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How to administer naloxone

Naloxone quickly reverses the effects of opioids. Knowing how it works & how to administer it safely can be lifesaving for someone experiencing an overdose.

By:
Ophelia team
Narcan® Nasal Spray
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Fact checked by
Arthur Robin Williams, MD

Opioid overdoses can slow or stop a person’s breathing, sometimes with fatal outcomes. Fortunately, the medication naloxone can save lives. Commonly referred to by the brand name Narcan®, this medicine acts as an antidote that quickly reverses the effects of opioids. Knowing how it works and how to administer it safely as a bystander can be a game-changer for someone experiencing an overdose.

What is emergency naloxone?

Naloxone is a safe and effective medication used to help counteract an overdose. The medication helps the person start breathing normally again in just 2 – 3 minutes. It attaches to opioid receptors in the body, ousting the opioid and blocking the drug’s effects on the brain.

Naloxone can combat the effects of any opioid, including fentanyl, morphine, heroin, and oxycodone. It does not work on other drugs. It isn’t harmful to use, however, so it’s safe to administer if you suspect someone is overdosing on opioids even if they are not.

If an individual is overdosing, naloxone must be administered by someone else. Emergency medical professionals, law enforcement, and non-emergency first responders carry and use it. If you or a loved one lives with opioid use disorder (OUD), it’s important to always have this life-saving medication around. You, other family members, and friends should all learn how to administer Narcan or any other brand of naloxone. Anyone can be trained to use it in just a few minutes, so ask your pharmacist or healthcare provider for assistance.

Naloxone is used only in the event of an overdose, but it is not a long-term treatment for OUD or a replacement for medical intervention. This is because naloxone can wear off within 30 – 90 minutes, so the effects of the underlying opioid may long outlast it. That means the individual overdosing may again stop breathing and again be at risk of death. Always call for emergency assistance after giving the first dose as survivors should be taken to the Emergency Room for close monitoring.

What are common administration routes for naloxone?

There are three naloxone administration routes:

  • Injected into the muscle (intramuscularly)
  • Given through a vein (intravenously)
  • Administered in the nose (intranasally)

Family members and bystanders are often the most comfortable with the nasal spray because it’s the easiest to use without training. But both the packaged spray and injectable form are FDA-approved. When you first receive these medications, carefully read the product instructions—and never use an improvised nasal spray device that could release an incorrect dosage. Be sure to ask a pharmacist or healthcare provider if you have questions about the process or dosage.

How to administer Narcan nasal spray

The intranasal spray is a prefilled, prepackaged device. It is only for use in the nose. If the medicine comes into contact with the eyes or skin, rinse it off right away with clean water. Here are the steps for administering it:

  • Take the nasal spray out of the box. Your thumb should rest on the bottom plunger, and your index and middle fingers each go on one side of the nozzle. 
  • Make sure the patient is on their back. Use your hand to support their neck and tilt their head back.
  • Place the tip of the nozzle into the patient’s nostril. It should be deep enough that your index and middle fingers touch the bottom of their nose.
  • Administer the full dose. Press down firmly on the plunger, then remove the device.

Gently turn the patient to their side and call for emergency medical assistance. If they do not respond to the medication within 2 – 3 minutes, give them another dose.

How to administer a naloxone injectable

Injectable naloxone comes with a needle and a vial of medicine. It is typically administered directly into the muscle, but it can also go into a vein or under the skin. You should inject it into the patient’s upper arm or outer thigh. Here’s how to go the injectable route:

  • Remove the orange cap and stick the needle through the rubber stopper.
  • Pull up the plunger to draw in all the medicine, ensuring there is no air left in the syringe.
  • Inject the needle straight into the muscle, through clothes if necessary. Push the plunger to completely empty the syringe.

Call for emergency medical help. If the patient does not respond to the medication in 2 – 3 minutes, inject another dose.

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