How Does Naloxone Work?

Naloxone is one of the most important medications in the fight against the opioid overdose epidemic. It is simple to use, safe for anyone, available without a prescription, and it saves lives every day. If you or someone you love uses opioids, understanding how naloxone works could mean the difference between life and death.

According to the CDC, nearly 80,000 of the 105,007 drug overdose deaths in 2023 involved an opioid⁶. A potential bystander was present in nearly 43% of those deaths. That means tens of thousands of lives could potentially be saved each year if more people carried naloxone and knew how to use it.

What Is Naloxone?

Naloxone (sold under brand names including Narcan, RiVive, Kloxxado, and Zimhi) is a medication classified as an opioid antagonist. It was first approved by the FDA in 1971¹ and has been used for over 50 years to reverse opioid overdoses. In March 2023, the FDA approved Narcan nasal spray for over-the-counter sale, making it the first naloxone product available without a prescription.

Naloxone has no addictive properties. It has no potential for abuse. It does not produce a high. It is safe to administer even if the person has not taken opioids. There is essentially no medical risk to giving someone naloxone when they may be overdosing.

How Naloxone Works in the Body

When a person takes an opioid (such as heroin, fentanyl, oxycodone, or morphine), the drug binds to opioid receptors in the brain. These receptors control breathing, pain, and consciousness. At high doses, opioids slow breathing to dangerous levels. If breathing stops, the person dies from oxygen deprivation within minutes. 

• Opioids bind to receptors in the brain and slow the body’s respiratory system.
• Naloxone is a competitive antagonist. It has a higher affinity for opioid receptors than the opioids themselves.
• When administered, naloxone rapidly displaces the opioid molecules from the receptors and takes their place.
• Because naloxone blocks the receptors without activating them, the effects of the opioid are immediately reversed.
• Breathing resumes, consciousness returns, and the person comes back from the brink of death.
• This process typically occurs within 2 to 3 minutes of administration.

Can Naloxone Get You High?

Naloxone cannot get you high.⁵

Naloxone only works to reverse the effect of opioids in someone’s system. There is also no risk of misuse, physiological dependence, or addiction associated with naloxone.^2,5

When to Administer Narcan

If you suspect that someone with you is experiencing an opioid overdose, you should administer Narcan (or another brand of naloxone). Naloxone will have no effect on someone that hasn’t taken opioids, but if they are overdosing, it could save their life.²

Some of the most common signs of an opioid overdose include:^2,3,6

How to Use Naloxone: Step by Step

Using naloxone does not require medical training. Here is what to do if you suspect someone is experiencing an opioid overdose:

• Call 911 immediately. Naloxone is a temporary measure. Emergency medical help is always needed.
• Check for signs of overdose: slow or stopped breathing, blue or gray lips and fingertips, pinpoint pupils, unresponsiveness, gurgling or snoring sounds.
• Administer naloxone. For nasal spray: tilt the person’s head back, insert the nozzle into one nostril, and press the plunger firmly. For injection: inject into the outer thigh or upper arm.
• If the person does not respond within 2 to 3 minutes, administer a second dose in the other nostril (or another injection site). Fentanyl overdoses may require multiple doses.
• Place the person in the recovery position (on their side) to prevent choking if they vomit.
• Stay with them until emergency help arrives. Naloxone wears off in 30 to 90 minutes, and the person could overdose again if the opioid is still in their system.
• Be prepared for withdrawal symptoms. When naloxone reverses an opioid overdose, the person may experience sudden withdrawal: agitation, nausea, vomiting, sweating, and body aches. This is uncomfortable but not dangerous.

When to Administer Naloxone

Administer naloxone if you observe any combination of these signs:

• Extremely slow, shallow, or stopped breathing.
• Blue, purple, or gray discoloration of lips, fingertips, or face.
• Pinpoint (very small) pupils.
• Loss of consciousness or inability to be woken up.
• Gurgling, choking, or snoring sounds while unconscious.
• Limp body or no muscle tone.

If you are unsure whether someone is overdosing, administer naloxone anyway. It will not harm someone who has not taken opioids. It is always safer to give it and not need it than to hesitate and lose precious time.

Important Limitations of Naloxone

• Naloxone only works on opioid overdoses. It will not reverse overdoses from cocaine, methamphetamine, benzodiazepines, alcohol, or other non-opioid substances.
• Naloxone is temporary. Its effects last 30 to 90 minutes. The opioid may outlast the naloxone, causing the person to overdose again. This is why calling 911 is essential.
• Fentanyl may require multiple doses. Because fentanyl is 50 to 100 times more potent than morphine, a single dose of naloxone may not be sufficient. Always have at least two doses available.
• Naloxone does not treat addiction. It reverses an acute overdose. It does not address the underlying substance use disorder. Professional treatment is needed for long-term recovery.
• Naloxone causes withdrawal. When it displaces opioids from receptors, the person will experience sudden withdrawal symptoms. These are uncomfortable but not life-threatening.

Naloxone Side Effects

Naloxone will typically have no effect on someone that has not taken opioids.^1,2

Because naloxone blocks opioids from binding to receptors, it can cause someone to enter opioid withdrawal if they are physiologically dependent on opioids. This precipitated withdrawal may be uncomfortable, but the reversal of opioid-induced respiratory depression can be lifesaving.^1,2

Where to Get Naloxone

• Pharmacies: Narcan nasal spray is available over the counter at pharmacies nationwide. No prescription needed.
• Community organizations: Harm reduction programs, recovery centers, and public health departments distribute naloxone for free in many communities.
• Mail order: Some state health departments and nonprofits mail free naloxone kits to individuals who request them.
• SAMHSA: Call 1-800-662-4357 for information about naloxone access in your area.
• Emergency departments: Naloxone may be provided to overdose survivors and their families upon discharge.
• Online: Some retailers sell naloxone nasal spray online with home delivery.

Getting Treatment for Opioid Addiction at Recovery First

Naloxone can save your life in the event of an opioid overdose. However, long-term recovery from opioid addiction often requires other interventions like the ones provided at Recovery First addiction treatment center in Florida.¹⁰

There are many different types of rehab offered at Recovery First, including:

• Medical detox.
• Inpatient addiction treatment.
• Partial hospitalization program (PHP).
• Intensive outpatient program (IOP).

Each level of care typically involves behavioral therapy for addiction, peer support, psychoeducation, and the use of medications for opioid use disorder (MOUD), if necessary.¹⁰

Upon admission to a treatment facility, clinicians will perform an evaluation to learn about your:¹¹

• Current and past substance use.
• Mental and physical health.
• Family history of substance use.
• Employment and living situation.

This information will be used to outline an individualized treatment plan. As you go through treatment and your needs evolve, further evaluations will determine changes in approach that need to be made.

Call to speak to an admissions navigator and begin the admissions process. Compassionate admissions navigators can also answer questions about using insurance to pay for rehab or other ways to cover the cost of treatment at our inpatient rehab in Hollywood or the outpatient center.

Frequently Asked Questions