Naloxone and overdose safety planning in NYC

Naloxone is a medicine that can reverse an opioid overdose. People who use opioids, take OUD medication or may be around someone at risk should discuss access and learn how to respond. You can also obtain over-the-counter naloxone products without waiting for a clinic appointment. The specific product and dispensing pathway determine whether a prescription is needed.

Naloxone blocks opioid effects and can restore breathing during an opioid overdose. Its effects can wear off before those of the opioid, so emergency assessment is still needed. It does not provide ongoing OUD treatment or directly treat stimulant toxicity. It can be useful when fentanyl is mixed with cocaine, methamphetamine or an unknown pill because an opioid overdose may occur without the person expecting opioid exposure.

Discuss naloxone if opioids are used or prescribed, there is a previous overdose, multiple sedating substances are involved, or opioid tolerance may have fallen. Risk can increase after time without use, discharge, a treatment gap or stopping naltrexone. Family, friends and other people who may witness an overdose can also learn the response. The right product and instructions should be reviewed before an emergency.

Discuss naloxone if opioids are used or prescribed, there is a previous overdose, multiple sedating substances are involved, or opioid tolerance may have fallen. Risk can increase after time without use, discharge, a treatment gap or stopping naltrexone. Family, friends and other people who may witness an overdose can also learn the response. The right product and instructions should be reviewed before an emergency.

Ask a pharmacist or clinician about OTC and other local access pathways. Confirm the specific device, expiration and storage instructions. Keep it somewhere that the people likely to help can find it promptly. Do not assume instructions for one nasal spray or injectable product match every product.

A person who cannot be awakened or has slow, shallow or absent breathing may be having an overdose. Other signs can include choking or gurgling sounds and discolored lips or nails. If uncertain but an opioid overdose is possible, respond promptly rather than waiting for proof of what was taken.

Administer available naloxone according to the product instructions and call 911. Tell the dispatcher what is happening and follow instructions for breathing support or CPR. More naloxone may be needed, especially with fentanyl. Repeat according to the product directions and emergency guidance.

Stay with the person until help arrives. Breathing problems can return after apparent improvement because naloxone may wear off. Do not assume that waking up means emergency care is unnecessary. Once immediate safety is addressed, discuss treatment, access barriers and another naloxone supply.

Possible overdose is an emergency. Call 911 and use available naloxone. Do not wait for an appointment, insurance confirmation or a prescription. Naloxone may cause sudden withdrawal in a person dependent on opioids, but saving breathing takes priority. Emergency monitoring is required even after an apparent response. It does not make high-risk opioid or sedative combinations safe.

No. Naloxone reverses an opioid overdose. It does not provide ongoing treatment for opioid use disorder or replace Suboxone, Sublocade or Vivitrol. Those medicines have separate treatment roles and starting requirements. Keep a reversal product available when relevant while following the clinician's ongoing care plan. During a suspected overdose, use it according to its directions and call 911.

Call 911 for suspected overdose, slow breathing, inability to wake, a seizure, severe confusion or immediate danger. Give available naloxone for a suspected opioid overdose and stay with the person while emergency help is called. Emotional distress without immediate medical danger also warrants prompt crisis support and a safety assessment. A routine booking or medication visit should not delay emergency care.

No. OTC naloxone products are available without a prescription. Other products or coverage pathways may involve a prescription or standing-order process. Ask about the specific product and local access.

Naloxone is available as a nasal spray and as injectable products. A ready-to-use nasal spray is an option for a bystander responding to a suspected opioid overdose; medical professionals may use an injection according to the product and setting. There is no one best route for every situation. Use the actual device’s instructions, call 911 and stay with the person. Do not wait for a preferred formulation before using available naloxone.

Call 911 or have someone call while you give naloxone. Lay the person on their back, insert the single-dose spray tip into one nostril as its instructions show, and press the plunger. Do not prime or test the spray first. If normal breathing does not return, or symptoms return, give another dose with a new device every 2–3 minutes, alternating nostrils, until emergency help arrives. Stay with the person and follow the dispatcher’s breathing or CPR instructions. Nasal instructions do not apply to an injectable product.

Naloxone is the active medicine; Narcan is one brand of naloxone nasal spray. Other naloxone products have different brands, strengths or devices. Read the instructions for the product you have rather than assuming every device is used the same way. All require emergency response for a suspected overdose; the naloxone ingredient in Suboxone does not replace a separate rescue product.

Its effect is temporary, often described as about 30–90 minutes, and may wear off before the opioid does. Breathing problems can return even after a person wakes up. Call 911, stay with them and give repeat doses according to the product instructions if needed. That time range is not a safe waiting period, and it cannot replace emergency monitoring.