How to Use Naloxone

Identifying an Opioid Poisoning Event 

Quickly assessing a person's responsiveness and breathing can help determine if they are experiencing an opioid poisoning. 

Signs of Responsiveness: 

The person is not likely experiencing opioid poisoning if they: 

• • Are awake and alert 

  • Responds to questions 

  • Can be easily woken up

  • Show minimal or no signs of sedation 

Signs of Normal Breathing:

The person is breathing normally if they: 

• • Take 12 or more breaths per minute 

  • Are breathing on their own 

  • Do not have abnormal or unusual breath sounds

If the person is unresponsive, breathing abnormally, or not breathing at all, act quickly--they may be experiencing an opioid poisoning and need immediate help. 

Additional Signs of Opioid Poisoning:

• Difficulty walking, talking or staying awake

• Blue, purple or grey lips or nails

• Very small pupils (also known as pinpoint)

• Cold and clammy skin

• Dizziness and confusion

• Extreme drowsiness

• Choking, gurgling or snoring sounds

• Not moving and body is limp

Before Responding to an Opioid Poisoning

If you suspect someone is experiencing an opioid poisoning:

1. Call 911 Right Away  

• • If the person has slow or no breathing, or is unresponsive, call 911 immediately. 

2. Ensure Your Safety

• Check that the area is safe for you to respond. 

• Identify hazards and take precautions to reduce harms. 

What to do if you Have to Leave Someone Alone 

If you need to step away to call for help, get a naloxone kit, or retrieve an Automated External Defibrillator (AED), take these precautions to keep the person as safe as possible:

1. Place Them in the Recovery Position

• • Always turn them into their side, whether they are breathing or not.

  • This position helps prevent choking if they vomit.

2. Why the Recovery Position Matters

• Vomiting can occur due to drug poisoning or precipitated opioid withdrawal after naloxone is given. 

• Keeping the person on their side reduces the risk of airway obstruction.

How is Naloxone Administered?

Naloxone should be given to anyone showing signs of an opioid overdose or when overdose is suspected. It can be administered either as a nasal spray or an injection.

• Naloxone Nasal Spray: The most common form of naloxone for public use. A prepackaged, needle-free device that is ready to use. It is sprayed into one nostril while the individual lies on their back.  Effects should be noticeable within 

• Injectable Naloxone: Requires drawing the medication from a ampule and administering it into a muscle, typically in the upper arm, thigh, or buttocks.

Precautions When Using Naloxone

Naloxone remains active in the body for 30 to 120 minutes, but opioids can last much longer. As a result, overdose symptoms may return once naloxone wears off. This is why calling 911 immediately is essential to ensure the individuals receives proper medical care. 

In cases involving stronger opioids, multiple doses may be necessary, you may need to use more than one dose of naloxone to restore breathing. 

Individuals who use opioids or have opioid dependence may experience withdrawal symptoms shortly after receiving naloxone. These symptoms can include headaches, changes in blood pressure, rapid heartbeat, sweating, nausea, vomiting, and tremors. 

What to Do After Giving Naloxone

1. Stay with the Person 

• Remain with them until medical help arrives.

• They may be confused or experience opioid withdrawl symptoms.

2. Explain What Happened

• Introduce yourself and let them know what happened.

• Tell them how many naloxone doses you administered and whether it was given as an injection or nasal spray.

3. Advise Them on Next Steps

• Encourage the person to wait until the naloxone wears off before taking more opioids. 

4. Provide Resource Information

• Call 211 for resources in community.

• Visit 'Help Starts Here' online anytime for available services and additional assistance.

Share Information on Safer Use Practices

• Suggest using a monitoring app or hotline, such as the Lifeguard App or NORS Hotline, if they are at risk of using alone.

• Find a local Overdose Prevention Site (OPS) or Safe Consumption Site (SCS)