Treatment for Opioid Overdose: Naloxone

It is widely known that opioid misuse is a major problem across the country. The number of opioid-related overdose deaths has steadily increased over the past decade.¹ In 2010, the number of opioid-involved overdose deaths was 21,088; in 2017, that number rose to 47,600, and, according to provisional data from the Centers for Disease Control and Prevention (CDC), in 2021, that number was an astounding 80,926 deaths in the United States.^{1, 11}

Fortunately, there is a lifesaving medication called naloxone to help reverse the potentially fatal effects of an opioid overdose.

This article will teach you about what naloxone is, how naloxone works, who should carry it, and how it can be used to reverse life-threatening respiratory depression from an opioid overdose. If you suspect someone is experiencing an overdose, call 9-1-1 immediately.

What Is Naloxone?

Naloxone is a life-saving overdose treatment medication that reverses the effects of opioids and can stop an overdose of drugs like heroin, fentanyl, and other prescription opioids (e.g., oxycodone, hydrocodone).^{2, 3}

Naloxone can be administered in several ways. However, the pre-dosed nasal spray form (Narcan, Kloxxado) can be used by anyone regardless of medical training. This can make it more accessible than injectable forms or intranasal administration of Narcan with a mucosal atomization device.^{2, 3}

Naloxone has been approved by the Food and Drug Administration (FDA) to reverse the effects of an opioid overdose and can save individuals who might have otherwise died without intervention.⁷

Studies have demonstrated that naloxone has and will continue to save lives across the country. A nationwide study shows that opioid overdose deaths decreased by 14% in states that passed naloxone accessibility laws.⁴

How Does Naloxone Work?

Naloxone is an opioid antagonist with a relatively high rate of bonding with the body’s opioid receptors. This means naloxone displaces most other opioids that are in the system and attaches to opioid receptors in the brain. The effects of other opioids get blocked and reversed so a person doesn’t experience their effects. Naloxone can help resume normal breathing once it has significantly slowed or even stopped due to an opioid overdose.⁸

Naloxone can and should be administered to individuals who are overdosing on multiple substances or to a person who you suspect took opioids, even if they did not, which can increase the chances of stopping an overdose. Naloxone won’t hurt someone who is overdosing on a substance other than opioids.³

Keep in mind that naloxone will only reverse the effects of opioids and it’s important to ensure emergency medical services are on the way to assist, regardless of whether or not naloxone reverses symptoms of overdose.⁵

Since illicitly manufactured fentanyl, a highly potent synthetic opioid, is increasingly being used as an adulterant or additive to other substances like cocaine and in counterfeit pills, it’s even more important to consider use of naloxone, even if a person thought they took something else.¹²

How to Use Naloxone

Naloxone can be obtained by anyone, and it is generally available as a pre-dosed nasal spray (Narcan, Kloxxado), intranasal naloxone with atomizer kit, or an intramuscular injection naloxone kit.¹³ Deciding on which form to carry requires some consideration. Factors to consider include:³

• Availability
• Cost
• Your level of comfort with administration.

If you have no formal training or feel uncomfortable around needles, the pre-dosed nasal spray may be most appropriate and comfortable for you to administer.⁸ Unlike the intranasal naloxone kit, which requires a person to learn how to attach and use an atomizer, the pre-dosed nasal spray requires no assembly, is pre-filled, and is simply sprayed into one nostril when an individual is lying down face-up.⁸

If using an intramuscular injection kit, the injection can be administered directly into the muscle of the upper thigh or upper arm.⁸

After naloxone has been administered, call 9-1-1 if you haven’t already and observe the person until emergency services arrive.⁸ You should see the effects of Narcan quickly; however, if you don’t see a response within a few minutes after the initial dose, administer a second dose.¹

Naloxone works to reverse an overdose for approximately 30 to 90 minutes, but many opioids remain in the body for longer periods. Because of this, it is possible for the naloxone to wear off, and the person will again experience the effects of an overdose. Also, some opioids, such as fentanyl, are stronger and might require multiple doses of naloxone.⁸

Who Should Carry Naloxone?

Naloxone is available in every state across the country, and in many states, you can get it without a prescription.³ Naloxone can be obtained at a local pharmacy or through community-based harm reduction or other programs, depending on the state in which you live.³

Anyone can carry naloxone, and if you or someone you know struggles with opioid misuse or opioid use disorder (OUD), takes high doses of prescription opioids, or takes benzodiazepines and opioids together, it’s a good idea to carry naloxone.³

As with most medications, the cost of naloxone varies. Factors that influence the cost include:⁸

• Where you get it from.
• The type of naloxone you get.
• Your insurance coverage.
• Availability of cost-assistance programs.

Dangers of Opioid Overdose

Knowing the signs of an overdose can help save a life, which can include:³

• Small, constricted “pinpoint pupils.”
• Shallow, slow, or stopped breathing.
• Loss of consciousness or not responsive.
• Limp body and pale blue or grey skin.
• Gurgling, snoring, or choking sounds.

Risks that can increase your chance of an opioid overdose include:^{5, 10}

• Taking opioids when you are alone.
• Using too much (especially after you have stopped using and your tolerance has decreased).
• Using opioids via IV or smoking.
• Being an older adult.
• Taking high-dose prescription opioids.
• Having other health complications such as HIV, heart disease, or respiratory illness.
• Having a history of opioid overdose.

Substance use treatment can be beneficial after you experience an opioid overdose.² An estimated 2.5 million people struggle with OUD across the country and receiving individualized treatment may encourage more positive outcomes.⁶

More specifically treatment for opioid use disorder can help:⁹

• Decrease opioid overdose deaths.
• Decrease opioid use.
• Reduce criminal activity.
• Lessen the spread of infectious diseases.
• Improve social functioning.
• Improve health outcomes for pregnant women.

Get Help for Opioid Addiction

If you or someone you love is struggling with addiction to opioids or other substances, or is ready to seek treatment after an overdose, help is available. American Addiction Centers (AAC) provides opioid addiction treatment across the country and our caring admissions team is available 24/7 at to help you get the treatment ou need. Contact us today to learn more and check if your insurance covers treatment at one of our top-rated facilities.