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Primer: How Does Narcan Work?


As part of our series Hope on the Front Lines, Morning Edition host Rick Ganley and producer Michael Brindley attended a training in Keene for people interested in learning life-saving skills, including how to administer Narcan, the drug used by first responders to counteract opioid overdose.

But what is Narcan, and how does it work?

Narcan is the brand name for the drug naloxone, which blocks the effects of opioids and reverses overdose. 

According to David Brooks, the Concord Monitor reporter behind the "Granite Geek" science column, the easiest way to explain Narcan is with a simple analogy: lock and key.

"If you think of your brain cells as having holes, the opioid comes along and fits like a key in a lock, and it causes your brain cell to do bad things," Brooks explained to NHPR's Peter Biello in an interview last fall.

"The naloxone comes along and replaces the heroin. It can knock it out, or it can fill the hole before the heroin comes along, and prevents the connection from being made, prevents the opioid from causing your brain cells to do bad things."

Related: In July 2015, NHPR's Paige Sutherland reported a story in which she recorded audio of first responders in Laconia reviving a patient with Narcan. You can listen to that story right here. 

The Chemistry Behind Narcan:

Credit Sara Plourde, NHPR

Because Narcan is fast-acting and is used in emergency response, it's often compared to the EpiPen - the brand name for an epinephrine injection used to counteract extreme allergic reactions. But that's where the comparison should end, as Brooks noted. 

"Epinephrine...does not affect what is happening when you have an allergic reaction. What it does is, it counter-balances many of the negative effects of it. It causes your heart to speed up and it causes your airways to open up and it does certain other chemical things, but it doesn’t affect the underlying mechanism, whereas the Narcan is a replacement. It replaces the underlying effect right at the very start."

Want to learn more about Narcan? Here are some resources:

The CDC's recommendations for expanding the use of Narcan

Granite Geek: Narcan Not the "EpiPen of Heroin"