Q. What is Narcan?
A. Narcan™ (generic name naloxone) is an opiate antidote. Opiates include heroin as well as prescription opiates like morphine, codeine, OxyContin, methadone and Vicodin. Narcan is a prescription medicine that blocks the effects of opiates. It cannot be abused or used to get a person high. If given to a person who has not taken opiates it will not have any effect on them. Find additional medical information about naloxone at: www.drugs.com/pro/naloxone.html
Q. How does Narcan work?
A. If a person has taken opiates and is then given Narcan, the opiates will be knocked off the opiate receptors in the brain. This reverses the effects of an opiate overdose including restoring breathing that has stopped or slowed down. Death typically does not occur until several hours after an opiate overdose, which provides a window of opportunity to intervene by calling 911, giving rescue breathing and administering Narcan. Narcan can help even if opiates are taken with alcohol or other drugs.
Narcan can be given by injection (into veins or muscles) or with a nasal spray device (into the nose). [Note that the nasal spray is an “off label” use, but has become standard practice in many large cities in the U.S. and the nasal spray version can be prescribed.]
Narcan generally works within about 5 minutes. Narcan starts to wear off after about 30 minutes and is mostly gone after about 90 minutes. By this time the body has metabolized enough of the opiates that the user is unlikely to stop breathing again. However, in some cases – such as after taking a massive dose or long-acting opiates like methadone – the patient might need another dose and longer medical observation.
Q. Who can be prescribed Narcan?
A. According to Washington’s “911 Good Samaritan Law” (RCW 69.50.315:), anyone at risk for having an overdose or witnessing one can be prescribed Narcan. They are also allowed to possess and administer Narcan to a person believed to have had an overdose. For more on how to prevent, recognize and intervene in an overdose see: harmreduction.org and odprevention.org.
For health care professionals:
The Prescribe to Prevent website provides information for health care providers about ordering and prescribing naloxone and potential reimbursement for overdose education and naloxone prescriptions. (Note this is a national website and not all information is necessarily correct for WA State.)
Another resource for sharing information and advocacy is the Facebook group: Expanding access to naloxone to prevent opioid overdose deaths.
Q. Where can I get Narcan?
A. In Washington, Narcan is not widely available by prescription or through distribution programs at this time. Check with your local health department or medical provider to learn if it is available locally. This website will be updated as information about take-home Narcan distribution in communities in Washington State becomes available. Procedures are being developed to allow pharmacists to prescribe Narcan; contact the Washington State Board of Pharmacy if you have any questions about this.
You can also use this search box to locate prevention and naloxone programs near you.
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Q. Doesn’t Narcan just provide a “safety net” that lets those who want to abuse drugs continue to abuse them or use even more than usual?
 A. Several research studies have investigated this common concern and found that making Narcan available does NOT encourage people to use opiates more.(d) The goal of distributing Narcan and educating people about how to prevent, recognize and intervene in overdoses is to prevent deaths. Other goals, such as decreasing drug use, can only be accomplished if the user is alive.
Q. Can Narcan harm a person?
A. Narcan only affects people who are using opiates. If a person is not having an overdose, but is using opiates, Narcan will put them into immediate withdrawal which can be very uncomfortable, but is not life threatening.
Q. Doesn’t a person need to be a medical professional to accurately recognize a serious overdose and appropriately administer Narcan?
A. Research has shown that with basic training, non-medical-professionals i.e. citizen bystanders, can recognize when an overdose is occurring and administer Narcan as well as a medical professional.(a)
Q. What has research shown to be the impacts of distributing Narcan to potential overdose bystanders?
- Naloxone administration has not resulted in dangerous health outcomes;(b)
- Drug users are willing to administer naloxone to each other;(c)
- Naloxone availability does not increase drug use;(d)
- Thousands of opioid overdoses have been reversed with naloxone given by bystanders in the U.S. Narcan distribution programs generally provide overdose prevention and recognition training combined with the prescription of take-home Narcan. More than 100 programs that distribute naloxone to opiate users are operating in at least 15 states.
Q. Why are opiate overdoses an important public health issue?
A. Approximately 2 people die each day in Washington State from opiate overdose. The number of opiate users in the state has increased substantially over the past 15 years. Opiate use and negative consequences (death, arrests, ER visits) are increasing across the state. For more information see:
This FAQ was prepared by Caleb Banta-Green, PhD, MPH, MSW [calebbg@uw.edu] and Phillip Coffin, MD, MIA [pcoffin@uw.edu], in October 2011.
(a) Green TC, Heimer R, Grau LE. (2008) Distinguishing signs of opioid overdose and indication for naloxone: an evaluation of six overdose training and naloxone distribution programs in the United States. Addiction 103(6):979-89.
(b) Doe-Simkins M, Walley AY, Epstein A, Moyer P. (2009). Saved by the nose: bystander-administered intranasal naloxone hydrochloride for opioid overdose. American Journal of Public Health 99:788-91.
(c) Lagu T, Anderson BJ, Stein M. (2006) Overdoses among friends: drug users are willing to administer naloxone to others. Journal of Substance Abuse Treatment 30(2):129-33.
(d) Seal KH, Downing M, Kral AH, Singleton-Banks S, Hammond JP, Lorvick J, et al. (2003) Attitudes about prescribing take-home naloxone to injection drug users for the management of heroin overdose: a survey of street-recruited injectors in the San Francisco Bay Area. Journal of Urban Health 80(2):291-301.
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