Patient education: How to give naloxone (The Basics)

What is naloxone? — Naloxone is a medicine that reverses the effects of opioids. It can prevent death from an opioid overdose. Naloxone comes in an injection (shot), or as a spray that goes in the nose (brand name: Narcan nasal spray).

If you or someone you know uses opioids or is trying to stop using them, it's a good idea to keep naloxone with you. Make sure that you and your family and friends know how and when to use it.

Where can I get naloxone? — In the US and some other areas, you can buy naloxone nose spray without a prescription. It is available in pharmacies and other stores that sell medicine.

When should I use naloxone? — It's important to know the signs of an opioid overdose so you know when to give naloxone.

Someone might be having an opioid overdose if they:

●Do not respond to your voice or when you shake them – You might not be able to wake them up.

●Make snoring or gurgling sounds as they breathe

●Have very slow breathing or are not breathing at all (less than 1 breath every 5 seconds)

●Have blue lips or fingernails

●Have very small pupils (the black circles in the center of the eyes)

If you think that someone might be having an opioid overdose but are not sure, you can still give naloxone.

What should I do if I think that someone has overdosed? — If you think that someone is having an opioid overdose, give naloxone immediately if you have it. Then, call for an ambulance (in the US and Canada, call 9-1-1). Let them know that you think the person might have overdosed. Tell them if you think that the person is not breathing.

To give naloxone nose spray (figure 1) – This comes in a syringe or a pre-packaged spray.

●Nose spray (syringe):

•Take the caps off of the plastic syringe and the tube of naloxone.

•Place the cone on the plastic syringe. Screw the tube of naloxone into the syringe.

•Place the cone into the nostril. Give a short, hard push on the tube to spray the naloxone into the nose. Give half of the naloxone in each nostril.

●Nose spray (prepackaged):

•Take the nose spray out of the package. Hold it with 2 fingers, with your thumb on the plunger.

•Place the tip of the nozzle into 1 nostril until your fingers touch the person's nose.

•Press the plunger with your thumb firmly to give the dose. You do not need to give another dose in the other nostril.

To give a naloxone injection (figure 2) – It is safe to give an injection of naloxone through pants, jeans, or other clothes. Naloxone comes in a vial (bottle) or in a prefilled syringe.

●Regular injection with syringe:

•Take the cap off of the vial. Remove the cap from the needle, and insert the needle into the vial of naloxone.

•Hold the vial upside down, and pull back on the plunger to fill the syringe with 1 mL (1 cc) of naloxone. Make sure that the syringe is filling with liquid and not air. Take the needle out of the vial.

•Push the needle into a large muscle such as the thigh, buttock, or shoulder. Press the plunger in all of the way.

●Prefilled syringe:

•Remove the needle cap. Do not touch the base. This is where the needle comes out.

•Hold the finger grips, and push the needle into the person's thigh muscle.

•Press the plunger until it clicks. Hold it firmly in place for 2 seconds and then remove the needle.

•Cover the needle with the safety cap, and throw away the syringe.

After you give naloxone, start rescue breathing ("mouth to mouth") if the person is not breathing or is breathing very slowly. You might need to start chest compressions if they have no pulse. The emergency dispatcher will give you step-by-step instructions.

Lay the person on their side. Stay with them until help comes. You might need to give more naloxone in 3 minutes if they are still not breathing on their own.

What else should I know?

●Naloxone lasts for 30 to 90 minutes. Opioid drugs can last much longer. It is important for someone to stay with the person who is overdosing. They might need more naloxone.

●It is very important for the person to still get medical care after they got naloxone.

●If you keep naloxone at home, read the instructions ahead of time. Make sure that you always know where it's kept.

●More information on naloxone can be found at the Centers for Disease Control and Prevention ("CDC") website: www.cdc.gov/stopoverdose/naloxone

More on this topic

Patient education: Taking opioids safely (The Basics)
Patient education: Opioid overdose (The Basics)
Patient education: Opioid use disorder (The Basics)
Patient education: Prescription drug misuse (The Basics)
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