Understanding Naloxone and Overdose Prevention

Every day in the United States, more than 150 people die from opioid-related overdoses. Behind each of those numbers is a person — someone's child, parent, partner, or friend. Many of those deaths are preventable with a medication that's been available for decades: naloxone.

Naloxone (sold under the brand name Narcan) is a fast-acting medication that can reverse an opioid overdose in minutes. It's safe, it's available without a prescription in most states, and it has saved hundreds of thousands of lives. Yet many people who need it most — or whose loved ones need it — still don't know how it works or where to get it.

This guide covers everything you need to know about naloxone: what it does, how to use it, where to find it, and how it fits into the bigger picture of overdose prevention and recovery.

What Is Naloxone and How Does It Work?

Naloxone is an opioid antagonist — a medication that blocks opioid receptors in the brain. When someone is overdosing on an opioid (heroin, fentanyl, oxycodone, or any other opioid), naloxone rapidly displaces the opioid from those receptors and reverses the life-threatening effects.

Within 2–5 minutes of administration, naloxone can:

• Restore normal breathing (opioid overdoses suppress respiration)
• Reverse unconsciousness
• Prevent brain damage and death

Naloxone only works on opioids. It will not reverse an overdose caused by alcohol, benzodiazepines, stimulants, or other non-opioid substances. However, because many overdoses involve opioids — and because naloxone is safe even when opioids aren't involved — it's always worth administering if you suspect an opioid overdose.

How Do You Recognize an Opioid Overdose?

Knowing the signs of an overdose can save a life. Look for:

• Slow, shallow, or stopped breathing — This is the most dangerous sign
• Blue or grayish lips, fingernails, or skin (especially in lighter-skinned individuals)
• Pinpoint (very small) pupils
• Unresponsiveness — The person can't be woken up by noise or physical stimulation
• Gurgling or choking sounds — Sometimes called the "death rattle"
• Limp body
• Slow or absent pulse

If you see these signs, act immediately. Opioid overdose can cause death within minutes due to oxygen deprivation.

How Do You Use Naloxone?

Naloxone comes in two main forms, and both are designed to be used by anyone — no medical training required.

Narcan nasal spray

This is the most widely available form. To use it:

1. Peel back the packaging to remove the device
2. Hold the device with your thumb on the bottom of the plunger and two fingers on the nozzle
3. Tilt the person's head back and insert the nozzle into one nostril
4. Press the plunger firmly to release the dose
5. If there's no response after 2–3 minutes, administer a second dose in the other nostril

Injectable naloxone

This form is administered with a syringe, either into a muscle (intramuscular) or under the skin (subcutaneous). Injection kits typically come with instructions and pre-measured doses.

After administering naloxone

Regardless of which form you use:

• Call 911 immediately — Naloxone is temporary. Its effects wear off in 30–90 minutes, and the person may go back into overdose if the opioid is still in their system.
• Stay with the person — Monitor their breathing and be prepared to give a second dose
• Place them in the recovery position — On their side, with their top knee bent forward, to prevent choking if they vomit
• Do not leave them alone until emergency responders arrive

Where Can You Get Naloxone?

Naloxone is available without a prescription in most states, including Virginia, Ohio, and Pennsylvania. You can get it from:

• Pharmacies — Most major pharmacy chains (CVS, Walgreens, Rite Aid) carry Narcan nasal spray over the counter
• Community health organizations — Many harm reduction programs distribute naloxone for free
• Health departments — State and local health departments often have naloxone distribution programs
• Online — Some organizations mail naloxone kits directly to your home

Cost

The over-the-counter price for Narcan nasal spray is typically $35–$50 for a two-dose package. However:

• Medicaid covers naloxone in Virginia, Ohio, and Pennsylvania, often with zero copay
• Many commercial insurance plans, including BCBS and Anthem BCBS, cover it as well
• Free naloxone programs exist in most communities — check with your local health department

Everyone who uses opioids — or lives with someone who does — should have naloxone on hand. This includes people who take prescription opioids exactly as directed. Accidental overdoses can happen to anyone.

Does Naloxone Have Side Effects?

Naloxone itself has virtually no side effects in someone who hasn't taken opioids. In someone who is opioid-dependent, naloxone will trigger immediate withdrawal symptoms, which can include:

• Nausea and vomiting
• Sweating
• Agitation and anxiety
• Body aches
• Rapid heartbeat

These symptoms are uncomfortable but not dangerous — and they are far preferable to death. If you administer naloxone to someone who is overdosing, they may wake up confused, disoriented, or upset. Stay calm, explain what happened, and keep them safe until help arrives.

Check your insurance and schedule a confidential appointment.

Does Carrying Naloxone Enable Drug Use?

This is a common concern, and research has thoroughly addressed it. No. Studies consistently show that access to naloxone does not increase opioid use or risk-taking behavior. What it does is save lives — and a person who survives an overdose has the chance to enter treatment and recover.

Think of naloxone like a seatbelt. Having one doesn't make you drive recklessly. It protects you from the worst outcome while you work on safer choices.

How Does Naloxone Connect to Suboxone?

You may have noticed that naloxone is also one of the ingredients in Suboxone. In Suboxone, naloxone serves a different purpose — it's included to discourage misuse. When Suboxone is taken as directed (dissolved under the tongue), the naloxone component has minimal effect because it's poorly absorbed through the mouth. But if someone tries to inject Suboxone, the naloxone activates and blocks opioid effects.

This is different from the standalone naloxone (Narcan) used for overdose reversal, which is designed to be rapidly absorbed through the nasal passages or injection.

What Should You Do After an Overdose?

Surviving an overdose is a critical moment. It's often a turning point where people are more open to treatment than they've ever been. If you or a loved one has experienced an overdose, it's important to talk to a medical provider about next steps.

Medication-assisted treatment (MAT) with Suboxone can dramatically reduce the risk of future overdoses. Research shows that starting MAT after a nonfatal overdose reduces the risk of death by more than 50% in the following year.

Grata Health offers same-day telehealth appointments for people ready to start treatment. We serve patients across Virginia, Ohio, and Pennsylvania — in cities like Chesapeake, Youngstown, and Scranton.

If you or someone you know is showing signs of opioid use disorder, treatment is available now — and it starts with a single conversation.

Overdose Prevention Is Everyone's Responsibility

Naloxone is one of the most important tools we have in the fight against opioid overdose deaths. Keeping it accessible, reducing stigma around carrying it, and knowing how to use it are things every community can do to save lives.

But naloxone is a rescue measure, not a solution. Long-term recovery requires treatment — and effective, evidence-based treatment has never been more accessible than it is today.

If you're ready to take the next step toward recovery, Grata Health is here to help. We offer compassionate, confidential telehealth addiction care with no waitlists and no judgment.

Get started with Grata Health today — same-day appointments available.