A nasal spray that reverses fentanyl overdoses in minutes is being touted as a potential antidote to America’s deadly epidemic.
Naloxone, sold under the brand name Narcan, works by blocking the synthetic opioid from attaching to receptors in the brain.
It was approved for over-the-counter use by the Food and Drug Administration (FDA) last month, paving the way for it to be sold at big box stores and vending machines.
Bars and nightclubs are also being encouraged to stock up on it to curb the spiraling number of accidental overdoses killing more than 75,000 Americans each year.
How to administer Narcan to someone suffering a fentanyl overdose, according to health officials in New York
What is it?
Narcan is a nasal spray that has been shown to quickly reverse an opioid overdose. It is an opioid antagonist. It works by blocking the opioid’s path to the brain and attaching to its opioid receptors, also called the mu, delta, and kappa receptors.
When Narcan is inhaled, the medicine is absorbed by mucous membranes in the nose, which allows it to enter the bloodstream quickly.
It has been shown to prevent fatal overdoses from fentanyl, as well as drugs such as oxycodone and heroin.
Narcan comes in a single dose, so if someone needs multiple doses, a new container must be used. The majority of the time, a single dose is sufficient.
Rescue kits each contain a zippered bag, two doses of Narcan, directions for appropriate use. Some kits also include latex gloves, nasal atomizers, face shields, and resources for getting help for substance abuse disorder.
How is it administered?
Narcan is administered via a nasal spray.
Lay the person on their back to receive the dose.
Remove the nasal spray from its packaging by peeling back the tab with the circle on it.
Hold the nasal spray with your thumb on the bottom of the red plunger and your first and middle fingers on either side of the nozzle.
The person’s head should be tilted back with neck support before inserting the tip of the nozzle into one nostril.
Your fingers on either side of the nozzle should be against the bottom of the person’s nose.
Press the red plunger firmly to give the dose, then remove from the nostril. The dose takes two to three minutes to work. If there is no change after three to five minutes, administer a second dose.
Narcan only lasts between 30 and 90 minutes, so it is possible that another overdose could occur. Stay with the person and wait out the risk period so another dose can be administered accordingly.
If the person goes into cardiac arrest, their chances of survival dwindle the longer the arrest lasts.
Always call emergency medical help after administering the dose.
Administering Narcan requires no medical training and can be done just by inserting the nozzle tip into one nostril
How to spot a Fentanyl overdose
A person is overdosing if they are unconscious and can’t be woken up. If they are conscious, they may involuntarily fall asleep or lose consciousness repeatedly. Their body may feel limp with cold, clammy, or discolored skin.
Their pupils may be small and constricted, also known as ‘constricted pupils.’
The person will most likely have slow, weak breathing. In some cases, they may not be breathing at all.
How much does it cost?
The price varies depending on your insurance plan and location.
If you have insurance, you may need to receive prior authorization before insurance determines how much of the cost to cover.
Emergent Solutions, Narcan’s manufacturer, has not specified an exact price point for the drug, but estimates range from $22 all the way up to $141 depending on location and insurance. It can be sold either in packs of one or two.
Some states offer Narcan for free after completing certain training programs or other requirements.
Ohio, for example, has a program called HarmReductionOhio, which allows Ohio residents to order Narcan online and receive it in the mail. In Iowa, residents who receive an online video consultation with a pharmacist can receive Narcan free of charge.
Coupons and assistance tools for affording Narcan are available, depending on insurance and location.
Where can I buy it?
The FDA approved Narcan for over-the-counter use in March, which will make it available in retailers, vending machines, supermarkets, and pharmacies without a prescription. However, OTC sales are not expected to be available until the end of summer.
In the meantime, Narcan is available to purchase from a pharmacist in all 50 states.
Some locations have also set up Narcan vending machines, which can be accessed at any time of day.
Narcan kits can also be given free of charge in certain locations or by certain organizations.
New York City, for example, launched the NARCAN BEHIND EVERY BAR campaign, which provides free training to venues, staff, and security on Narcan use and opioid overdose. Qualifying parties can also order Narcan kits by mail to keep in their venues.
Harm reduction centers located across the country can also have Narcan kits on hand.
Who makes it?
Narcan is manufactured by Emergent BioSolutions, a specialty biopharmaceutical company that develops vaccines and antibody therapies for infectious diseases and opioid purposes.
Why is Narcan being pushed so hard?
The Biden Administration today launched a media marketing campaign to promote Narcan.
The goal of the campaign is to target young people through social media posts and advertisements in locations such as college campuses, restaurants, and bars.
It will use online influencers like college athletes and ‘lifestyle content creators’ to urge people to keep the nasal spray to hand in case they or a friend overdose.
Fentanyl, which is flooding into the US from Mexico and China, has become the leading cause of death for those aged 18 to 49, surpassing guns and car accidents.
The NIH estimated fentanyl-related deaths in young people increased by 182 percent from 2019 to 2021.
It is cheap, highly addictive, relatively easy to smuggle into the US, and cost effective for dealers to mix it into their supplies, which saves them money and can extend or boost the high experienced by users.
Narcan has an extremely high success rate. A study from Brigham and Women’s hospital found that 94 percent of people who were given naloxone survived their overdose.
In a study from Harm Reduction Journal, more than 90 percent of participants were worried that a single box of Narcan would not be enough for a successful reversal. However, 95 percent of overdose events were prevented.
Launching the public health campaign today, Biden’s drug czar Dr Rahul Gupta said: ‘We know that the majority of adolescent overdose deaths had one or more bystanders nearby, and that’s why today’s announcement is so critical—we are meeting young people where they are to prevent drug poisonings being driven by illicit fentanyl and ensure they know how they can save a life with Naloxone.
‘This campaign builds on President Biden’s whole-of-government approach to beat the overdose epidemic by working to get Naloxone into all communities and dismantle drug trafficking operations producing lethal substances like fentanyl.
‘Our message is simple: Naloxone is a medication that can reverse an opioid overdose, it’s easy to use, and it’s available without a prescription in all 50 states.
‘Even if young people or their friends don’t use drugs, carrying Naloxone could help them save a life in the event of an overdose.’