How to get naloxone and use it to stop an overdose
Naloxone (Narcan is one brand) reverses an opioid overdose. On March 29, 2023, the FDA approved the 4 mg nasal spray for sale without a prescription, so it can be sold in drug stores, grocery stores, gas stations and online. Many community programs and health departments give it out free.13
If someone won't wake up and their breathing is slow or stopped: spray one dose into a nostril, call 911, turn them on their side, and give another dose in a new spray every 2 to 3 minutes until they respond or help arrives. Naloxone won't hurt a person who hasn't taken opioids.42
Updated October 2026. Rules differ by state, so call your office before you go. Questions? We're here: call or text 888-860-RISE.
Who should carry naloxone
The FDA recommends naloxone for anyone prescribed opioid pain medicine or medicine for opioid use disorder, anyone at higher risk of overdose (including people who also use alcohol or drugs such as benzodiazepines), and their caregivers.2
Just got out of jail, prison, treatment or the hospital? Your tolerance is lower after time without opioids. SAMHSA names people recently released from incarceration as people who should have it.3
Your steps, in order
- 1
Get naloxone, free or over the counter
You don't need a prescription for the 4 mg nasal spray. The maker sets the store price. Some other forms and doses of naloxone still need a prescription.1
Free naloxone is available through community distribution programs, local public health organizations and health departments. Check with your state for what's offered near you.3
Many states have a standing order, which lets you get naloxone straight from a pharmacist without a prescription.2
Medicare Part B covers naloxone you get from a doctor or an opioid treatment program, and Part D drug plans may cover it too.5
Bring- Nothing is required to buy the over-the-counter spray
- Your insurance card if you want to try to use coverage at the pharmacy
Tip:Get at least two sprays. Each spray holds one dose and works only once, and a person may need more than one dose.4
- 2
Know the signs of an overdose
Signs of an opioid overdose: the person won't wake up or respond to your voice or touch; breathing is very slow, shallow or has stopped; pupils are tiny; lips, nose or fingertips look blue; the body is limp.32
Test it: shout their name and rub the middle of their chest hard. If they don't wake up, act now.4
Not sure it's opioids? Give it anyway. The FDA says naloxone generally has no effect and causes no harm in someone without opioids in their system, and it can be used for people of any age.2
- 3
Give the first dose (nasal spray)
1. Lay the person on their back.4
2. Take the spray out of the box and peel back the tab. Don't test or prime it. Each spray holds only one dose.4
3. Hold it with your thumb on the bottom of the plunger and your first and middle fingers on each side of the nozzle.4
4. Put your hand behind their neck so their head tilts back. Gently put the tip in one nostril until your fingers touch the bottom of their nose.4
5. Press the plunger firmly, then take the nozzle out of their nose.4
- 4
Call 911 and turn them on their side
Call 911 right away after the first dose.4
If someone else is with you, one of you sprays while the other calls.
Turn the person on their side (the recovery position) so they don't choke.42
Stay with them until help arrives, even if they wake up. Naloxone wears off, and they could stop breathing again and need another dose.2
Tip:Afraid of getting in trouble? Most states have laws that protect people who call 911 for an overdose (see the state examples below). A 2021 federal review found 47 states and Washington, D.C. had one, and that how well people know about them varies a lot.6
- 5
Give more doses if they don't respond
A person usually wakes up within 1 to 3 minutes.2
If they don't wake up to your voice or touch, or don't start breathing normally, or they wake and then fade again, give another dose. Use a new spray each time, switch nostrils, and repeat every 2 to 3 minutes until help arrives.4
Naloxone may not fully reverse some opioids, such as buprenorphine, so more doses may be needed.4
Naloxone still works when opioids were mixed with other drugs. It can't reverse an overdose from benzodiazepines, cocaine or meth alone, which is one more reason to call 911.3
- 6
After: withdrawal, storage and a fresh kit
When the person wakes, they may go into sudden withdrawal: body aches, diarrhea, a fast heartbeat, fever, runny nose, sweating, nausea or vomiting, shaking, and feeling nervous or irritable. Stay calm, keep them with you, and let medical help take over.1
Put used sprays back in the box, out of reach of children, until you can throw them away.4
Store naloxone at room temperature, away from light, and don't let it freeze. Replace it when it expires, or if it has been colder than 39°F or hotter than 104°F (for example, left in a car).43
What it costs
| Where | Cost |
|---|---|
| Community programs and health departments | Free |
| Over-the-counter 4 mg nasal spray at a store | Price set by the maker; varies by store |
| Medicare | Part B covers naloxone; Part D plans may cover it |
Overdose 911 laws: state examples
Most states protect people who call for help during an overdose, but what's covered differs. These are summaries of each state's law, not legal advice.
Utah
If you report an overdose in good faith, give the location, stay until a police officer arrives and cooperate, you have a legal defense to charges for possessing or using drugs (including less than 16 ounces of marijuana) or paraphernalia from the same events. It covers the caller, a bystander who stays, and the person who overdosed. It's a defense you raise in court, not full immunity. Utah pharmacists can give naloxone without a doctor's prescription, and the state health department maps places that give out free naloxone and free fentanyl test strips.789
Washington
A person who seeks medical help in good faith for someone overdosing can't be charged or prosecuted for drug possession based on evidence found because they called. The person who overdosed is protected the same way.10
New York
A person who seeks help in good faith for an overdose, and the person overdosing, are protected from charges for having drugs, paraphernalia or, if under 21, alcohol, found because of the call. It doesn't cover selling drugs.11
California
It's not a crime to be under the influence of, or have for personal use, a drug or paraphernalia when you seek help in good faith for someone overdosing and don't get in the way of responders. The person overdosing is covered too. It doesn't cover selling or giving drugs, or driving under the influence.12
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Questions people ask
Do I need a prescription for Narcan?
No. The 4 mg naloxone nasal spray has been sold over the counter since March 2023, in drug stores, grocery stores, gas stations and online. Some other forms and doses still need a prescription.
Where can I get naloxone for free?
Community programs, local public health organizations and health departments often give it out free. In Utah, the state health department keeps a map of free naloxone locations.
Can naloxone hurt someone who isn't overdosing on opioids?
The FDA says naloxone generally won't have any effect or cause harm in a person without opioids in their system. If you're not sure, give it and call 911.
Will I get arrested if I call 911 for an overdose?
Most states have a Good Samaritan law that protects people who call for help from some drug charges, but each state's rules differ. In Utah, you must stay at the scene until police arrive and cooperate to keep that protection.
Are fentanyl test strips legal?
It depends on your state, so check your state health department before you carry them. In Utah, the state health department lists places that give them out free.
Keep going: more first-step guides
Sources
Official pages, read in October 2026. Rules change. If something here looks out of date, please let us know at hello@riseaid.org and we'll fix it.
- 1.U.S. Food and Drug Administration. FDA approves first over-the-counter naloxone nasal spray (March 29, 2023)
- 2.U.S. Food and Drug Administration. Access to naloxone can save a life during an opioid overdose
- 3.Substance Abuse and Mental Health Services Administration. Opioid overdose reversal medications
- 4.MedlinePlus (National Library of Medicine). Naloxone nasal spray: how to use it (revised September 2026)
- 5.Medicare.gov. Opioid use disorder treatment services (naloxone coverage)
- 6.U.S. Government Accountability Office. GAO-21-248: Drug misuse: most states have Good Samaritan laws (March 2021)
- 7.Utah Legislature. H.B. 362 (2020), Overdose Reporting Amendments, enrolled text: Utah Code 58-37-8(16)
- 8.Utah Department of Health and Human Services. Stop the Opidemic: naloxone
- 9.Utah Department of Health and Human Services. Stop the Opidemic: free naloxone and fentanyl test strip locations
- 10.Washington State Legislature. RCW 69.50.315: Medical assistance, drug-related overdose, prosecution for possession
- 11.New York State Senate. New York Penal Law § 220.78: Witness or victim of drug or alcohol overdose
- 12.California Health and Safety Code (via Public.Law). Section 11376.5: Seeking medical assistance for a drug-related overdose