Naloxone is a life-saving medication that can reverse an overdose from opioids—including heroin, fentanyl, and prescription opioid medications—when given in time. Source: CDC

Naloxone was first approved by the FDA, over fifty years ago, in 1971 as a prescription medication. On March 29, 2023, the FDA approved Naloxone for over-the-counter nonprescription use.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8327685/

Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine, and many others. Source: NIDA

Opioid overdose is life-threatening and requires immediate emergency attention. Recognizing the signs of opioid overdose is essential to saving lives. Source: SAMHSA

An opioid overdose can occur for a variety of reasons, including:

• When a person overdoses on an illicit opioid drug such as heroin or morphine

• When a person overdoses on methadone.

• When a person misuses an opioid-based pain medication, using not as prescribed by their physician or one prescribed for someone else. Children are particularly vulnerable to accidental overdoses if they take medication not intended for them.

Source: SAMHSA

Prescription opioids can be prescribed by doctors to treat moderate to severe pain but can also have serious risks and side effects. Source: CDC

Signs may include small, constricted “pinpoint pupils”; falling asleep or losing consciousness: slow, weak, or no breathing; choking or gurgling sounds; limp body; cold and/or clammy skin; discolored skin (especially in lips and nails). Source: CDC

Yes, an FDA advisory committee voted unanimously in March 2023 to approve Narcan for over-the-counter sales without a prescription. The specific dose approved for retail sales is the 4-milligram naloxone hydrochloride nasal spray. It is currently available over the counter.

Naloxone is very easy to administer. It is a 5-step process. Source: SAMHSA

1. Evaluate for signs of opioid overdose

2. Call 911 for help

3. Administer Naloxone

4. Support the person’s breathing

5. Monitor the person’s response

Yes, it can be administered by non-medical personnel, which makes it ideal for individuals to treat overdose in people who have been prescribed opioid pain medication and those who use heroin and other opioids. Naloxone only works if a person has opioids in their system, as the medication has no effect if opioids are absent. There is no harm in giving a person who is experiencing an overdose multiple doses of Naloxone.

It is recommended that all individuals distributing naloxone receive training on recognizing the signs and responding to an overdose. In some states, the Naloxone Access Law requires that basic instruction and information on administering naloxone be included with any distribution. State laws link at the bottom of this handout.

Naloxone can (but does not always) cause withdrawal symptoms or unpleasant physical reactions in people physically dependent on opioids. Withdrawal symptoms may include fever, anxiety, irritability, rapid heart rate, sweating, nausea, vomiting, and tremors.

Naloxone Access Law varies from state to state. They protect any agent of a community-based organization that distributes naloxone under the standing order of a medical provider from civil or criminal liability. State laws link, www.safeproject.us/naloxone/awareness-project/state-rules/

It provides immunity from arrest, charge, or prosecution for drug possession or paraphernalia when individuals experiencing or witnessing an overdose summon emergency services.

Naloxone cannot harm an individual who is not overdosing on an opioid. It works in the brain only, binding to the opioid receptors and blocking the effects of opioids. If someone has a medical emergency other than an opioid overdose – such as a diabetic coma or cardiac arrest – giving them naloxone won’t have any effect or cause them additional harm.

Naloxone can indeed prevent death in opioid overdoses, but it typically has a shorter duration of action than many opioids, potentially requiring additional doses. Medical assistance must be obtained as soon as possible after administering/receiving Naloxone.

There is an expiration date on naloxone. Check the package for the expiration date.

Yes, check the packaging to see what temperature range is recommended. Generally, room temperature is advised.

Many, but not necessarily all, first responders carry naloxone. And, while many first responders may carry Naloxone, there may not be sufficient supply to treat all individuals, for example: on December 9, 2022, in Cambridge, Massachutes four workers at one location required Naloxone at the same time. The first responders used Naloxone from the employers first aid supplies to supplement the supplies that they had. All four workers received treatment and survived.

Naloxone is a fast-acting drug that can reverse opioid overdose and restore normal breathing within 2-3 minutes. Additional doses of naloxone may be needed for larger quantities of opioids or more potent opioids like fentanyl.

Naloxone is safe and effective and has no potential for abuse. In addition, naloxone cannot be taken before substance use to avoid an overdose.

Yes, this can occur when someone accidentally takes an extra dose, deliberately misuses a prescription opioid, or mixes opioids with other medications, alcohol, or over-the-counter medications. An overdose can be fatal when mixing an opioid and anxiety treatment medications, including derivatives of Benzodiazepine, such as Xanax or Valium.

Reversing an opioid overdose using naloxone gives an individual a second chance at life. Following a successful overdose reversal, an individual can access additional treatment options they may not have considered previously.

It is uncommon for the revived person to become violent or combative.
https://bjatta.bja.ojp.gov/naloxone/does-naloxone-have-any-side-effects

Yes, for the first time in U.S. history, a person is more likely to die from an accidental opioid overdose than from a motor vehicle crash, according to National Safety Council analysis.

https://www.nsc.org/newsroom/for-the-first-time,-were-more-likely-to-die-from

True. The CDC found that nearly 17,000 overdose deaths involving prescription opioids (limited to natural and semi-synthetic opioids and methadone) occurred in 2021, which is equivalent to 45 deaths per day.

https://www.cdc.gov/opioids/data/analysis-resources.html

True. Nearly 645,000 people died from an opioid overdose between 1999 and 2021.

https://www.cdc.gov/opioids/data/analysis-resources.htmlscription

Most states have passed Good Samaritan Laws to protect the person administering the Naloxone. State laws link, www.safeproject.us/naloxone/awareness-project/state-rules/

Yes, an FDA advisory committee voted unanimously in March 2023 to approve Narcan for over-the-counter sales without a prescription. The specific dose approved for retail sales is the 4-milligram naloxone hydrochloride nasal spray. It is currently available over the counter.

Yes, in some cases, fentanyl may be so potent that multiple doses of naloxone are required. Incidental skin exposure to fentanyl is very unlikely to harm you. If you believe you may have come in contact with fentanyl, wash your hands with soap and water as soon as possible, especially before eating or touching your mouth or nose.

Multiple studies indicate that opioid users do not have more confidence when using due to Naloxone availability, and habitual users do not want naloxone reversal at any time.

Many states have passed overdose prevention laws that support treatment instead of arrests. State laws link, www.safeproject.us/naloxone/awareness-project/state-rules/

Bystander naloxone and Take-Home-Naloxone programs have repeatedly demonstrated mortality reductions.