To learn how to use Narcan (naloxone nasal spray): call 911, lay the person on their back, gently put the nozzle in one nostril and press the plunger firmly, then turn them on their side. If they do not respond in 2 to 3 minutes, give another dose in the other nostril with a new device. Stay with them until help arrives.
Narcan can save a life, and you do not need medical training to use it. This guide walks you through recognizing an overdose, giving naloxone step by step, what happens afterward, and where to get it in Pennsylvania.
What Is Narcan (Naloxone)?
Narcan is a brand name for naloxone nasal spray. MedlinePlus explains that naloxone is an opioid antagonist that works by blocking the effects of opiates to relieve dangerous symptoms, such as slowed breathing, caused by high levels of opioids in the blood.
The CDC notes that naloxone can reverse an overdose from opioids, including fentanyl, heroin and prescription opioid medications, when given in time. It comes in two forms that anyone can use: a prefilled nasal spray and an injectable version. This guide focuses on the nasal spray, which is the most common form people carry.
In 2023, the FDA approved the first over-the-counter naloxone nasal spray, so you can buy Narcan without a prescription at drug stores, convenience stores, grocery stores, gas stations and online.
Signs of an Opioid Overdose
Before you can help, you need to recognize an overdose. MedlinePlus lists these opioid overdose warning signs:
- Very small, “pinpoint” pupils
- Falling asleep, losing consciousness or not being able to stay awake
- Slow, shallow or stopped breathing
- Choking or gurgling sounds
- Vomiting
- A limp body
- Pale, blue or cold skin, or purple lips and fingernails
If you are not sure whether it is an overdose, give naloxone anyway. The CDC says naloxone won’t harm someone who is overdosing on drugs other than opioids, so it is always best to use it if you think someone is overdosing. Because fentanyl is now common in the drug supply, learn more about fentanyl overdose signs.
How to Use Narcan Nasal Spray: Step by Step
These steps follow the MedlinePlus instructions for naloxone nasal spray. Always read the directions on your package too.
- Call 911. Say someone is not breathing or is unresponsive. You can put the phone on speaker so your hands are free.
- Lay the person on their back.
- Get the spray ready. Take the device out of the box and peel back the tab. Do not prime or test-spray it. Each device holds one dose.
- Hold it correctly. Put your thumb on the bottom of the plunger and your first and middle fingers on either side of the nozzle.
- Insert the nozzle. Support the back of the person’s neck with your hand so their head tilts back. Gently put the tip of the nozzle into one nostril until your fingers touch the bottom of their nose.
- Press the plunger firmly to give the dose. Then remove the nozzle.
- Move them into the recovery position. Turn the person on their side so they will not choke if they vomit.
- Watch and repeat if needed. If the person does not wake up or breathe normally within 2 to 3 minutes, give another dose in the other nostril using a new device. You can keep giving doses every 2 to 3 minutes, alternating nostrils, until they respond or help arrives.
Pennsylvania’s Department of Drug and Alcohol Programs also advises rescue breathing if the person isn’t breathing and staying with the person until help arrives.
What Happens After You Give Narcan
The CDC says naloxone can restore normal breathing within 2 to 3 minutes. More than one dose may be needed with strong opioids like fentanyl. Here is what to expect next:
Stay With the Person
Naloxone is not a substitute for emergency care. The CDC advises staying with the person until emergency help arrives or for at least four hours to make sure their breathing returns to normal. MedlinePlus also notes that naloxone may not reverse the effects of certain opiates such as buprenorphine and may require additional doses.
Withdrawal Symptoms Are Possible
Because naloxone blocks opioids suddenly, a person who is dependent on opioids may wake up in withdrawal. MedlinePlus lists possible symptoms such as body aches, sweating, nausea, vomiting, a fast heartbeat, shivering, restlessness and irritability. The person may feel sick, scared or upset. Stay calm, reassure them and explain what happened. Encourage them not to use more opioids, which could lead to another overdose.
Where to Get Narcan in Pennsylvania
Getting naloxone in Pennsylvania is easier than ever:
- Over the counter: The CDC notes naloxone is available in all 50 states over the counter at pharmacies and other stores.
- Standing order: The Pennsylvania DDAP explains that a statewide standing order lets people get naloxone at pharmacies without a prescription.
- Free programs: DDAP also notes that free overdose prevention supplies, including naloxone, are available through state programs, with mail-based options for people who cannot pick it up in person.
Store Narcan at room temperature, away from light and extreme heat, and do not freeze it. Check the expiration date regularly and keep it where family members can find it quickly, but out of children’s reach.
Pennsylvania’s Good Samaritan Law
Fear of police should never stop you from calling 911. Pennsylvania’s Act 139, known as David’s Law, includes a Good Samaritan provision that offers criminal and civil protections to people who seek and receive emergency medical services for an overdose.
A Pennsylvania Good Samaritan immunity fact sheet explains that the person reporting must act in good faith with a reasonable belief that someone is overdosing, and must stay with the person and cooperate with police. The protection covers some drug possession and paraphernalia charges, but it does not grant immunity from arrest itself.
Frequently Asked Questions
Can Narcan hurt someone who isn’t overdosing on opioids?
No. The CDC says naloxone won’t harm someone who is overdosing on drugs other than opioids. If you think someone may be overdosing, give it.
Do I still need to call 911 if the person wakes up?
Yes. Call 911 right away and stay with the person. They may need more naloxone or other emergency care, and their breathing needs to be watched.
How many doses of Narcan can I give?
If there is no response after 2 to 3 minutes, give another dose in the other nostril with a new device. Keep giving doses every 2 to 3 minutes as directed on the package until the person responds or help arrives.
Does Narcan work on fentanyl?
Yes. Naloxone can reverse overdoses from fentanyl, heroin and prescription opioids. With strong opioids like fentanyl, more than one dose may be needed.
Get Help for Opioid Addiction in Lancaster, PA
Knowing how to use Narcan can save a life today. Treatment can help protect that life for the long term. If you or someone you love is struggling, learn the signs of opioid addiction, explore Suboxone for opioid addiction, and visit our opioid addiction page. The Ranch Pennsylvania Outpatient Services in Lancaster offers addiction treatment programs, including a partial hospitalization program (PHP) and an intensive outpatient program (IOP), with medication-assisted treatment available when clinically appropriate. You can verify your insurance online, and our admissions team is available 24/7. Calls are free and confidential.
