FAQ

‘Naloxone’ is the generic term and denotes any naloxone hydrochloride opioid antagonist product. While currently used as a brand name for Adapt Pharma’s intranasal naloxone device, for many years the term ‘Narcan’ was used in a generic sense and is often understood as such.

Several companies now manufacture naloxone or naloxone administration devices in the U.S. Formulations range from 0.4mg/ml for naloxone intended for intramuscular injection, to 2mg or 4mg for nasal spray devices. While newer products have been designed for use by consumers and thus may be somewhat easier to use with limited training, no independent studies have shown any type of naloxone to be clearly better than another.

There are no independent studies that suggest one type of naloxone is clearly better than another. All naloxone is similarly effective, and programs often provide more than one naloxone product. You should talk to people who your program will target in order to better understand their needs and comfort with different naloxone products. You should also consider the cost to your program of different products, including whether grant funding or charitable donations by naloxone manufacturers are available.

You can use the Overdose Prevention Program Locator tool on the Prevent & Protect resources page to find nearby programs by entering the name of your city and state.

Anyone who dispenses naloxone – whether they be a nurse, pharmacist, or outreach worker – should have training on opioid overdose prevention and management in order to ensure that accurate, consistent information is passed on to consumers. Training of trainers should encompass the causes and physiology of opioid overdose, overdose prevention strategies, and first aid including airway management, use of available naloxone formulations, and aftercare. Other topics should be included whenever appropriate in a given setting (e.g. where fentanyl overdose is common). Training curricula for providers is available from several sources. We recommend Harm Reduction Coalition’s collection of tools and best practices.

Ideally training should accompany naloxone dispensing, but the first priority should be to equip people with naloxone if they are likely to witness an overdose. You should strive for a balance between providing thorough information and making the opportunity to acquire naloxone as simple as possible. High quality training can be delivered in even 5 to 15 minutes. In cases where people are rushed and cannot participate in training, the right choice is always to provide naloxone, supplemented with written materials and an offer to talk more when time permits. Especially with newer, purpose-built naloxone devices, studies have shown that people often require minimal or no training to correctly administer naloxone. Naloxone education tips and other program resources may be found in the Harm Reduction Coalition’s Guide to Developing and Managing Overdose Prevention and Take-Home Naloxone Programs.

People who use illicit opioids are most likely to be at the scene of an overdose of their peers, and should be the main targets of overdose prevention and naloxone distribution programs. This focus is supported by scientific studies, which have shown that providing people who use drugs with naloxone reduces population level overdose deaths. And a national survey of community naloxone programs found that 83% of reported overdose reversals were done by people who use drugs rescuing their peers. Other individuals who may witness overdose, especially family members and professional first responders, should also be equipped with naloxone whenever possible.

Visit our community resources page to find naloxone program guidance, posters video, and other materials that are free to use. You may also wish to visit our affiliated site Prescribe to Prevent, which provides resources for healthcare professionals interested in prescribing and dispensing naloxone.

It depends on your audience. Overdose is the most accurate and widely understood description of what we are trying to prevent. However, because the concept of overdose may be stigmatized in relation to substance use disorders, some individuals (e.g. those on high dose short-term opioid pain medication or people using opioids for long-term pain management) may be better served by a framework that presents a medication safety approach foremost.

Because they often result in periods of abstinence during which people’s opioid tolerance diminishes, periods of incarceration or drug treatment without the use of opioid agonist medication are strongly associated with overdose risk. Overdose prevention programs have been developed that reach individuals at risk before they leave an institution, and which in some cases dispense naloxone at the time of discharge. You may also build referral linkages so that institutions connect people directly with community overdose prevention programs. For those involved in the criminal justice system, in some areas community supervision (e.g. parole) staff have also been important allies in helping people access overdose prevention services.

Partner with a local naloxone access program, many of which are happy to educate concerned people and dispense naloxone on request. You can use the Overdose Prevention Program Locator tool to find nearby programs, or inquire with your local health department or harm reduction / syringe exchange program.

Because of unstable housing, homelessness, or other circumstances, some people who use drugs do not have a safe, secure place of their own to use. They may see organizations that serve them as a better alternative than using in a public park or restaurant bathroom. Many organizations have consequently taken steps to protect both staff and clients. At minimum, any organization that routinely serves people at risk of overdose should have a protocol for on-site overdose management, provide basic training to staff, and equip staff with naloxone directly or with shared kits at a site. The same approach can be taken with any location where people may be at risk of overdose (e.g. fast food restaurants, libraries). For more information on this subject and sample policies and procedures forms, visit the Safety Policies page.

Start by talking to pharmacists and other pharmacy staff about the importance of naloxone access in your area and the role that pharmacies may play. Several national pharmacy chains have established naloxone access programs in some states, which local branches may be able to tap in to. For independent pharmacies, it may be helpful to offer extra training and to connect them to peers elsewhere in your state. In all case, be sure to follow up over time to make sure naloxone is being stocked and that pharmacy staff feel informed and invested.

Some national pharmacy chains have already established naloxone standing orders in particular geographic areas. Start by determining whether your local pharmacy can take advantage of this by checking the Prescription Drug Abuse Policy System for state naloxone laws. In states where naloxone standing order prescribing is supported by law, generally any corporate pharmacy medical director, or outside individuals able to oversee pharmacy-based programs (e.g. through a government health department), may establish a standing order in accordance with local laws and regulations.

Develop good working relationships with pharmacies in order to both troubleshoot issues as they occur and to get feedback (e.g. number of naloxone kits being dispensed or subjective thoughts of staff about how the project is going). Many people have also employed a ‘secret shopper’ approach, whereby individuals seek to obtain naloxone and then briefly document the experience in terms of availability, price, ease of access, and pharmacy staff behavior.

Yes! The website Prescribe to Prevent has content that is directed at providers.

No! This site was created using government funding as part of a public health outreach program. We do not receive funds from any manufacturer of any component of naloxone rescue kits, nor do we endorse specific products. Manufacturers are mentioned only to facilitate access. For a full list of contributors and their disclosures, see here.

The site is run by MDs, PhDs, public health professionals, and overdose prevention advocates, including people who use drugs.

Check out some FAQs from patients and community members here.

Check out some FAQs from prescribers and pharmacists at our sister site, Prescribe to Prevent.