Naloxone, commonly referred to as Narcan, is an opioid antagonist. It can help reduce the likelihood of an overdose-related death. You can’t get high on it and there are few side effects. You cannot overdose on Narcan.

If you administer naloxone to someone that is not overdosing, don’t worry, nothing will happen and the dose will not harm the person.

There are some populations that are more at-risk than others for an overdose. You should think about getting naloxone if:

• You have built a tolerance to the opioid/opiate you are using
• You’ve starting using again after not using for a long time
• You are mixing drugs (this includes alcohol)
• You are concerned about what else is in your supply of drugs
• You frequently inject the drugs that you use (there is a higher risk of overdose with injection use)
• You have overdosed in the past
• You use alone

Everyone can have naloxone, because you never know when someone may need it! More specifically, however, you should get naloxone if you or someone you know:

• Has just started to use drugs again after a period of abstinence
• Has recently been released from incarceration and had previously used opioids
• Has a prescription for opioids for medical conditions
• Works with staff, clients, or family members that fit any of these descriptions

Some signs and symptoms that you can look out for that may indicate an overdose is if someone is/has:

• Unresponsive
• Breathing slow, irregular, or not at all
• Slow, erratic, or no pulse (heartbeat)
• Limp body
• Blue skin tinge (noticeable on lips/under fingernails)
• Pale face
• Vomiting
• Making choking/gurgling/snoring noises

The naloxone that ACT provides is the Narcan pre-filled intranasal spray. Here are the steps for administration:

1. Remove the Narcan from the package.
2. Tilt the person’s head back, insert the applicator into one of their nostrils, and press the plunger. Make sure to press the plunger all the way, so that the full dose is administered.
3. If they don’t respond within 2-3 minutes, give the second dose.

Watch Narcan Video

There are other ways to administer naloxone that are linked below.

Rub the middle of the person’s chest hard and yell their name. If they are not breathing:

1. Tilt the person on their side and make sure the passageway is clear.
   1. Look in their mouth to see if anything is blocking their airway. This is called the recovery position and it’s important to keep the person in this position while you call 911.
2. Call 911.
   1. This step is imperative. Emergency responders have more naloxone and the person may need additional doses. It is unlikely that you will face legal repercussions, as your action here falls under the “good Samaritan” law (see below). Let the operator know as much as possible in regard to the situation. Is the person breathing? What have they taken? Are they responding at all? Are you going to/have you administered naloxone?
3. Perform rescue breathing
   1. If you don’t feel comfortable completing this step, move on to step 4.
   2. Rescue breathing is the quickest way to get oxygen into the body if someone has stopped breathing and is unresponsive. Here are the steps:
      1. Place the person on their back and pinch their nose.
      2. Tilt the chin to open the airway. Check to see and remove object if there is anything in the mouth to block the airway.
      3. Give two slow breaths.
      4. Blow enough air into the lungs to make the chest rise.
      5. Turn your head after each breath to ensure the chest is rising and falling. If it doesn’t work, tilt the head back more.
      6. Breathe again every five seconds.
4. Administer naloxone
   1. If you are doing rescue breathing, administer the naloxone between breaths. If not, administer after you’ve called 911.
5. Return to rescue position and stay with this person until medical help arrives.

DO NOT:

1. Put the person in a bath or ice
2. Make the person vomit
3. Hit, burn, or kick the person
4. Inject the person with anything other than naloxone

No matter what the potency of a certain opioid/opiate is, naloxone works on reversing its’ effects. Someone may need several doses, but potency does not change the efficacy of naloxone.

We can provide you with naloxone. We will give you two nasal injectors and instructions on how to use the nasal applicator. When you use it, lose it, or need a new one, we can give you a new one, but we will have to ask you a couple of short questions. Stop by our SSP van or call our office!

You can ask your health care provider for a prescription for naloxone in any of the available administration methods. Many pharmacies in CT have certified pharmacists who can prescribe AND dispense naloxone. Most insurance, including Medicaid and Medicare, have the intranasal form and nasal spray available. Purchasing it out of pocket can be too expensive for a lot of people.

If you’re going to a pharmacy for naloxone, it may be best to call in advance to make sure that it’s available and there’s a trained pharmacist.

Naloxone is very safe and there has been no documented case of an allergic reaction from naloxone. Some side effects that may occur are similar to the symptoms of withdrawal from the opioid/opiate. Here are some examples:

• Agitation
• Nausea
• Vomiting
• Diarrhea
• Goose bumps
• Runny nose/tearing of the eyes
• Yawning

Naloxone in a nasal spray is less likely to result in severe withdrawal symptoms than the naloxone by injection.

The “Good Samaritan Law” protects you! If you call for help during an overdose, you cannot be arrested for drug use. However, authorities can confiscate your works and drugs. Also, if you have outstanding/active warrants, you can be arrested for them.

CT statute PA 16-43 protects anyone that is administering naloxone from getting in trouble for giving it to someone they think is overdosing.

"Any person, other than a licensed health professional acting in ordinary course of such person’s employment, who administers an opioid antagonist in accordance with this subsection shall not be liable for damages in a civil action or subject to criminal prosecution with respect to the administration of such opioid antagonist."

Intranasal (not pre-filled) - Watch Video

1. Remove small purple and yellow caps from Naloxone vial and injector
2. Attached vial to injector using three half turns or until stopper is pierced by needle
   1. **Do not push vial into injector**
3. Remove large yellow cover from injector
4. Make sure there are no air bubbles in injector
5. Twist plastic side of nasal atomizer onto injector
6. Insert side with white foam tip into person’s nostril
7. Push half of Naloxone out of injector into person’s nostril, then push remaining half into the other nostril
8. Administer a second dose of Naloxone if person is not responsive after 3-5 minutes.

Evzio - Watch Video

1. Pull off red safety guard
2. Place black end on out thigh of person
3. Press the device firmly into the person’s thigh and hold for 5 seconds
4. Remove device
5. Administer a second dose if a person is not responsive after 3-5 minutes.

Injectable with Intramuscular Syringe - Watch Video

1. Open syringe packet
2. Attach needle to body of syringe by pressing blue side of cap into top of syringe
3. Remove cap from Naloxone and syringe
4. Insert needle into Naloxone vial
5. Pull 1cc of Naloxone into syringe
6. Make sure there are no air bubbles in syringe
7. Administer Naloxone into person’s arm, thigh or buttocks
8. Replace cap onto needle
9. Administer second dose if person does not respond after 3-5 minutes

Nasal with Intramuscular Syringe - Watch Video

1. Open syringe packet
2. Attach needle to body of syringe by pressing blue side of cap into top of syringe
3. Remove cap from Naloxone and syringe
4. Insert needle into Naloxone vial
5. Pull 1cc of Naloxone into syringe
6. Make sure there are no air bubbles in syringe
7. Replace cap onto need and remove needle by twisting top
8. Twist plastic side of nasal atomizer onto syringe body
9. Insert side with white foam tip into person’s nostril
10. Push half of Naloxone out of syringe into person’s nostril, then push remaining half into the other nostril
11. Re-administer if person is not responsive after 3-5 minutes.