Naloxone and Opioid Use Disorder: What To Know

Naloxone is a safe, effective medicine that can save a life during an opioid overdose. It works within two to three minutes to quickly reverse the life-threatening effects of opioids, and it’s available as a simple nasal spray or injected shot. Having naloxone on hand gives you the power to act in an emergency.

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Across the United States, opioids remain a serious public health challenge. In 2023 alone, over 79,000 people died from an opioid overdose, including from prescription medications, narcotics, and illegal opioids like heroin. Naloxone can save someone’s life during an opioid overdose.

In this article, we’ll explain what naloxone is, how it works, and why keeping it nearby could make all the difference in a crisis.

What Is Naloxone?

Naloxone is a lifesaving medication and opioid antagonist. In simple terms, that means that it prevents opioids from working in the brain.

Opioids like morphine, codeine, oxycodone, hydrocodone, heroin, and fentanyl bind to proteins in the brain called opioid receptors. These proteins live on the surface of neurons (nerve cells) to control pain and breathing, among other bodily functions. When someone takes too much of an opioid, it can slow their breathing down so much that it stops altogether. Naloxone steps in and bumps the opioids off those receptors. This can quickly restore normal breathing and prevent an overdose from becoming fatal.

Naloxone isn’t addictive. It doesn’t cause a “high,” and it won’t hurt someone who hasn’t taken opioids. In fact, it’s so safe that healthcare providers and first responders give it even when they aren’t sure what kind of overdose has happened. Potential side effects include opioid withdrawal symptoms and, in rare cases, allergic reactions.

Naloxone only works on opioid receptors, so it won’t reverse a drug overdose from other dangerous substances, such as cocaine or methamphetamine.

Also, it’s important to know that naloxone is only a temporary fix. The effects of opioids can last longer than the effects of naloxone. That’s why it’s always necessary to call 911 and get medical help after using it.

Forms of Naloxone

Naloxone comes in both nasal spray and injectable versions. Both are approved by the U.S. Food and Drug Administration (FDA) and work quickly to reverse an opioid overdose. The main difference is how you give the medication.

Nasal Spray Form

The naloxone nasal spray is the form that most people are familiar with. It’s sold as the brand name Narcan, and, in the United States, it is available over-the-counter without a prescription. It looks like a simple nose spray used for allergies.

To give it, simply place the tip inside one nostril and press the plunger. The medicine quickly absorbs through the lining of the nose and begins to work within two to three minutes. It’s easy to carry and simple to use. People with opioid use disorder and their family members are strongly encouraged to keep it on hand.

Injectable Naloxone

The injectable version of naloxone (Zimhi) is also very effective. It can come as a vial with a syringe or as a prefilled syringe. This form is given into a muscle in the arm, thigh, or buttock. While some people may feel nervous about using a needle, injectable naloxone has the same lifesaving power as the spray.

Many community-based programs and harm-reduction groups offer training so people feel more comfortable using naloxone. In emergencies, either version can restore breathing and prevent an overdose death.

How To Recognize the Signs of an Opioid Overdose

If you’re unsure whether it’s an overdose, it’s always safest to treat it like one. Giving naloxone won’t cause harm if opioids aren’t involved.

How To Use Naloxone in an Emergency

When someone starts showing potential signs of an opioid overdose, every minute counts.

• 1
  First, call 911.
• 2
  Then administer naloxone right away.
• 3
  After giving it, lay the person on their back and check their breathing. Naloxone restores breathing within three minutes.
• 4
  If they aren’t breathing within three minutes after naloxone administration, give the second dose and rescue breaths or CPR if you know how. Multiple doses are safe, and if breathing hasn’t resumed within three minutes, multiple doses are necessary.

Stay with the person until help arrives. Naloxone works fast, but it can wear off in 30 to 90 minutes. The effects of opioids may return once the medicine wears off, so the person may need another dose of naloxone. Emergency first responders will provide care and watch for any problems once they arrive.

It’s important to know that sometimes a person may seem upset or even angry when they wake up after you give them naloxone. This happens because naloxone can cause sudden withdrawal symptoms, which feel very uncomfortable, or because it quickly ends the effects of opioids. You may feel hurt or confused if this happens to you, but remember that it is common reaction and administering naxolone was the right thing.

Why Naloxone Matters

Naloxone is one of the most important tools we have for overdose prevention. The number of overdose deaths in the U.S. remains very high, largely due to powerful opioids like fentanyl. This medicine gives people another chance, and it can be used by anyone — healthcare providers, first responders, friends, or family. Naloxone isn’t a cure for opioid use disorder, but it can keep people alive long enough to seek help and work toward their recovery goals.

Where To Get Naloxone

Naloxone is becoming easier to get in many places, but access can differ depending on where you live. Since 2023, naloxone spray has been available over-the-counter in all 50 states. Many pharmacies now carry naloxone spray.

Local community-based harm-reduction groups often give naloxone out for free, sometimes with short training sessions on how to use it properly. In some cities and states, it is also distributed for free by the local government. Doctors, healthcare providers, and clinics can also prescribe it. In addition, some public health agencies have information on their websites about tool kits and resources for families to get and use naloxone.

Myths and Misconceptions About Naloxone

Let’s be clear: The benefits of naloxone far outweigh any potential risks. Despite this, myths about it persist. These misunderstandings can increase stigma and stop people from carrying it or using it when necessary. Let’s clear up some of the most common myths and misconceptions.

Myth: Naloxone Encourages Drug Use

Studies show that access to naloxone doesn’t increase or encourage substance use in any way. People don’t choose to risk an overdose just because naloxone exists.

Myth: Naloxone Is Only for People Addicted to Drugs

Anyone taking opioids — even prescription opioids like oxycodone or hydrocodone — could have an accidental drug overdose. Naloxone can save the lives of people managing chronic pain as well as those using drugs recreationally.

Myth: Naloxone Is Dangerous

Naloxone is safe for everyone. If given to someone not using opioids, it won’t harm them. The main side effects are temporary withdrawal symptoms in people with opioid dependence, which may include sweating, nausea, and headaches.

Myth: Calling 911 Will Get You Arrested

Almost all states have Good Samaritan laws, which protect people who call for help during an overdose. These laws are meant to save lives, not punish people. Calling for help right away is the most important thing.

Naloxone Isn’t a Treatment for Opioid Use Disorder

While naloxone can save lives by reversing an opioid overdose during an emergency, it’s not a long-term treatment option for opioid use disorder (OUD). After an overdose, people still need follow-up support to manage cravings and reduce the risk of another overdose.

Treatment for OUD often includes detoxification from opioids and medications for addiction treatment (MAT). These medicines are FDA-approved and backed by research.

Alongside medication, many people benefit from counseling, peer support, or mental health services. Resources from organizations like SAMHSA and local community-based providers can help connect people to care.

Join the Conversation

On MyOpioidRecoveryTeam, people share their experiences with opioid use disorder, get advice, and find support from others who understand.

What myths or misconceptions about naloxone have you heard? Let others know in the comments below.