Naloxone (Narcan®) nasal spray should be given to anyone showing signs of opioid poisoning:

If by “form” you mean “form of administration” there are two “forms,” intramuscular and intranasal. Intramuscular (IM) is injected via syringe into a large muscle, e.g.,  the butt, thigh, or arm. Intranasal is sprayed up the nose. Both methods of administration are equally effective. 

• Injectable brands of naloxone are offered by several different companies. Typically, the proper dose must be drawn up from a vial. Usually, it is injected with a needle into muscle, although it also may be administered into a vein or under the skin. 

• Prepackaged Nasal Spray (generic naloxone, Narcan®, Kloxxado®) comes in a prefilled, needle-free device that requires no assembly and is sprayed into one nostril while the person lays on their back. This device can also be easier for people without formal training to administer. 

• The FDA recently approved ZimhiTM, a single-dose, prefilled syringe that can be injected into the muscle (IM) or under the skin i.e., subcutaneously.  

• For more information about naloxone please see: https://nida.nih.gov/publications/drugfacts/naloxone.

Tacoma Needle Exchange carries both intramuscular (IM) and Nasal Spray (Intranasal) forms of naloxone. We encourage people to carry whichever “form” of naloxone (IM or intranasal) they are comfortable administering.

Short answer: No. According to the CDC, “you can’t use naloxone on yourself”. This is why, if you use opioids, it is critical that the people around you know that you have naloxone and they know how to administer it properly. At Tacoma Needle Exchange we tell people you don’t carry naloxone for yourself, but for your loved ones and your community.

Naloxone only works on opioids e.g., heroin, fentanyl, oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, and morphine. It has no effect on non-opioids such as methamphetamine, cocaine, benzodiazepines, etc.

However, if you witness someone experiencing overdose-like symptoms i.e., extremely pale face and/or feel clammy to the touch, limpness, fingernails or lips develop or have a purple or blue color, vomiting or making gurgling noises, they cannot be awakened, are unable to speak, or their breathing or heartbeat slows or stops, you should assume they are experiencing an overdose and administer naloxone and call 911.

Yes. Recognizing the signs of an opioid overdose and knowing how ro properly administer naloxone is not only something people-who-use-drugs should do. Naloxone can/should be carried by anyone that is capable of being trained and comfortable administering it. By getting trained to recognize and properly respond to the signs of an opioid overdose you could save a life.

The Washington State Project to Prevent Prescription Drug/Opioid Overdose (WA-PDO), a five-year project supported by the WA State Health Care Authority/Division of Behavioral Health and Recovery with funds from the Substance Abuse and Mental Health Services Administration, documented 9,526 opioid overdose reversals between Sept. 1, 2016 – August 31, 2021.  9,240 (97%) of these overdoses were reversed by lay-responders, i.e., regular people not first responders i.e., Police, Paramedics, EMTs, etc. Anyone with the proper training and naloxone can save a life. 

Possible, but highly (highly) improbable. Fentanyl doesn’t absorb through the skin very well, so that’s not a significant risk. We recommend that you wash your hands with soap and water (not alcohol or sanitizer) if you get it on your skin.

In addition, when someone smokes fentanyl, most of the drug has been filtered out by the user before there is secondhand smoke. Studies have looked at fentanyl concentrations in the bloodstream after someone has had secondhand fentanyl exposure from smoke. The levels are extremely low or not detectable. So, there’s no real risk for the everyday person being exposed to secondhand opioid smoke. 

Fentanyl and other opioid drugs are what we call very fat-soluble. They like to get inside cells, in tissues like the brain. If a person takes fentanyl, it will quickly be taken up by the brain, the liver, and other fatty tissues and not linger in the air. 

For additional information on fentanyl exposure please read the ACMT and AACT Position Statement: Preventing Occupational Fentanyl and Fentanyl Analog Exposure to Emergency Responders

Hell no! Don’t do that! While the heart is a muscle, IM naloxone should only be injected into the buttocks, thigh, upper arm, i.e., a large muscle that is not the heart.