Naloxone is an opioid antagonist medication that is used to reverse an opioid overdose..
What Is Naloxone?
Naloxone is a medication approved by the Food and Drug Administration (FDA) designed to rapidly reverse opioid overdose. It is an opioid antagonist—meaning that it binds to opioid receptors and can reverse and block the effects of other opioids, such as such as heroin, morphine, and oxycodone. Administered when a patient is showing signs of opioid overdose, naloxone is a temporary treatment and its effects do not last long. Therefore, it is critical to obtain medical intervention as soon as possible after administering/receiving naloxone.
The medication can be given by intranasal spray (into the nose), intramuscular (into the muscle), subcutaneous (under the skin), or intravenous injection.
A practitioner should assess the need to prescribe naloxone for patients who are receiving medication-assisted treatment (MAT) or otherwise considered a risk for opioid overdose.
Candidates for naloxone are those who:
- Take high doses of opioids for long-term management of chronic pain
- Receive rotating opioid medication regimens
- Have been discharged from emergency medical care following opioid poisoning or intoxication
- Take certain extended-release or long-acting opioid medication
- Those who have had a period of abstinence to include those recently released from incarceration.
Pregnant women can be safely given naloxone in limited doses under the supervision of a doctor.
A doctor or pharmacist can show patients, their family members, or caregivers how to administer naloxone.
Patients given an automatic injection device or nasal spray should keep the item available at all times. It is important to remember to replace medication when the expiration date passes and if exposed to temperatures below 39F or above 104F.
Naloxone is effective if opioids are misused in combination with other sedatives or stimulants. It is not effective in treating overdoses of benzodiazepines or stimulant overdoses involving cocaine and amphetamines.
Side Effects of Naloxone
Patients who experience an allergic reaction from naloxone, such as hives or swelling in the face, lips, or throat, should seek medical help immediately. They should not drive or perform other potentially unsafe tasks.
Use of naloxone causes symptoms of opioid withdrawal. Medical assistance must be obtained as soon as possible after administering/receiving naloxone.
Opioid withdrawal symptoms include:
- Feeling nervous, restless, or irritable
- Body aches
- Dizziness or weakness
- Diarrhea, stomach pain, or nausea
- Fever, chills, or goose bumps
- Sneezing or runny nose in the absence of a cold
Opioid overdose can happen:
- When a patient misunderstands the directions for use, accidentally takes an extra dose, or deliberately misuses a prescription opioid
- With illicit drug use
- If a person takes opioid medications prescribed for someone else
- If a person mixes opioids with other medications, alcohol, or over-the-counter drugs
Signs of opioid overdose:
- Person does not wake or respond to touch or voice
- Breathing is not normal, very slow, or has stopped
- Pin-point sized pupils
- Bluish lips and nose
Opioid overdose is life-threatening and requires immediate emergency attention. Recognizing the signs of opioid overdose is essential to saving lives. Learn more about opioid overdose.
SAMHSA’s Efforts to Expand the Use of Naloxone
SAMHSA continues to work with its federal partners, states, first responders, and other stakeholders to educate on the use of and increase access to naloxone.
In an effort to save more lives from opioid overdose, SAMHSA published the Opioid Overdose Prevention Toolkit - 2018. The Toolkit equips communities and local governments with material to develop policies and practices to help prevent opioid-related overdoses and deaths. It also serves as a foundation for educating and training:
- Prescribers of opioid pain medications
- First responders
- Patients who are prescribed opioid medications
- Individuals and family members who have experienced an opioid overdose
Training on Providing Naloxone
Naloxone is a prescription drug. You can buy naloxone in many pharmacies, in some cases without a prescription. It’s important to understand how to administer naloxone properly.
SAMHSA offers tools, training, and technical assistance to practitioners in the fields of mental and substance use disorders. Find information on SAMHSA training and resources.
Resources and Publications
- Information about Naloxone
- Law Enforcement Naloxone Toolkit at the Bureau of Justice Assistance’s National Training and Technical Assistance Center
- Naloxone Injection at MedlinePlus
- Opioid Overdose Prevention Toolkit – 2018
- Opioid Overdose Reversal with Naloxone
- Providers Clinical Support System (PCSS)