- Opioids slow down the central nervous system, which slows down breathing and heart rate. An opioid overdose occurs when the brain can no longer regulate breathing, causing respiratory depression (not breathing enough) until breathing stops completely. Opioids, such as heroin, prescription opioids or fentanyl, bind to opioid receptors in the brain. Naloxone binds to the same receptors but are a “better fit,” so they essentially “kick” the opioids off and block the opioid receptors for about an hour.
FAQ
Where can I go for additional information?
- For additional information and current reports on fentanyl, visit:
- This article addresses some common myths and misconceptions surrounding fentanyl:
How long does it take for naloxone to take effect?
- Anywhere from 30 seconds to 5 minutes, depending on the route of administration and the amount of opioids in someone’s system.
Fentanyl
- Fentanyl is a powerful synthetic (manufactured) opioid prescribed by physicians to treat patients with severe pain, such as post-surgical or cancer pain. Legally prescribed fentanyl generally comes in the form of a patch, nasal spray, lozenge, injection, tablets or films. However, illegally manufactured fentanyl can be found in a powdered form and is frequently used to “cut” heroin or in counterfeit prescription pills (including fake opioids and benzodiazepines).
- The onset of an overdose caused by fentanyl can occur at a much quicker rate (sometimes within seconds) than heroin and may take multiple doses of naloxone to counteract due to the potency of fentanyl. In the majority of cases, fentanyl overdoses appear very similar to other opioid overdoses. However, atypical overdose symptoms due to fentanyl have been reported, including:
- Immediate blue or grey lips
- Body stiffening/seizure like activity
- Foaming at the mouth
- Confusion before becoming unresponsive
What are the risks associated with naloxone use?
- Minimal risks are associated with naloxone. Naloxone cannot get you “high” and is not addictive. Someone who is physically dependent on opioids may experience some withdrawal symptoms (such as nausea, vomiting, sweating, aches, or irritability).
How long does naloxone last?
- The effects of naloxone only stay in the system for about an hour, which is a shorter amount of time than some opioids. This means that it is possible to slip back into an overdose after the naloxone wears off. It is important to always call 911 in the case of an overdose, even if naloxone is administered
*Missouri has recently enacted a 911 Good Samaritan Law that offers protection to those who call 911 during an overdose. Click here for more information.
What if naloxone is given to someone who is not overdosing on opioids? Will naloxone work for alcohol, cocaine, meth or other types of overdoses?
- Naloxone only blocks the opioid receptors so it will not have an effect, positive or negative, on anything other than an opioid overdose. If you mistakenly give naloxone to someone who is not overdosing on opioids, you will not help or harm them.
Can you overdose on naloxone?
- No, you cannot overdose on naloxone. If a person experiencing an opioid overdose does not respond to the first dose of naloxone in 2-3 minutes, it is safe to administer additional doses.
What types of naloxone are available?
- Intramuscular:
- A naloxone injection directly into the muscle of the upper thigh or upper arm.
- Auto injector – Evizio:
- A ready-to-use, automatic injection device, which gives electronic voice-guided, step-by-step instructions. Note, this version is typically very expensive (around $4000) and may not be covered by some insurances.
- Prepackaged Nasal Spray – Narcan Nasal Spray:
- A preassembled, ready-to-use device. After the nasal spray nozzle is gently inserted into the person’s nostril, firmly press the plunger to spray one entire dose into one nostril. The naloxone is absorbed into the bloodstream so there is no need for the person to inhale it for the medication to work.
- Nasal Atomizer:
- A pre-filled cartridge of naloxone and a nasal atomizer that requires assembly. Note, this device is not FDA approved.
Naloxone can also be administered intravenously (through an IV) by medical professionals.
Naloxone, Narcan, Naltrexone, Suboxone… What’s the difference?
- Naloxone is the generic name for the opioid overdose reversal (“antidote”) medication.
- Narcan is one brand name of the prepackaged nasal spray naloxone
- Suboxone is the brand name for buprenorphine + naloxone (prescribed as Medication Assisted Treatment for opioid use disorder)
- Naloxone ≠ naltrexone (longer-acting opioid antagonist for alcohol use disorder treatment and relapse prevention in opioid use disorder)