Naloxone Explained: What People in Recovery and Their Families Should Know

Opioids can dangerously slow or stop breathing during an overdose. Naloxone blocks opioid effects and can restore breathing. It is available in nasal spray and injectable forms; the instructions depend on the product. Some nasal sprays can be purchased over the counter in the United States.

Naloxone is an emergency medication. Its effect can wear off before the opioid does, so emergency care is still needed even if the person wakes up. It does not provide ongoing treatment for opioid use disorder. If a person has taken several substances, naloxone may reverse the opioid component, but other life-threatening effects may remain.

• Learn the instructions for the exact product you keep, rather than assuming every device works the same way.
• Having naloxone available is a preparedness step that can accompany ongoing recovery care.

Warning signs can include being unable to wake the person, very slow or absent breathing, choking or gurgling sounds, and discolored lips or nails. Very small pupils may also be present. Do not wait for every sign to appear before seeking emergency help.

A person who cannot be awakened and is making unusual snoring sounds may be overdosing rather than simply sleeping. If you suspect an opioid overdose, treat it as an emergency. You do not need to know exactly which drug was taken to call 911 and give available naloxone.

• Tell the dispatcher the person’s location, whether they are breathing, and that an overdose is suspected.
• If others are nearby, ask one person to call while another gets naloxone so help is not delayed.

Give naloxone according to its instructions and call 911 immediately. Follow the dispatcher’s directions for rescue breathing or CPR if the person is not breathing normally. If you are trained, use those skills as directed. Do not leave the person alone.

For commonly used naloxone nasal sprays, another dose with a new device may be needed after 2 to 3 minutes if the person does not respond, or if breathing slows again. Follow your product’s instructions. If the person is breathing normally but remains unconscious, place them on their side to reduce the risk of choking and keep monitoring breathing until help arrives.

• Do not assume the emergency is over because the person wakes up; breathing problems can return.
• Stay with the person, explain what happened to responders, and tell them when naloxone was given.

Ask a pharmacist, healthcare provider, or local health department about obtaining naloxone and learning how to use it. Availability and cost vary. Some community programs offer it at no cost or a reduced cost. Check the expiration date and follow the package directions for storage.

Tell trusted people where the kit is kept and make sure they can access it quickly. Review the instructions together before an emergency. Also ask your recovery provider about ongoing overdose prevention and treatment. A naloxone kit and a recovery care plan serve different purposes, and both can be part of a conversation about safety.

• Replace expired or used devices and avoid storing the kit where temperature extremes can damage it.
• If a kit is unavailable during a suspected overdose, call 911 immediately and follow the dispatcher’s instructions.