Airlines Now Carry Drug-Overdose Antidotes. Should You?

In 1961, scientists developed a life-saving medication called naloxone (commonly known by the brand name Narcan), a drug that acts as an antidote to the lethal effects of an opioid overdose. Now, a half-century later, not only has naloxone become available over the counter, but it is stocked on commercial aircrafts. Southwest Airlines recently joined other major airlines that already included the nasal spray in their medical kits, including Delta, United, and Alaska.

Why should planes carry naloxone? Although there haven’t been studies that specifically report on how common it is for people to overdose while in flight, Southwest’s decision came after a young male passenger became unresponsive due to an opioid overdose, sending fellow passengers scrambling to perform lifesaving measures while the plane made an emergency landing. Immediately upon landing, the medical emergency response team gave him naloxone twice, restoring his breathing and giving him another shot at life—and, hopefully, recovery.

Members of Congress had urged the Federal Aviation Administration to require all airlines to carry naloxone in medical kits, after more than 5 years of pushing for the same by the Association of Flight Attendants, which represents flight attendants working for 19 airlines across the country.

Digging into the science behind naloxone and the opioid overdose crisis, here’s what we know:

• Opioids such as painkillers and heroin act on the brain to make a person feel a rush of intense pleasure (also known as euphoria) by attaching themselves to “receivers” in brain cells known as receptors. Naloxone blocks those receptors, essentially kicking the opioids off of them, and in doing so, reverses the body’s response to an overdose.
• In 2022 drug overdose deaths hit a new record with nearly 110,000 fatalities, driven largely by the synthetic opioid fentanyl, which is often taken unintentionally by those who suffer its lethal effects.
• Studies show that 80% of drug overdoses occur outside of a medical setting, where a bystander with naloxone in hand may be the only way to save a life.

Should you carry naloxone?

It's a personal choice, of course, but here are a few considerations that can help you decide.

Do you need to have medical background or training to use it? No. Naloxone comes in a nasal spray form that is easy to use and small enough to fit on a keychain.

Are there certain people who should consider carrying naloxone because of their life situation or that of their loved ones? Yes. There are at least two groups of people who should strongly consider having naloxone on hand:

• If you know or love someone who struggles with addiction—even if opioids aren’t their “drug of choice”—it is a great idea to carry naloxone with you in your purse, car, and at home. People who use drugs other than opioids can easily and unknowingly take something that was mixed with opioids like fentanyl, which can be lethal even in very small amounts.
• If you are a parent with teenagers, keep naloxone in your home. Some high schools are now providing training to their students on how to give Narcan as part of First Aid and CPR certification courses, because teens are highly vulnerable to the lethal effects of opioids and can overdose the first time they try them.

To learn more about where to find naloxone and how to give it to someone who has overdosed, here are a few resources:

• Though widely available over the counter at local pharmacies, naloxone is also offered free of charge through community organizations, such as NEXT Distro.
• Step-by-step instructions on how to give naloxone to someone who has overdosed can be found here.

My upcoming book, Addiction: What Everyone Needs to Know, goes into greater depth about the opioid crisis, the lifesaving impact of naloxone, and the most effective treatments for opioid addiction.