Signs of a Possible Opioid Overdose

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• Cannot be awakened by shouting or tapping their shoulders

• Breathing is very slow, shallow, irregular, or has stopped

• Choking, gurgling, or unusual snoring sounds

• Tiny “pinpoint” pupils

• Pale, gray, or bluish skin, lips, or fingernails

• Body is limp

• Skin feels cold or clammy

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If you are unsure whether the person is asleep or overdosing, treat it as an overdose. CDC

When Is It Safe to Give NARCAN®?

Give NARCAN when someone is unresponsive, is not breathing normally, and an opioid overdose is known or suspected.

If you are unsure what the person took, it is still safe to give NARCAN. It will not harm someone if opioids are not causing the overdose, but it will not reverse an overdose caused only by alcohol, cocaine, methamphetamine, or other non-opioid drugs. 

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How to Give NARCAN Nasal Spray

1. Make sure the area is safe.

2. Shout the person’s name and tap their shoulders.

3. Lay the person on their back.

4. Remove the NARCAN device from its package. Do not test or prime it.

5. Hold the device with your thumb on the plunger and two fingers around the nozzle.

6. Tilt the person’s head back.

7. Insert the nozzle into one nostril until your fingers touch the bottom of the nose.

8. Press the plunger firmly. Each device contains only one dose and cannot be reused.

9. Call 911 immediately and tell the dispatcher that NARCAN was given. 

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What to Do After Giving NARCAN

• If the person is not breathing normally, begin CPR or rescue breathing according to your training and follow the 911 dispatcher’s instructions.

• If the person is breathing normally but remains unconscious, place them on their side in the recovery position.

• Watch their breathing continuously.

• If they do not wake up or breathe normally within 2–3 minutes, give another dose using a new device in the other nostril.

• Continue giving a new dose every 2–3 minutes if needed and available.

• Stay with the person until EMS arrives. Do not assume they are safe because they woke up.

• Be prepared for vomiting, sweating, shaking, confusion, anger, or other withdrawal symptoms.

• If vomiting occurs, keep them on their side and protect their airway.

• Do not allow them to take more drugs.

• The effects of NARCAN can wear off before the opioid does, so overdose symptoms may return. The person still needs emergency medical care.