Naloxone (Narcan): what it is and how to get it

What naloxone is and what it does

Naloxone is a medicine that rapidly reverses an opioid overdose. According to the National Institute on Drug Abuse (NIDA), it is an opioid antagonist — it attaches to opioid receptors and reverses and blocks the effects of other opioids. The Substance Abuse and Mental Health Services Administration (SAMHSA) describes it the same way: it binds to opioid receptors and can reverse and block the effects of opioids such as heroin, morphine, and oxycodone.

There is an over-the-counter nasal spray

On March 29, 2023, the U.S. Food and Drug Administration (FDA) approved Narcan, a 4 mg naloxone nasal spray, for over-the-counter, nonprescription use — the first naloxone product cleared to be sold without a prescription. In July 2023 the FDA approved a second over-the-counter naloxone nasal spray, RiVive (3 mg), for the emergency treatment of known or suspected opioid overdose.

Where people get it

SAMHSA notes that naloxone nasal spray is available over the counter in many pharmacies, and through community-based distribution programs, local public health organizations, or local health departments — often free of charge. Because it is now a nonprescription product, you do not need a doctor’s prescription to buy the over-the-counter nasal spray.

It only works if opioids are present

Naloxone acts specifically on opioids. As NIDA explains, naloxone has no effect on someone who does not have opioids in their system, and it is not a treatment for opioid use disorder. Because fentanyl and other opioids increasingly turn up in supplies where people don’t expect them, giving naloxone when an overdose is suspected is a reasonable step even if you are not certain opioids are involved.

Calling emergency services is still essential

Naloxone buys time — it does not replace emergency care. NIDA notes that naloxone works for only about 30 to 90 minutes, and because many opioids remain in the body longer, overdose symptoms can return after a dose wears off. For that reason one of the most important steps is to call 911. NIH MedlinePlus likewise advises starting by calling — or having someone call — 911 if you believe someone may be experiencing an opioid overdose.

Good Samaritan laws

NIH MedlinePlus notes that some states have “Good Samaritan laws” that can protect the caller and the person overdosing from drug-possession charges when 911 is called. These laws vary, so we don’t make state-by-state claims here — the point is simply that in many places the law is written to encourage people to call for help.

How to use it — official instructions

We don’t reproduce dosing or step-by-step administration instructions on this page. Follow the directions printed on the product, and read the official guidance:

• SAMHSA — Opioid Overdose Reversal Medications (naloxone)
• FDA — Information about Naloxone and Nalmefene
• NIDA — Naloxone DrugFacts

Sources: SAMHSA, U.S. FDA, NIDA, and NIH MedlinePlus. We don’t sell or ship naloxone; this page is educational.