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How to Use Naloxone Nasal Spray to Reverse Opioid Effects

What is naloxone nasal spray?

Naloxone (Narcan®) is a medicine that can rapidly reverse the effects of taking too much opioid medication or an opioid overdose. It is often given as a spray or mist into the nose.

Naloxone is safe to use in an emergency. It can be given even if you are not sure that someone has taken opioids. It does not work for other types of overdose.

Signs of opioid overdose

Opioid overdose can cause breathing to slow or stop. This can lead to loss of consciousness or death without prompt treatment. 

Signs of an opioid overdose include: slow or irregular breathing, slow or irregular heartbeat, pale or clammy skin, blue lips or fingernails, small pupils, drowsiness, and not responding to sound or touch.

Preparing for an opioid emergency

Opioids are strong medicines that are prescribed for pain or other medical reasons. Common opioids include hydrocodone, morphine, hydromorphone, oxycodone, fentanyl, and methadone. Taking too much of these medicines can be life-threatening. Anyone who takes opioids can be at risk for an overdose.  

Patients and family caregivers can keep naloxone nasal spray on hand for use in an emergency. Naloxone is available over-the-counter at retail pharmacies.

Give naloxone right away if you know or think someone has taken too much opioid medicine. If you are unsure, you can still give naloxone because it won’t harm someone if they haven’t taken opioids.

In an opioid emergency, naloxone is usually given to the patient by another person. Be sure to alert others about the signs of an opioid overdose, when and how to give naloxone, and where it is stored.  

What to do if you suspect an opioid overdose

  1. Check to see if the person is responsive. Shake them or shout loudly to try to wake them.
  2. If there is still no response, CALL 911.
  3. Give naloxone spray.
  4. Stay with the person until help arrives.
  5. Administer CPR if is patient unresponsive and not breathing normally, or if they have no pulse, even if naloxone has been given.

How to give naloxone spray 

The medicine comes with instructions. Read the instructions to know what to do in case of an opioid emergency. Always follow the instructions for the specific medicine you are using. Talk to your care team if you have any questions.

General steps for giving naloxone nasal spray:

  1. Remove the medicine from the packaging. Do not test the nasal spray to see if it works or prime it. It contains only 1 dose of naloxone, so it cannot be used more than once.
  2. Lay the person on their back. Support the back of the person’s neck and let their head tilt back.
  3. Hold the nasal spray with your other hand. Put your thumb on the bottom of the plunger and hold the nozzle between your fingers.
  4. Gently insert the tip of the nozzle into one of the person’s nostrils. Your fingers holding the nozzle will be touching the bottom of the person’s nose.
  5. Give the medicine by pressing the plunger firmly. After giving the medicine, remove the medicine tip from the person’s nostril.
  6. Move the person onto their side after giving the naloxone. This recovery position keeps the airway open and helps prevent choking.

Get emergency medical help right away. Do not leave the person alone. Stay with them until emergency help arrives. If the person does not respond to the medicine in 2-3 minutes, and emergency help is not present, you may need to give another dose of naloxone or administer CPR. Use a different device and other nostril to give a 2nd dose. Let the emergency team know that you gave naloxone and the number of doses.

Care after giving naloxone

  • When the person wakes up, they may be confused, anxious, or agitated. Let them know that they had too much opioid and that you gave them medicine.
  • Naloxone has minimal side effects when given in the nose. But some people who use opioids regularly may have rebound pain (sudden, intense pain) or signs of opioid withdrawal after getting naloxone.
  • Always seek medical care after giving naloxone. Naloxone lasts in the body for about 30 to 90 minutes (up to 1½ hours).
  • The naloxone may wear off before the opioids are out of the body or the person may need additional treatment for problems caused by the opioid overdose.

Key points about naloxone nasal spray

  • Naloxone nasal spray, such as Narcan®, is a medicine that can quickly reverse the effects of an opioid overdose.
  • Naloxone is easy to use and is safe, even if a person has not taken opioids.
  • Give naloxone right away if you think someone has taken too much opioid medicine.
  • Seek medical care right away after giving naloxone.

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Review: February 2026

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