Naloxone Access in California
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LA County fentanyl-related overdose deaths fell 37% in 2024, according to the LA County Department of Public Health, and naloxone (brand name Narcan) is one of the tools anyone can carry. Naloxone nasal spray was approved for over-the-counter sale in 2023 (FDA); California's CalRx program sells a twin-pack to any California resident for $24 plus tax and shipping (Office of the Governor); and LA-area community programs distribute it free.
What Naloxone Is and How It Works
Naloxone is an opioid antagonist — it blocks opioids at receptors in the brain and can reverse the slowed breathing that causes overdose death. It's usually available as a nasal spray (easiest for laypeople to use) or an injection. With potent opioids like fentanyl, more than one dose may be needed; follow the package directions. Naloxone does not reverse non-opioid sedatives like xylazine, but because xylazine is usually used with opioids, the CDC says naloxone should still be given in a suspected overdose.
Buying Naloxone at California Pharmacies (Over-the-Counter)
In March 2023, the FDA approved Narcan 4 mg naloxone nasal spray for over-the-counter, nonprescription use, so pharmacies can sell it without a prescription. Prices vary by pharmacy and product, and some insurance plans cover it. Pharmacists can show you how to use it.
CalRx — $24 Direct-to-Consumer
Since April 2025, California's CalRx program has sold its 4 mg naloxone nasal spray twin-pack directly to any California resident for $24 per carton plus tax and shipping (Office of the Governor). Order at calrxnaloxone.com. Before that change, CalRx naloxone was sold only to government entities and businesses.
Free Naloxone Distribution in LA County
LA County Department of Public Health operates community distribution through harm reduction partners, including the ByLAforLA.org platform (bylaforla.org). Syringe exchange programs and harm-reduction coalitions across LA distribute naloxone free to people who use drugs, family members, and community members. The LA County Substance Abuse Service Helpline at 1-844-804-7500 can refer callers to specific distribution sites. Eligible organizations may qualify for free naloxone through the California DHCS Naloxone Distribution Project (Office of the Governor).
Fentanyl Test Strips
Fentanyl test strips let people check a drug sample for fentanyl before use. The CDC notes they are inexpensive and typically give results within 5 minutes, but even a negative result calls for caution because strips might not detect more potent fentanyl-like drugs such as carfentanil. LA County harm-reduction organizations distribute test strips alongside naloxone. They don't prevent overdose, but they support more informed decisions.
How to Administer Naloxone Nasal Spray
Follow the directions printed on the package. In general: remove the device from the packaging, tilt the person's head back, insert the nozzle into one nostril, and press the plunger firmly to release the dose. Call 911. If the person doesn't respond after a few minutes, the package directions explain when and how to give another dose with a new device. Stay with the person and keep them on their side to prevent choking. Naloxone can wear off while opioids are still in the body, so emergency care is still needed even after the person wakes up.
California Good Samaritan Law
Under Health and Safety Code §11376.5 (added by AB 472), it is not a crime to be under the influence of, or possess for personal use, a controlled substance, analog or paraphernalia if you, in good faith, seek medical help for someone whose overdose is related to your own possession and you don't obstruct medical or law enforcement personnel. The person who overdosed is protected under the same conditions when help is sought for them. No other immunities are intended.
Last reviewed: October 29, 2026
Frequently Asked Questions
Do I need a prescription for Narcan in California?
No. The FDA approved Narcan nasal spray for over-the-counter, nonprescription use in March 2023, so pharmacies can sell it without a prescription.
Where can I get free naloxone in LA?
LA County DPH and partner harm-reduction organizations distribute naloxone free. The ByLAforLA platform lists sites. LA County's Substance Abuse Service Helpline at 1-844-804-7500 can connect callers to distribution locations.
How do I use fentanyl test strips?
Follow the instructions that come with the strips. The CDC notes results typically appear within 5 minutes, and a negative result may still miss more potent fentanyl-like drugs, so use caution either way. LA-area harm-reduction organizations distribute strips.
Will I get arrested for calling 911 during an overdose?
Under California's Good Samaritan law (Health and Safety Code §11376.5, added by AB 472), it is not a crime to be under the influence of, or possess for personal use, a controlled substance, analog or paraphernalia if you, in good faith, seek medical help for someone whose overdose is related to your own possession and you don't obstruct medical or law enforcement personnel. The person who overdosed is protected under the same conditions. No other immunities are intended.
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