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Fighting the Opioid Epidemic: Safe Use of Narcan Nasal Spray

narcan for opioid addiction image

by Jennifer Bingham, PharmD, BCACP & Stephanie Forbes, PharmD

The Prescription Opioid Addiction Epidemic

Pain is complex and the sensation and intensity can vary among individuals who are suffering, so there are many treatment options — mind-body techniques, acupuncture or physical therapy, and medications, both over the counter and prescription. For many patients with severe pain from injuries or surgery, opioid painkillers are supposed to provide pain relief, but because they have been heavily marketed and inappropriately prescribed, there has been an ever increasing number of deaths throughout the U.S. caused by misuse and addiction.

What is Narcan®?

Narcan® (naloxone hydrochloride) is an opioid antidote.1 It is indicated for patients that has suspected opioid overdose symptoms, such as respiratory and central nervous system depression.1 It is available in two formulations, including injectable and nasal preparations. The nasal spray contains one dose per unit,1 hence it is important to contact 9-1-1 for emergency medical assistance once opioid overdose is suspected to ensure additional assistance is available if needed. 

Who Should Use Narcan Nasal Spray?

Narcan nasal spray is intended for use by people who are experiencing an opioid overdose or are showing signs of opioid overdose.2,3 As mentioned above, it’s use is not a substitute for emergency medical care. Whenever administering Narcan, always call 9-1-1 right away.  Since it is an opioid antagonist, Narcan only works to reverse the effects of opioids, both prescription and non-prescription. Some examples of opioids it reverses are morphine, codeine, opium, hydrocodone, heroin and methadone.4

Who should have Narcan Nasal Spray?

People who receive Narcan are typically taking high doses of opioids for pain management over a long treatment period.2,5 Additionally, those taking extended-release or long-acting opioid medications or receive rotating opioid medication regimens may also have Narcan.   Patients who have a known hypersensitivity to naloxone hydrochloride should not use Narcan.1 Narcan access (needing a prescription) varies across states and the medication should be replaced before the expiration date passes.5

How to Store Narcan Nasal spray?

Narcan nasal spray should be stored in the blister and cartons provided until use.1 A controlled room temperature between 59°F to 77°F with protection from light is recommended for storage, and the product should not be frozen. The nasal spray may be stored at temperatures outside of this range (39°F to 104°F) for brief periods of time only.

Ask your pharmacist if you should talk to your provider about Narcan.

References:

  1. Narcan Nasal Spray (naloxone hydrochloride) [prescribing information]. Radnor, PA: Adapt Pharma Inc; January 2017.
  2. Naloxone. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/medication-assisted-treatment/treatment/naloxone/. Last Updated April 11, 2019; Accessed June 3, 2019. 
  3. Coffin, Phillip MD, MIA. Prevention of lethal opioid overdose in the community. UptoDate®. Last Updated June 25, 2018. Accessed June 3, 2019.
  4. What Are Opioids. Department of Health and Human Services. https://www.hhs.gov/opioids/prevention/index.html. Last Updated May 15, 2018. Accessed June 4, 2019
  5. Opioid Overdose Reversal with Naloxone. National Institute of Drug Abuse. https://www.drugabuse.gov/related-topics/opioid-overdose-reversal-naloxone-narcan-evzio/. Last Updated April 2018, Accessed June 3, 2019.

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