.
- There are choking, gurgling, or snoring-like sounds from someone who cannot be awakened.
- The lips, fingernails, or skin appear blue, gray, pale, or unusually clammy, depending on skin tone.
- The pupils are very small or “pinpoint.”
- The body is limp.
Do not wait for every sign to appear. If someone is unresponsive and an opioid overdose is possible, treat the situation as an emergency.
What to do
- Call 911. Tell the dispatcher the person is unresponsive or not breathing normally and that an opioid overdose may be involved.
- Give naloxone. Follow the instructions for the product you have. Nasal sprays and injectable products are not all used in exactly the same way.
- Support breathing and prevent choking. Follow the dispatcher’s instructions. If appropriate, place the person on their side.
- Watch for a response. CDC guidance says to wait two to three minutes to see whether normal breathing returns before giving a second dose. Follow the specific product directions and emergency instructions.
- Stay with the person. Naloxone’s effects are temporary. Overdose symptoms can return, and medical evaluation remains necessary even if the person wakes up.
A person may wake confused, frightened, nauseated, or experiencing withdrawal. Speak calmly, explain that help is coming, and do not allow the person to use more substances.
Who should keep naloxone available?
Naloxone is relevant wherever opioid exposure is possible. A physician or pharmacist may specifically recommend it when someone takes prescription opioids, has an opioid use disorder, has recently stopped using opioids, or uses other substances that could contain fentanyl. Reduced tolerance after detoxification, treatment, hospitalization, incarceration, or a period of abstinence can increase overdose risk if opioid use resumes.
Families do not need to wait for certainty. It is reasonable to ask a pharmacist or clinician which product is appropriate, how many doses to keep, where it should be stored, and when it expires. Household members and other trusted people should know where it is and how to use it.
Access and storage
The FDA approved the first over-the-counter naloxone nasal spray in 2023 and has since approved additional nonprescription products. Availability and cost vary by location and product. Pharmacies, community programs, health departments, and harm-reduction organizations may offer naloxone.
Follow the package instructions for temperature, light, expiration, and replacement. Do not leave naloxone where heat or cold could damage it. Check the expiration date periodically, and replace any dose that has been used.
Naloxone is emergency protection—not a recovery plan
Surviving an overdose does not resolve the conditions that led to it. After the immediate emergency, a qualified professional can assess medical needs, substance use, mental health, prior treatment, withdrawal risk, and the appropriate level of care.
Families may feel pressure to solve everything at once. A more useful goal is to move from the emergency toward one clear next step. That may include medical stabilization, treatment, intervention planning, case management, family guidance, or recovery support.
When the immediate crisis has passed
Silver Lining helps families understand treatment options, organize the right people, and build a practical plan after an overdose or other serious substance-use concern. Learn about case management, family support, or request a private consultation.