What Drugs Does Narcan Work On? A Teen Rehab Guide

According to the CDC in 2023, synthetic opioids such as fentanyl accounted for 75% of teen drug overdose deaths. Many teens unknowingly consume potent opioids that are laced in more common drugs abused among youth, such as cannabis, MDMA, or stimulants [1].

Fortunately, over recent years, opioid overdose deaths in both youth and adults have decreased. A large part of this is thanks to Naloxone (Narcan). Read on to learn more about this life-saving drug and how it is pulling teens, their families, and entire communities out of the grips of the opioid overdose crisis. 

Understanding Naloxone in Teen Opioid Use 

Naloxone (Narcan) is a medication used to reverse opioid overdoses and is safe and effective for teens. Naloxone works by blocking opioid receptors in the brain to restore normal breathing within seconds to minutes.

It is often administered as a nasal spray, but can be injected as well. Many states now offer naloxone over the counter or as part of Narcan distribution programs, increasing accessibility for families, schools, and communities to respond quickly to youth overdoses. 

For teens, naloxone is especially important given the rise of opioid overdose deaths in some states. Some school districts are now keeping naloxone on hand to prepare for a rare but potentially fatal overdose event. 

It’s also important to note that naloxone is safe to give even if a teen is not overdosing on opioids. It causes no harm or side effects to those without opioids in their system. After administering naloxone, it’s essential to call 911 so they can monitor vitals, as naloxone effects are temporary and in some cases, more than one dose might be needed [2]. 

Signs of Teen Opioid Overdose 

It’s essential to recognize the signs of an overdose so you can administer naloxone if available and call 911.  If your teen has struggled with opioid or other drug abuse in the past, it’s recommended that parents keep a dose or 2 of naloxone in the home. 

Signs of an opioid overdose in teens include: 

• Slowed or stopped breathing 
• Weak or limp limbs 
• Pale, blue/purple mouth or lips 
• Snoring, gurgling, or choking sounds
• Cold, clammy, pale skin
• Vomiting, disorientation 
• Tiny, pinpoint pupils 
• Slowed or stopped heartbeat 

How Narcan Works on Opioid Receptors

Naloxone is an opioid antagonist, meaning it binds to opioid receptors in the brain but does not activate them. Instead, it blocks the effects of these receptors so opioids cannot attach to them.  

Naloxone targets the same receptor sites as opioids such as fentanyl, heroin, and pain pills, but because naloxone binds more strongly, it displaces the opioids already attached and prevents them from working.  However, although naloxone is incredibly strong, it is short-lasting (30 to 90 minutes). Naloxone is not a permanent treatment but rather a way to quickly block opioid effects in the brain, to buy time to get to a hospital [2]. 

Naloxone Alternatives Compared 

Naloxone is currently the most widely used and effective opioid and fentanyl reversal medication. However, others are currently being researched and explored for their potential effectiveness [3]. These include:

• Nalmefene: Opioid receptor antagonist similar to naloxone but with a longer duration of action. Potential benefits could show increased effectiveness for long-acting opioids. 
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• Respiratory Stimulants: Non-opioid medications that stimulate breathing. Several types have been explored, including potassium channel blockers, NMDA receptor antagonists, and ampakines. 
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• Buprenorphine: Primarily used for opioid use disorder treatment, there have also been reports of people using buprenorphine to reverse opioid overdoses when naloxone was unavailable.
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• ‍Wearable Naloxone Delivery Devices: These are under development to address the narrow treatment window associated with potent synthetic opioids such as fentanyl. One device has undergone a pilot study. However, more research is needed. 

Types of Opioids Teens May Encounter

Overall, teen opioid use is generally low. Most doctors will not prescribe prescription opioids to youth, and heroin use among teens is extremely low (less than 0.2% reported lifetime use). However, the rise in fentanyl, especially in the presence of more common drugs that teens abuse, such as cannabis or MDMA, has increased the danger of opioid overdoses. 

• Prescription opioids misused by teens include oxycodone (OxyContin), hydrocodone (Vicodin), codeine, morphine, and Percocet. Teens often access these substances from family medicine cabinets, from peers at school or in the neighborhood, or through online sources. 

• Synthetic opioids such as fentanyl are a major contributor to the recent overdose deaths in youth. Fentanyl is often found in counterfeit pills or stimulants that teens unknowingly consume. 

Fentanyl and Its Role in Overdose Prevention

In 2024, there were nearly 55,000 opioid overdose deaths linked to fentanyl across the US. Although this number has decreased significantly from 2023 (83,000 deaths), it is still higher than the population of many US towns [4]. 

The decrease in overdose deaths may reflect an essential part that naloxone is playing in the opioid crisis, to quickly reverse the effects of an overdose and buy time for people to receive medical intervention.   

Naloxone Effectiveness in Teen Overdose Treatment 

Naloxone has been shown to save the lives of teens and reverse the effects of opioid overdoses, including in highly potent opioids such as heroin and fentanyl. This is especially helpful for youth, who often overdose on opioids unwillingly (e.g., buying cannabis or party drugs such as MDMA laced with fentanyl). 

Community-based naloxone distribution programs combined with public health interventions and increased access to social services saw opioid overdose treatment reduced deaths by up to 37% [5]. 

Factors Affecting Naloxone Effectiveness in Teens 

There are several factors that can impact naloxone effectiveness in teens. These include the potency of opioids, individual biological factors such as metabolism, and the method of use. 

• Potency: Highly potent opioids such as heroin or fentanyl may require extra doses of naloxone. 

• Method of Use: Injected or inhaled opioids, such as heroin or fentanyl, can work extremely quickly, sometimes causing harm before naloxone is able to be administered. 

• Long-Acting: Methadone and extended-release formulations of prescription opioid pills can outlast the effectiveness of naloxone, often requiring repeated dosing. 

• Metabolism: Faster metabolisms have been found to shorten naloxone's duration of action (typically 30 to 90 minutes).

• Tolerance: Teens who have been regularly abusing opioids, or have accumulated more in their bodies, may need extra dosing for increased effectiveness. 

• Respiratory Issues: Breathing issues such as COPD and sleep apnea can complicate naloxone administration due to decreased lung function and a lack of responsiveness to respiratory stimuli. 

• Polydrug Use: Taking more than one drug at a time, such as mixing pills with alcohol, can reduce the effectiveness of naloxone.

Success Rates

In a 2024 study looking at emergency medical service responses, the administration of Narcan led to a 54% clinical improvement in pediatric cases after the first dose. Most Narcan administrations for teens occur in the home or residential settings, with the majority of cases involving teens 14 to 17 [6]. 

Helping Teens Recover from Opioid Abuse in Florida 

Lotus Behavioral Health is a residential treatment facility for teens located in Florida. Our programs are designed to support teens and their families with the tools they need to recover from substance abuse and co-occurring mental health disorders. 

Our treatment programs help teens recover from opioid addiction, including prescription pain pills and synthetic opioids, with a combination of medically supervised care, individual therapy, group therapy sessions, skill-building workshops, and aftercare and transition services to support long-term recovery.

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Sources

[1] Opioid Overdoses. 2023. CDC. 

[2] Naloxone Drug Facts. 2022. National Institute on Drug Abuse.  

[3] Opioid Overdose Reversal Medications (OORM). 2024. SAMHSA. 

[4] Drug Overdose Deaths: Facts and Figures. 2024. National Institute on Drug Abuse. 

[5] McDill, V. 2024. Greater availability of naloxone and increases in witnessed overdoses can reduce opioid-related deaths. School of Public Health. University of Minnesota. 

[6] Gaw, C. et al. 2025. Pediatric Emergency Medical Services Activations Involving Naloxone Administration. Journal of Prehospital Emergency Care. ​​29(4):1-10.