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Naloxone Use to Prevent Deaths from Opioid Overdose

Even as the world and the country have been focused on COVID during the pandemic, the opioid epidemic rages on and has only worsened.

Tara Haelle

February 1, 2022

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# min read

More than 100,000 people in the United States died from drug overdoses from May 2020 to April 2021, the highest number for 12 months ever recorded, according to the CDC’s Morbidity and Mortality Weekly Report in late December. Sadly unsurprisingly, more than half involved opioids: 64% of the deaths occurred due to an overdose of synthetic opioids, excluding methadone, especially fentanyl and fentanyl-like drugs. Even as the world and the country have been focused on Covid during the pandemic, the opioid epidemic rages on and has only worsened.

While tackling opioid addiction requires a large toolbox, there is one thing all healthcare providers can do to be a part of the solution. Any healthcare provider can undergo training to administer naloxone (brand name Narcan), get a prescription, and keep it with them to give any patient experiencing symptoms of an overdose. Here’s what you need to know about naloxone and training.

About Naloxone

Most healthcare providers, especially those in areas with high opioid addiction rates, are already familiar with naloxone, but it’s taken years for access to it to be broadly available. The prescription medication temporarily stops the effects of opioids by displacing opioids from receptors in the brain. Naloxone is administered as an intranasal spray or an intramuscular injection, ideally in the thigh or upper arm.

Naloxone should be administered as soon as possible once the overdose symptoms are recognized and begins working within two to five minutes. The effects last 30 to 90 minutes, so multiple doses may be required depending on the particular opioid the person took and how big the dose was. Some opioids can last for several hours, so a person can re-enter overdose when the drug wears off if another dose isn’t given. Although naloxone only works on opioids, it’s recommended for anyone experiencing an overdose because it’s usually not possible to know exactly what drugs they took, especially if they took more than one.

Symptoms and Risk Factors of Overdose

The following signs and symptoms indicate a likely opioid overdose, according to the National Drug Court Institute:

A person cannot be woken up.

Slow or no breathing.

Gurgling, gasping, or snoring.

Clammy, cool skin.

Blue/gray lips or nails.

An opioid overdose may be more likely in the following circumstances:

Resuming opioid use after a break (i.e., while in jail, hospital, detox, or treatment) when tolerance has dropped.

Using opioids with other drugs like stimulants (cocaine or methamphetamine), depressants like benzodiazepines or alcohol, or with additional opioids.

Taking opioid medications more often or in higher doses than prescribed.

Using someone else’s opioid medications.

Unknown strength or contents of heroin or other opioids bought on the street.

Any current or chronic illness that reduces heart or lung function.

‍Naloxone and the Law

Providers have been able to prescribe naloxone for patients to take home since 1971, and laws have increasingly expanded access since then. Most states allow lay people to be prescribed and carry naloxone doses, especially if they have a friend or family member with an opioid addiction. Most states also have Good Samaritan laws that protect lay people and bystanders who call 911 and administer first aid, CPR, and/or naloxone to strangers without facing liability for any harm that occurs while attempting to save the person’s life. You can find out the details for what your state’s law allows for naloxone use here, and information on Good Samaritan state laws for overdose prevention is here.

Where to Get Training

All healthcare providers and even many non-healthcare providers, such as people with addiction, friends and family members, and bystanders, can take online training through multiple sources. Below are some of the options to explore:

The federal Substance Abuse and Mental Health Services Administration (SAMHSA) has a page of resources for practitioner training that includes opioid overdose treatment training and a range of other training opportunities. SAMHSA also provides an online Opioid Overdose Prevention Toolkit.

GetNaloxoneNow offers both bystander and first responder training modules.

The American Red Cross has an online first aid course for opioid overdoses.

The Overdose Lifeline has a course explicitly designed for laypersons that healthcare providers can pass along to people with addiction and their friends and family. The cost is a bit steep at $225, though training can be done in groups for $400.

For a refresh, the National Harm Reduction Coalition has step-by-step instructions for responding to an overdose.

Contact SAMHSA for More Information

Below is the SAMHSA contact information for a range of other services related to drug addiction treatment:

For information on buprenorphine waiver processing, contact the SAMHSA Center for Substance Abuse Treatment (CSAT) at 866-BUP-CSAT (866-287-2728) or infobuprenorphine@samhsa.hhs.gov.

For information about other medication-assisted treatment (MAT) or the certification of opioid treatment programs (OTPs), contact the SAMHSA Division of Pharmacologic Therapies at 240-276-2700. DPT@SAMHSA.HHS.Gov.