What to know about over-the-counter Narcan

Now that Narcan (Naloxone), a life-saving medication that immediately reverses the effects of an overdose from opioids, is available as an over-the-counter nasal spray, it may mean that more lives will be saved. The U.S. Food & Drug Administration (FDA) approved its use on March 29, 2023, and it can be purchased in pharmacies, convenience stores, grocery stores, gas stations, and online, according to the FDA press release.

But medical experts warn that an understanding of how the drug works and how to administer it is essential.

“Narcan is definitely a tool that when used properly, can save a life, but it has to be used properly,” said Craig Cornwall, MD, a Cape Cod Hospital emergency medicine physician. “While it is a tool for saving someone’s life, there are other things to be considered.”

Most of the overdose patients seen in the hospital Emergency Department have already received Narcan from Emergency Medical Services (EMS), according to Dr. Cornwall. Department personnel then have a chance to help the patient beyond medical care, he said.

“When they come into the ED, we have an opportunity to offer them secondary services such as referrals to detox centers, rehabilitation, social services, and counseling. When someone is given Narcan at home or someplace privately, and they aren’t seen in the ED, we don’t have the chance to offer those services. Narcan is then a temporary fix.”

How to Give Narcan

Dr. Cornwall offers these recommendations for administering Narcan, if you see someone become unconscious or find someone who is unresponsive:

• Check for pulse and breathing.
• Call 911.
• Try to get someone who may be nearby to help you.
• If you know for a fact that a person used an opioid such as Oxycodone, Fentanyl, or heroin, and they are unconscious, give them Narcan.
  • If the person who just used the drug becomes unconscious, and turns blue, then give a full dose of Narcan.
  • If they are a little sleepy, you may not need to give a full dose of Narcan.
• Be aware that for those who have chronic pain and overdose on their opioid medication, giving Narcan can cause them to be in agonizing pain once the Narcan takes effect because they no longer have any pain medication in their system to control the pain. This is why it is very important to call EMS for their assistance.

Opioid Use in Older Individuals

“In the past, opioid use was mostly seen in young people coming to the ER, but now we are seeing it in individuals in their 50s and 60s,” said Dr. Cornwall. “I think it is a result of widespread use of narcotics in the community and it’s becoming more of a problem. That is why they are trying to get Narcan into the general public because it is becoming such an epidemic.

“Being able to give Narcan is good news but getting that person into detox, mental health counseling and support services provides the most valuable help.”

While there isn’t any harm in mistakenly giving Narcan to someone who is having another medical event that mimics an opioid overdose, it is still important to call EMS immediately for anyone who is unconscious, he said. You may delay treatment for another condition, such as a cardiac arrest or another medical problem, if you don’t know what is going on.