How to Use Naloxone: What Is Narcan and Where to Find It

If someone is overdosing, immediately call 911 or local emergency services.

Narcan, or naloxone, is used to reverse opioid overdose. Opioids, such as heroin, opium, morphine, codeine, and fentanyl, can be legal prescription medications or illegal substances. 

Overdose occurs when an opioid’s depressant effects on the central nervous system cause life-threatening reactions. Narcan reverses an overdose by binding to the same brain receptors as opioids, thereby blocking the opioids from attaching to the receptors. This helps restore normal breathing and consciousness.

Narcan is usually administered through a nasal spray, and it can also be injected.

When to Use Narcan

It’s possible for opioid users to accidentally ingest too much at once and overdose. Other substances like MDMA can be cut with opioids, such as fentanyl, to lower production costs. If someone is displaying the signs of overdose, even if they didn’t knowingly take an opioid, you can still administer narcan—narcan won’t harm someone who didn’t ingest opioids¹.

Overdoses usually include respiratory failure, where breathing becomes slow, shallow, or even stops completely. Other signs of overdose¹ include:

• Unconsciousness 
• Very small pupils
• Vomiting
• Inability to speak
• Faint heartbeat
• Limp arms and legs
• Pale skin
• Purple lips and fingernails

Without immediate medical intervention, an opioid overdose can be fatal. In addition to using narcan in the event of an overdose, immediately call 911 or local emergency services.

Until emergency services arrive, you can help someone who’s overdosing² by assisting them to sit or lay down in an open space. You can administer CPR if you are qualified, and if their skin is blue, perform mouth-to-mouth resuscitation. Additionally, use Narcan.

How to Administer Narcan

The American Medical Association created instructions showing how to administer Narcan³. You can also watch in video format:

If you are using NARCAN nasal spray, follow these steps:

1. Peel back the package and remove the device. Put your thumb on the bottom of the plunger and two fingers on the nozzle.
2. Place and hold the tip of the nozzle in either nostril until your fingers touch the bottom of the patient’s nose.
3. Press the plunger firmly to release the dose into the patient’s nose.

Tip: When administering a nasal spray, help the patient gently tip their chin upward. This helps open their airways so the spray can better reach the bloodstream.

If you are using EVZIO auto-injector, follow these steps:

1. Pull the auto-injector from the outer case.
2. Firmly pull off the red safety guard; do not touch the black base (this is where the needle comes out).
3. Place the black end of the auto-injector against the outer thigh, through clothing if necessary.
4. Press firmly and hold in place for 5 seconds. (There will be a distinct “hiss” and “click” sound when working properly. The needle will not be visible after use.)

If you are using yellow cap nasal spray, follow these steps:

1. Pry off the syringe’s yellow caps (both sides).
2. Pry off the purple cap on the naloxone capsule. 
3. Grip the clear plastic wings on the spray nozzle.
4. Thread the spray nozzle on the syringe.
5. Gently screw the naloxone capsule into the barrel of the syringe.  
6. Insert white spray nozzle into the patient’s nostril. Give a short, firm push on the end of the naloxone capsule to spray.
7. Administer half of the capsule into each nostril.

If you are using an intramuscular syringe needle, follow these steps:

1. Inject 1 cc of naloxone straight into a muscle, such as the thigh, outer side of the glute, and shoulder.

Administer another dose of Narcan if the patient doesn’t respond/wake up after 2-3 minutes.