Fentanyl, Narcan & Overdose Prevention

Table of Contents
    Add a header to begin generating the table of contents

    Did you know that in 2019 70,630 people died from a drug overdose? It’s no secret that addiction and the lack of available treatment are problems in the United States. 

    It’s scary when you or someone you love are in the grips of addiction. Will the next time you use, be your last? Fortunately, drugs such as Narcan have been developed to help counteract the effects of some medicines. 

    But, how does Narcan work? What are the uses of Narcan when it comes to addiction? How can Narcan help with the threat of overdose? 

    If you want to learn more about Narcan and addiction, keep reading our comprehensive guide to Narcan.

    What is Narcan?

    The name naloxone also knows Narcan. This drug acts as an antidote to opioids/opiates. 

    Opioids/opiates include drugs such as:

    While Narcan can reverse the effects of opiates/opioids, it cannot change the effects of other drugs such as benzodiazepines, cocaine, or alcohol. If someone uses a combination of drugs and overdoses, you can still administer Narcan to counter the effects of the opioids in their system.

    One of the effects of opiates/opioids is that they slow down the breathing of the person who takes them. If they take too many, this can lead to death. 

    Narcan counteracts those effects and helps the person wake up and keep breathing.

    How Does Narcan Work?

    Narcan blocks the effects of opioids on the brain. This allows the person to continue breathing. 

    Throughout your body, you have what are called opioid receptors. When opioids are used, they help reduce pain and slow breathing by acting on the receptors in the brain. 

    When Narcan is administered, it plays the role of an opioid antagonist in your brain. This reduces the harmful effects of an overdose by making it so that your brain cannot absorb the opioids.  

    It can also knock opioids out of the receptors in your brain. This helps to reverse the damage of an overdose.

    How Is Narcan Given?

    There are a few ways that Narcan can be given to an individual who has overdosed. One of the more common ways is through nasal spray. 

    However, it can also get given intravenously or given intramuscularly. When given intramuscularly, it can get injected through clothes and into the muscle.

    How Fast Does Narcan Work?

    Typically Narcan will act within two to three minutes. However, if Narcan is administered and the person doesn’t wake up by the time three minutes hits, a second dose can get given. 

    Typically, rescue breathing gets done while waiting for the Narcan to take effect when Narcan is given. This allows the affected person to continue getting oxygen to their brain.

    Fentanyl Use

    Fentanyl is a synthetic opioid that is approved to treat severe pain.  This opioid is 50x more potent than heroin and 100x stronger than morphine.  

    Fentanyl has been a major contributor to several overdoses in the United States.  It is administered in two different ways: pharmaceutically and illicitly.  

    Most recently, fentanyl has been linked to overdoses that are distributed illegally. 

    There have been multiple cases of Fentanyl being sold illegally for its heroin-like effects in the US. Oftentimes, people can find fentanyl being mixed with other drugs such as heroin or cocaine.  There are also times when this is done without the person’s knowledge, resulting in overdose.

    America’s most commonly abused drugs are prescription opioid pain relievers. 

    In 2012, an estimated 2 million people reported abusing prescription opioid relievers. According to the Substance Abuse and Mental Health Services Administration, only 169,868 people looked for treatment.

    Signs and symptoms of fentanyl addiction include:

    When Should You Use Narcan?

    Narcan should get given at the first signs of a potential overdose. Typically, the container will only have one dose when utilizing a nasal spray. If more than one dose is needed, you will need to open a new container. 

    Having the ability to recognize the signs of an overdose is essential.  An opioid overdose can occur in a variety of situations. This is not limited to only the misuse of opioids.

    Drug Abuse

    One major cause of opioid is due to drug abuse. This can be from prescription medications, heroin, fentanyl, or other opioids.

    Accidental Overdose

    An accidental overdose can happen if you accidentally take too many prescribed pain medications. This can occur if you don’t remember when your last dose was or are confused about what time you took your medication. 

    Due to the sleepiness brought on by these medications, it’s very easy to become confused.

    Taking Someone Else's Medicine

    Another way overdose can occur is if you take someone else’s medication. This is especially true of children. Either small children who take a pill they found because they think it’s candy or older teens looking to experiment with drugs.

    Mixing Opioids With Other Drugs

    If you mix opioids with alcohol, illegal drugs, or other medications, overdose can occur. When mixing opioids with certain anxiety medications, the results can be fatal. 

    This is why it’s essential to let your doctor know about all of your medications and have conversations surrounding drug interactions.

    Purposeful Overdose

    It is estimated that 30 percent of opioid overdose can get attributed to suicide. Unless the person leaves a suicide note, knowing whether the overdose was accidental or purposeful can be challenging. 

    This makes having exact numbers difficult and is why 30 percent is estimated

    Risk Factors for Overdosing

    There are several populations of individuals at risk of a drug overdose. These populations vary far and wide. 

    People Who Misuse Prescription Medication

    When you’re in pain, it is easy to take more medication than you are prescribed. However, individuals who commonly misuse their medication are at an increased risk of overdose. 

    Individuals Who Take Illegal Opioids

    This can include those struggling with heroin, OxyContin, prescription meds, or fentanyl addiction. Any opioid taken that is not prescribed to you puts you at risk of an overdose. 

    Individuals With Medical Certain Medical Conditions

    Certain medical conditions can increase the risk of overdose. These include conditions such as sleep apnea or conditions that cause reduced liver or kidney function. 

    Your liver and kidneys help filter toxins out of your body, and if they are not operating correctly, this could lead to an overdose.

    People With Certain Mental Health Disorders

    Individuals with depression, anxiety, post-traumatic stress disorder, and other mental health disorders are also at a higher risk for overdose. This population is at an increased risk of self-medicating behaviors and addiction. 

    In addition, this population may choose to use opioids as a means of committing suicide.

    People Who Mix Drugs

    People who mix drugs or drugs and alcohol are at an increased risk of overdose. One popular party for teens gets referred to as a “pharm party” or “skittles party.” 

    During these parties, teens bring whatever drugs they can access at home. They take the pills from a bowl and wash them down with alcohol. This brings about a huge risk for overdose during these parties. 

    However, the habit of mixing drugs is not exclusive to teens.

    Identifying the Signs of an Overdose

    How do you know someone is overdosing on opioids? Knowing the signs of an overdose can help you save someone’s life.


    An individual who overdoses on opiates will likely become excessively sleepy, or you might not have the ability to wake them. They may also experience intermittent loss of consciousness.

    Decreased Respirations

    Breathing problems can occur with overdose. This can include shallow or irregular breathing. 

    However, it can also go as far as respiratory arrest. This is when the affected individuals stop breathing. An average respiration rate for an adult is 12 to 16 breaths per minute when resting. 

    When that respiration rate slows, it gets referred to as bradypnea. If the person’s respiration rate falls below 12 per minute for more than two minutes, it’s a concerning abnormally low rate. 

    You can count the respiration rate by counting the number of times the chest rises and falls within a minute. Respiratory depression is the most significant symptom; it is also the most dangerous and can ultimately lead to death.


    One of the signs of an overdose might also be confusion. If a person experiences a significant amount of confusion, disorientation, or acts drunk, this could indicate an overdose. 

    Skin and Nails

    If you’re worried that someone may have overdosed, check their skin and nails. If their skin is cold and clammy, that could indicate a drug overdose. 

    In addition, if their skin is a bluish color around their lips or under their fingernails, this could indicate an overdose and the fact that they’re not getting enough oxygen. 

    Keep in mind that the bluish color will be present for lighter-skinned individuals. For individuals with darker skin, their skin will appear greyish or ashen.

    Other Symptoms

    The symptoms above are not the only signs of overdose that can get experienced. You should also watch for:

    Once you can recognize the signs of overdose, you can move forward with responding appropriately. 

    What Should You Do if You Suspect an Overdose?

    How should you respond if you suspect that someone you love has overdosed? The most important thing you need to do is not delay your response. 

    Dying from an overdose is typically not quick. It is a slow process; however, you still need to act quickly. The process can take a couple of hours; however, it may also take minutes.

    Try to Wake Them

    Try to get the person to wake up. You can do this by yelling their name or doing a hard sternum rub. This is done by rubbing the knuckles on the sternum. 

    The sternum is the middle of the chest where your ribs meet. You can also try pinching the back of their arm or rubbing your knuckles on their upper lip. 

    If you are able to get them to wake up, do your best to keep them awake.

    Call 911

    Call 911. Response time is essential, and you need to get help there as soon as possible. 

    When you call, make sure you let them know what you are seeing. Some people recommend avoiding using words such as overdose or drugs. 

    There is fear of calling 911 in certain situations because often, the police will respond as well. In some circumstances, the police may not arrest anyone. However, in other cases, they may arrest bystanders.

    On the other side, the operator can help you with taking the proper steps and assessing the situation. 

    When the ambulance does arrive, make sure you tell the workers everything you know, including what drugs the person may have taken. 

    If you’re unable to call 911, you need to make an alternate plan. This could include getting someone else to call 911 or administering Narcan and then going somewhere you can call. 

    Administer Narcan

    If you have access to naloxone to use, use it. When using Narcan for overdose, you can administer it more than once. 

    You will also need to do rescue breathing for a few quick breaths if the person is not breathing. Then you will want to administer the Narcan. 

    Nasal Spray Administration

    When administering Narcan through a nasal spray, you will put the nasal atomizer or applicator on the needleless syringe and assemble the cartridge. 

    You will then tilt the person’s head back and spray half up one side of the nose and the other half up the other side of the nose. If the person is still not breathing or their breathing continues to be shallow, continue rescue breathing while you wait for the Narcan to work.  

    If there is no change within three to five minutes, you can give a second dose and continue rescue breathing. However, if that still doesn’t work, it’s possible that they have not overdosed on an opioid or that too much time has passed. 

    However, it could also mean that they took a very strong opioid such as fentanyl. If this is the case, they might need more Narcan. 

    Injectable Narcan Administration

    Injectable Narcan can come in a few different forms. You want to continue the same steps with this type of Narcan when calling 911 and providing rescue breaths. 

    When it comes to administering the Narcan as an injectable, you will use an intramuscular needle. You can get these from needle exchange programs or pharmacies. 

    You will take the orange top off the vial and draw 1cc of Narcan into the syringe. You want to inject this into the person’s muscle. This can include the thighs, upper, outer quadrant of the bottom, or the shoulder. You want to inject the needle straight in to be sure to hit the muscle. 

    After you give this, continue rescue breathing. If the person does not respond in two to three minutes, give another dose of Narcan. 

    After Administering Narcan

    Keep in mind that the effects of Narcan only last 30 to 90 minutes. Once it wears off, it is possible for an overdose to reoccur because the effects of opioids last much longer. 

    In addition, it is likely the person will want to use drugs again after you administer Narcan. This is because Narcan stops the action of opioids, and the person can experience withdrawal symptoms. 

    However, doing so can trigger another overdose. It’s essential that the person is not alone and not allowed to use again for several hours after an overdose.

    Put the Person in the Recovery Position

    If you administer Narcan afterward, you want to put the person in recovery. You also want to do this if you need to leave the person even for a minute to call 911. 

    Putting them in the recovery position will help prevent them from choking if they begin to throw up and keep their airway clear. The recovery position includes laying them slightly on their side, bending their knee, and turning their face to the side.

    How Do You Get Narcan?

    If you are someone in one of the categories at risk for overdose from opioids or have a prescription opioid in your home, you need Narcan in your home too. The good news is that it is easy to access because of the positive results seen from programs that trained non-medical personnel to give Narcan. 


    You can get Narcan from a pharmacy with no prescription. In comparison, prescription medication laws are implemented in every state that allows access to Narcan in the community. 

    You can get Narcan directly from a pharmacist because of these laws.


    Typically, Narcan is covered by insurance. Ninety-seven percent of insured Americans have access to Narcan. 

    Around 49 percent of individuals can get it with no copay, and those that do have a copay are typically able to get it for below twenty dollars.

    Narcan Side Effects

    Narcan does have some potential side effects. These side effects include: 

    After administering Narcan, keep in mind that the person may become aggressive or experience withdrawal symptoms. This is especially dangerous for infants who have been receiving opioids.