March 6, 2023

New data show most Nebraskans are unaware of Narcan

Hand holding a Narcan Evzio Naloxone nasal spray opioid drug overdose prevention medication
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Narcan naloxone nasal spray is a quick-acting drug that blocks opiate receptors in the nervous system and is used to prevent overdose deaths from opioids. It is available throughout the state, for free, through a program established by state law.

Naloxone — better-known by its brand name, Narcan — can save lives, but a new report from the University of Nebraska–Lincoln’s Rural Drug Addiction Research Center suggests that few Nebraskans understand what Narcan is, where to get it or how to use it.

Based on data collected over three years in the Nebraska Annual Social Indicators Survey, the report’s authors estimate that only 10-20% of Nebraskans know where and how to obtain naloxone and found that a quarter to a third of Nebraskans don’t understand what Narcan is. Of Nebraskans who know what Narcan is, only a quarter answered that they also knew how to use it.

Naloxone is a quick-acting drug that blocks opiate receptors in the nervous system, reversing or reducing the effects of opioids. It is so effective at reversing opioid overdoses that a committee of advisers to the Federal Drug Administration voted unanimously in February to recommend making Narcan available without a prescription — a move that could make it available over the counter in all states by the end of the year.

Nationally, opioids account for about 75% of overdose deaths, of which there were 102,429 in 2022. Though not uniformly reported statewide by type of substances involved, Nebraska has tracked an increase in overdose deaths in recent years. According to statewide figures, 126 overdose deaths occurred in 2015. That total rose to 221 in 2021.

In response to the increasing number of opioid overdoses nationwide, the Nebraska Legislature in 2015 passed a law to make access to naloxone easier. Today, 94 pharmacies across Nebraska are part of the free Narcan distribution program. A standing order from the Nebraska Department of Health and Human Services states that Narcan can be purchased from any licensed pharmacist without a prescription.

Patrick Habecker, research assistant professor with the RDAR Center and co-author on the report, said the results show a continuing need for public education about Narcan, especially as overdose deaths continue to increase.

“Clearly, there are still a lot of people who don’t know what (Narcan) is, much less where to get it and how to use it,” Habecker said. “The state is quite focused on the dissemination of Narcan as a primary response to overdose deaths, but it’s maybe not as successful as they were hoping it would be.”

Habecker pointed out that over three years, the baseline of knowledge and access remained very stable across the state. There has been a slight uptick in knowledge, most notably in the Omaha metro area, where in 2020, 29% answered they didn’t know what Narcan was, dropping to 15% in 2022.

“This gives us a good baseline, and we’ll continue to include these questions in the survey, as well as do some detailed analysis on what else might be contributing to this,” he said. “It’s important that Nebraskans know about the program and how to use Narcan.

“The whole nation has seen a higher prevalence of overdose deaths involving stimulants and synthetic opioids like fentanyl, and I don’t think Nebraska is going to be an exception to that trend. Particularly, the pressed pill issues, where substances are added, appear to be produced by a regulated manufacturer, but are actually illicitly produced. These are going to continue to be a problem here, just as they are elsewhere.”

Habecker said the report is publicly available, and that center researchers share the data with Nebraska’s Department of Health and Human Services. Naxolone resources provided by the state are available here.

Any Nebraskan can go to one of the 94 pharmacies to obtain Narcan free of charge and learn how to use it by reading the instructions or watching an instructional video.

“They’ve really made it very easy to use and to access,” Habecker said. “This can help combat opioid overdoses, but it requires individuals to know it exists, how to get it and how to use it.”