Basics

  • Opioids are drugs related to opium poppies like heroin, morphine, fentanyl, codeine, methadone, and oxycodone.
  • Opioid overdose occurs when an individual stops breathing due to the effects of the drugs.
  • Naloxone (Narcan) reverses the effects of opioids, allowing an individual experiencing an opioid overdose to breathe normally.
  • Naloxone is a prescription medication, but it is not a controlled substance (not scheduled), not addictive, and has no potential for abuse. It has been used in hospitals and by EMS for decades.
  • Naloxone does not work for overdoses of benzodiazepines, cocaine, methamphetamine, or alcohol.
  • In a mixed overdose (opioids and benzos, heroin and cocaine, etc), naloxone will help reverse the effects of the opioids, but will not have any effect on other substances present.

Naloxone Administration

  • Naloxone's effects begin in 3-5 minutes and last for 30-90 minutes.
  • Rescue breathing must be performed until the naloxone takes effect in order to provide oxygen to the vital organs and prevent brain damage.
  • It is imperative that an individual who has overdosed and was given naloxone be evaluated and monitored in a medical setting (i.e. emergency department) because the overdose can re-occur after the naloxone wears off.

Benefits

  • Increasing naloxone access does not increase drug use.
  • Naloxone training can link people using drugs with essential resources.
  • Training individuals to prevent, recognize and respond to overdoses provides an opportunity to recommend other health or treatment services.
  • Existing law enforcement naloxone programs have resulted in thousands of lives saved.

Storage

  • Naloxone must be stored out of direct light. Effective methods include leaving it in its box or storing in a standard orange medication bottle.
  • Naloxone must be kept at room temperature (59-86°F or 15-30°C). It should never be stored in a refrigerator or a vehicle glove box or trunk.
  • If naloxone is stored improperly, it loses its effectiveness. It does not become harmful if administered.

Side Effects

  • If naloxone is given to someone who is not experiencing an opioid overdose, there are no adverse effects.
  • When naloxone is given to an individual experiencing an opioid overdose, they will begin breathing normally and may also have symptoms of opioid withdrawal. These include pain, nausea, vomiting, sweating, and anxiety.
  • With the dose of naloxone given by law enforcement, individuals very rarely become combative or violent.

Liability

  • With minimal training, non-medical first responders and laypeople can effectively recognize and respond to opioid overdose, including administering naloxone.
  • The Good Samaritan Overdose Prevention Act (RIGL 21-28.8-3) provides civil and criminal immunity to an individual when they administer naloxone to another person “in good faith” and “with reasonable care”.
  • The specific protections for law enforcement are being clarified and will be reflected in departmental policies.

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Toolkit for law enforcement naloxone programs