Free Narcan in Texas: where to get naloxone and how to use it

Someone won't wake up or isn't breathing? Call 911 now, give naloxone if you have it, and stay with them. In a mental health or substance use crisis, call or text 988. SAMHSA's National Helpline, 1-800-662-4357, is free and open 24/7.

Where to get naloxone in Texas

Where	Cost	What to know
Naloxone Texas (naloxonetexas.com)	Free	The state program, formerly called More Narcan Please. Individuals and organizations can request it. Mail takes time, so don't wait on it if you need naloxone today.
Any pharmacy	The store's price	No prescription needed for the 4 mg and 3 mg nasal sprays. It may be behind the counter; ask the pharmacist.
Pharmacy, with Medicaid or insurance	Your plan's share	Texas Medicaid has covered naloxone through its drug formulary. A pharmacist can dispense it under a prescription or a standing order.
Your treatment program	Free when it's handed out	Texas lets organizations give out naloxone under a prescriber's standing order, as long as they don't charge for it. Ask your program or opioid treatment clinic.

Naloxone Texas: the free program

Naloxone Texas is run by UT Health San Antonio under contract with HHSC, with Texas Targeted Opioid Response funding. It gives free naloxone to people and to organizations, including recovery and treatment programs, and offers training. Request it at naloxonetexas.com.

• Mailed kits take time. Plan ahead, and buy a box at a pharmacy if you need it now.
• Supply has run short before. The program ran out of money in 2022 and stopped taking new requests for a time (KUT), and in 2024 the Texas Tribune reported delays and an unpredictable supply. If a request isn't filled, use one of the other routes.
• Ask for enough. One kit for the home, one for the car or bag, and one for anyone who lives with or visits the person at risk.

At a pharmacy, without a prescription

Since 2023, naloxone nasal spray has been sold over the counter, like a pain reliever. You don't need a prescription. Two things to know:

• It may not be on the shelf. A 2024 Rice University Baker Institute study found that 71% of Houston pharmacies that carried naloxone kept it behind the counter or in a locked cabinet. Ask at the counter.
• Check the date. In January 2024 the FDA said newly made Narcan 4 mg nasal spray has a 4-year shelf life, up from 3. Go by the expiration date printed on the box.

With Medicaid or insurance

Texas Medicaid has covered naloxone through the Vendor Drug Program formulary, with preferred products and quantity limits. Check the current list at txvendordrug.com, or call the member number on your card. Private plans may also cover it when a prescriber writes a prescription; call your plan to ask what you'd pay.

You don't need to see a doctor first. Texas Health and Safety Code chapter 483 lets a prescriber issue a standing order and lets a pharmacist dispense naloxone under it to a person at risk of overdose, or to a family member, friend or anyone else in a position to help. The Texas Overdose Training Initiative offers a free standing order to pharmacies and organizations in Texas.

Which products are over the counter

Product	Status
Narcan 4 mg nasal spray	Over the counter since March 29, 2023, the first naloxone sold without a prescription
RiVive 3 mg nasal spray	Over the counter since July 28, 2023
Rextovy 4 mg nasal spray	Approved for over-the-counter sale on June 16, 2026
Injectable naloxone, higher-dose sprays and some other forms	Still need a prescription or a standing order

Signs of an opioid overdose

The CDC lists these signs. Someone may have only some of them:

• They won't wake up, or can't talk.
• Slow, shallow or no breathing.
• Choking, gurgling or snoring sounds.
• Blue, gray or pale lips and fingertips.
• Very small, pinpoint pupils.

Fentanyl can be mixed into other drugs, so an overdose can happen to someone who didn't know they took an opioid.

How to use it

1. Call 911. Say the person isn't breathing or won't wake up, and give the address.
2. Give the naloxone. Lay them on their back, put the nozzle in one nostril and press the plunger. Follow the instructions on the box.
3. Support their breathing. If you're trained, give rescue breaths. If they're breathing, roll them onto their side so they don't choke.
4. Stay with them. Naloxone wears off, and an overdose can come back. If they don't respond in 2 to 3 minutes, give a second dose in the other nostril, as the box directs.

The CDC says naloxone is safe, and it's unlikely to harm someone who isn't having an opioid overdose. When in doubt, give it.

What Texas law protects

Law	What it says
Health and Safety Code 483.105	Anyone may possess naloxone, with or without a prescription.
Health and Safety Code 483.106	A person who, in good faith and with reasonable care, gives naloxone to someone they believe is having an opioid overdose is protected from criminal prosecution, professional discipline and civil liability.
The overdose Good Samaritan law (HB 1694, 2021)	A defense to prosecution for low-level drug possession for the first person who calls 911 for someone who may be overdosing, and for the person overdosing, if the caller stayed until help arrived and cooperated.

The Good Samaritan law has limits. It doesn't cover people with certain earlier drug convictions, people who have used the defense before, or people who called 911 for an overdose in the previous 18 months. It's a defense, not immunity: a person can still be arrested and must raise it. Call 911 anyway. A life matters more.

After an overdose: treatment

An overdose is a sign that someone needs care now. Medication is the strongest treatment for opioid use disorder: buprenorphine (Suboxone), methadone or naltrexone, alongside counseling. Our guides explain how to get Suboxone in Texas and how methadone clinics work. If cost is the worry, see free and state-funded rehab in Texas.

Programs that offer medication for addiction, by city: Houston, Dallas, San Antonio, Austin, Fort Worth and El Paso. Everywhere else: addiction treatment in Texas, by city, or answer four quick questions to see where to start.