Naloxone Bulletin 2.14.23

Naloxone Saves Lives

Naloxone can quickly restore normal breathing and save the life of a person who is overdosing on opioids. Naloxone is a safe medication that is widely used by emergency medical personnel and other first responders to prevent opioid overdose deaths. Unfortunately, by the time a person having an overdose is reached, it is often too late.

Friends, family, and other bystanders can save lives with naloxone. Naloxone distribution programs such as the IDHS/SUPR Drug Overdose Prevention Program give naloxone kits to opioid users, their friends and families, and others who may find themselves in a position to save the life of someone at risk of an opioid overdose.

How Does Naloxone Work?

Naloxone is an opioid receptor antagonist meaning it binds to opioid receptors and reverses or blocks the effects of other opioids. Giving naloxone rapidly reverses the effects of opioid drugs, restoring normal respiration. It can be administered by injection or through a nasal spray.

Is Naloxone Safe?

Yes. There is no evidence of significant adverse reactions to naloxone. Administering naloxone in cases of opioid overdose can cause withdrawal symptoms when the person is dependent on opioids; this is uncomfortable without being life threatening. The risk that someone overdosing on opioids will have a serious adverse reaction to naloxone is far less than their risk of dying from overdose. Naloxone works if a person has opioids in their system and has no harmful effect if opioids are absent. Naloxone should be given to any person who shows signs of an opioid overdose or when an overdose is suspected. Pregnant women can be given naloxone in a suspected overdose.

Is there a Preferable Delivery System?

All systems used by first responders deliver the stated dose of naloxone and can be highly effective in reversing an opioid overdose. Naloxone comes in two FDA-approved forms: injectable and prepackaged nasal spray. In 2015, the FDA approved the first naloxone nasal spray, in 2019, the FDA approved the first generic nasal spray, and in 2021 the FDA approved higher dose naloxone nasal sprays.

Good Samaritan Laws for Naloxone

In the state of Illinois, there is legal immunity for friends, family and other bystanders, or "Good Samaritans" seeking medical aid for someone experiencing an opioid overdose (Emergency Medical Services Access Law of 2012).

After Naloxone is Given

Bystanders: Call 911 Immediately

It is important to call emergency responders right away. Naloxone is only active in the body for 30 to 90 minutes and its effects could wear off before those of the opioids, causing the user to stop breathing again. People who are given naloxone should be observed constantly until emergency care arrives.

Repeat Naloxone Dosing if Needed

Overdoses involving highly potent synthetic opioids (e.g., fentanyl) or large quantities of opioids may require multiple doses of naloxone. If respiratory function does not improve, naloxone doses may be repeated every two to three minutes.

Report an Overdose

If you are a friend, family member or outreach worker and have administered the medication naloxone, please consider reporting at Illinois Saves OD - your data is stored anonymously and securely. This allows public health departments and IDHS/SUPR to ensure that naloxone is widespread as it is a crucial strategy in reducing overdose deaths in Illinois.

Clinicians: Screen for Opioid Use Disorder

An overdose reversal is a critical opportunity to identify people with opioid use disorder and engage them in treatment.

Where Can I Get Naloxone?

Naloxone can be purchased in Illinois at pharmacies using the IDPH Illinois Naloxone Standing Order without a prescription. All FDA approved forms and strengths of naloxone, if available, can be purchased at a pharmacy through this standing order. Most insurance programs pay for naloxone, including Medicaid. Naloxone can also be obtained by individuals from an IDHS/SUPR Overdose Education and Naloxone Distribution (OEND) services organization and Community-based organization registered in the Access Narcan project.

Who Should Be Given a Prescription or Dispensed Naloxone?

  • Individuals who use illicit or prescribed opioids
  • Patients who have been discharged from emergency medical care following opioid poisoning or intoxication
  • Those who have had a period of abstinence including individuals recently released from incarceration
  • Any individual who cares for or may be in contact with someone who may have an opioid overdose

References

Recognizing an Overdose

IDHS/SUPR Drug Overdose Prevention Program

IDHS: Illinois Overdose Prevention Programs: Contact Information (state.il.us)

Naloxone Standard Procedures

Adapted from the National Institute on Drug Abuse - Policy Brief: Naloxone for Opioid Overdose