What is naloxone?
:format(webp))
The bottom line
Naloxone is used to temporarily reverse the effects of opioid overdose. It is a safe and effective way of preventing respiratory failure and death from opioid poisoning. Naloxone can be given by bystanders as a nasal spray to people with suspected opioid poisoning.
Prevention Tips
If you think there might be a need for naloxone for yourself, a friend, a co-worker or a family member, purchase at least 2 packages of naloxone.
Read the instructions for naloxone use before the need arises. Ask your pharmacist if you have questions.
Check naloxone product expiration dates and replace them when they expire. Immediately replace any naloxone you use.
Check the Good Samaritan laws in your state.
This Really Happened
A 22-month-old girl swallowed an unknown amount of her mother’s liquid methadone (a long-acting opioid). The girl became increasingly sleepy, and the mother put her into the shower to try and keep her awake. The mother then gave the girl 1 dose of her naloxone nasal spray, and the girl improved. The mother then called her poison center and was advised to take the girl by ambulance to an emergency room. In the ER, the girl was alert, and her physical exam was normal. About 4 hours after the home naloxone dose, the girl became sleepy, had pinpoint pupils, and developed respiratory depression. She was given 2 IV doses of naloxone and then started on a continuous IV naloxone infusion. The infusion rate was slowly decreased over 36 hours. The child was discharged about 48 hours after the ingestion (from Lebin et al., 2019).
Poisoned? Get expert help.
Don't guess what you should do. Get accurate answers online or by phone. Both ways are free and confidential.
OR
call 1-800-222-1222
Support Us
Your donation to our 501(c)(3) organization enables us to help those who prefer to go online when faced with a poison emergency. Our webPOISONCONTROL online tool and app is a free, confidential, quick and easy way to get expert help. It has guided more than a million users faced with a poison emergency.
Subscribe to The Poison Post®
The Poison Post® is a free, quarterly
e-newsletter delivering poison prevention tips right to your inbox!
What is naloxone?
Overdoses with opioids (strong pain medications) are a major public health problem. Naloxone is a drug used to temporarily reverse the effects of opioid overdose. Naloxone is often given by injection in healthcare facilities, but nasal spray products are used elsewhere. Common opioids include:
Codeine
Fentanyl
Heroin
Hydrocodone (Vicodin)
Hydromorphone (Dilaudid)
Methadone
Morphine
Oxycodone (OxyContin)
How does naloxone work in the body?
In order to exert their effects, opioid molecules attach to areas on the surface of cells called opioid receptors. Different opioid molecules have different strengths of attachment (binding affinity) to these receptors. Naloxone’s binding affinity is greater than that of the opioids, so it will displace opioid molecules from the receptors and reverse their effects. Importantly, while naloxone is attached to the opioid receptors, it doesn’t act like an opioid, and it blocks opioid molecules from binding to the receptors.
Signs and symptoms of an opioid overdose
Commonly encountered signs and symptoms of an opioid overdose include:
Unconscious or unresponsive
Slowed or stopped breathing and heartbeat
Pinpoint pupils
Blue- or gray-tinged skin or fingernail beds
Cold or clammy skin
Snoring or gurgling sounds coming from the mouth
Vomiting
How to give naloxone
Naloxone comes as a single-use, non-prescription (OTC) nasal spray; the drug is rapidly absorbed through nasal tissues. If the victim is not breathing, start CPR then:
Call 911.
Open the package.
Place the nozzle into a nostril.
Push the plunger firmly.
If there is no response or only a partial response within 2–3 minutes, give a second dose of naloxone in the other nostril.
The effects of naloxone are temporary. Some opioids last longer than the effects of naloxone and, without proper treatment, the signs and symptoms of overdose can return. Any use of naloxone represents a medical emergency, and the victim needs to be evaluated in a healthcare facility regardless of how they respond to naloxone.
Most states have “Good Samaritan” laws that provide protection from negligence claims for people providing emergency care. Someone giving naloxone to a person who needs it is an example of acting as a Good Samaritan.
Where can I get naloxone?
Naloxone is now an OTC drug and so is available from a wide variety of sources, including online vendors. The best place to purchase naloxone is your pharmacy, where the pharmacist has received training in naloxone use and can answer your questions. Since second doses are needed by some victims, buying naloxone nasal spray in pairs is a good idea.
Who should carry naloxone?
The most obvious people who should carry naloxone are opioid abusers and their friends and family, who are likely to be nearby if an overdose occurs. Less obvious but equally important are patients who are receiving high-dose opioids for treatment of severe pain along with their families. Many health professionals who specialize in pain management insist that their patients have naloxone nearby as a condition of their treatment. Anyone can carry naloxone to be prepared to save a life
Is naloxone safe to use if opioids are not present?
Naloxone is specifically designed to reverse opioid overdose and is very safe to use if opioids are not present. Opioid overdose shares some symptoms with other types of overdoses (such as alcohol, benzodiazepines, cocaine, and PCP) and many medical conditions (such as low blood sugar, low body temperature, and inadequate oxygen in the blood). Giving naloxone to unconscious patients with opioid overdose-like symptoms is a common step in their diagnosis because naloxone will either reverse an unknown opioid or have no effects.
What are the side effects of naloxone?
The only significant side effect of naloxone is the sudden onset of withdrawal when it is given to opioid-dependent patients. Common withdrawal symptoms include anxiety, aggression, nausea and vomiting, diarrhea, abdominal pain, sweating, and a runny nose.
Does naloxone have any other uses?
Naloxone is a component of some opioid abuse treatments that are given by mouth, like buprenorphine/naloxone (Suboxone). Buprenorphine acts at opioid receptors and is used to help people reduce their dependence on opioids. Because naloxone is not well absorbed by the gastrointestinal system, it does not counteract or reverse the effects of buprenorphine after oral administration.
However, the presence of naloxone discourages buprenorphine users from dissolving the medication and injecting it into their veins, as the naloxone would immediately counteract the effects of the injected opioid.
Have more questions about opioid overdose or naloxone?
If you have questions about opioid overdose or naloxone, use the webPOISONCONTROL® online tool to get help, or call your poison center at 1-800-222-1222. Whether online or by phone, expert guidance is always free, confidential, and available 24 hours a day.
:format(webp))
:format(webp))
:format(webp))
:format(webp))
:format(webp))
:format(webp))