Medically reviewed by Kevin Wandler, MD, Chief Medical Advisor
Naloxone is a medication that can reverse an opioid overdose and save a life. You may know it by the brand name Narcan, a nasal spray. With fentanyl and other powerful opioids involved in many overdoses, knowing what naloxone is, how to use it and where to get it in Texas is useful for anyone, whether or not they use drugs themselves.
If you think someone is overdosing, call 911 immediately and give naloxone if you have it.
What Naloxone Is
Naloxone is an opioid antagonist, a medication that blocks and reverses the effects of opioids. It’s used in emergencies to restore normal breathing in someone whose breathing has slowed or stopped because of an opioid overdose. It comes in more than one form, including ready-to-use nasal sprays and injectable versions.
How Naloxone Works
Opioids such as heroin, fentanyl, oxycodone and morphine attach to opioid receptors in the brain. In an overdose, they can slow breathing to a dangerous or fatal degree. Naloxone binds to those same receptors, displacing opioids and temporarily blocking their effects. This can quickly restore breathing.
A few important points:
- It works on opioids only. Naloxone won’t reverse overdoses from alcohol, benzodiazepines or stimulants alone. Because many overdoses involve more than one substance, though, it can still help if opioids are part of the mix.
- It’s safe to give if you’re unsure. Naloxone won’t harm someone who isn’t overdosing on opioids.
- More than one dose may be needed, especially with strong opioids like fentanyl.
- It’s temporary. Naloxone can wear off before the opioids do, so overdose symptoms can return.
Getting Naloxone Without a Prescription in Texas
In 2023, the U.S. Food and Drug Administration approved naloxone nasal spray for over-the-counter sale. That means you can buy it without a prescription at many pharmacies, grocery stores and other retailers, as well as online. Texas pharmacies were also able to provide naloxone without a personal prescription before over-the-counter versions became available.
Other ways to get naloxone may include:
- Asking your pharmacist, who can explain options and how to use them
- Checking whether your health insurance covers certain naloxone products
- Contacting community organizations and public health programs, some of which offer naloxone at no cost
Texas Health and Human Services has information about statewide efforts to prevent opioid overdoses.
How to Use Naloxone Nasal Spray
- Check for signs of overdose. Look for unresponsiveness, slow or stopped breathing, pinpoint pupils, and blue or gray lips or fingertips.
- Call 911. Tell the dispatcher someone is unresponsive and not breathing well.
- Give naloxone. Lay the person on their back, insert the nozzle into one nostril and press the plunger, following the package directions.
- Support breathing. If you’re trained, give rescue breaths or CPR as directed by the dispatcher.
- Give another dose if needed. If the person doesn’t respond, the package explains when to give a second dose using a new device in the other nostril.
- Use the recovery position. Once the person is breathing, turn them on their side.
- Stay until help arrives. Watch the person closely, since symptoms can return.
What to Expect After Naloxone Is Given
When naloxone works, the person may wake up and start breathing more normally. People who are physically dependent on opioids may experience sudden withdrawal symptoms, such as agitation, nausea, vomiting, sweating or body aches. These symptoms are distressing but are generally far less dangerous than the overdose itself. Stay calm, reassure the person and encourage them not to use more opioids. Everyone who receives naloxone for an overdose should get emergency medical care.
Who Should Carry Naloxone
Consider keeping naloxone on hand if you or someone you know:
- Uses opioids, whether prescribed or not
- Takes high-dose prescription opioids
- Uses other drugs that could be contaminated with fentanyl
- Is in recovery from opioid use, since tolerance drops after a period without use
- Lives with or cares about someone in any of these groups
Store naloxone at room temperature and away from direct light, check the expiration date, and replace it after use. Tell friends and family where you keep it. In Texas, avoid leaving it in a hot car for long periods, since extreme temperatures can affect the medication. Keeping one kit at home and another in a bag you carry every day means it’s more likely to be close by when it’s needed.
Legal Protections in Texas
Texas law generally protects people who give naloxone in good faith to someone they believe is experiencing an opioid overdose. Texas also offers limited legal protections for some people who call 911 for an overdose, with conditions. This is general information, not legal advice. Whatever the circumstances, always call 911.
Naloxone Saves Lives; Treatment Supports Recovery
Naloxone can reverse an overdose, but it doesn’t treat the underlying opioid use disorder. Treatment can. Options include opioid detox, medication-assisted treatment and fentanyl addiction treatment. If you’re concerned about someone, learn the common signs of opioid misuse.
Frequently Asked Questions
Do I need a prescription for Narcan in Texas?
No. Naloxone nasal spray is available over the counter, and pharmacists can help you find it.
Can naloxone hurt someone who isn’t overdosing?
Naloxone won’t harm someone who isn’t overdosing on opioids, so it’s safe to give if you’re unsure.
Does naloxone work on fentanyl?
Yes. Naloxone can reverse fentanyl overdoses, though more than one dose may be needed.
Is Narcan covered by insurance?
Some plans cover certain naloxone products. Check with your plan or pharmacist.
Get Help for Opioid Use
If you or a loved one is struggling with opioids, treatment can help. Review our insurance options, contact us, or call (469) 546-9303 any time. In an emergency, call 911.