Opioid Overdose Response and Lay Naloxone Administration Training
- Understand lay administration of naloxone, including "Good Samaritan" protection
- Understand signs of opioid overdose
- Identify causes and risk factors for opioid overdose
- Clarify what NOT to do during opioid overdose
- Provide information that may assist in the reversal of an overdose
- Provide certificate of training for lay administrators of naloxone
Overdose is most common when:
- After abstaining from opioids for extended periods of time, like after being in jail, detox or drug-free treatment, you are fully susceptible to the adverse effects of opioid use.
- When drugs are mixed, especially with alcohol or benzos.
- When you use alone.
Recognizing an overdose in someone who has been using opioids
- Unresponsiveness to yelling or stimulation, like rubbing your knuckles on breast bone
- Effectively draws the line between overdosing and being really high but not overdosing
- Slow, shallow, or no breathing
- Turning pale, blue or gray (especially lips and fingernails)
- Choking sounds
What NOT to do During an Overdose
DO NOT put the individual in a bath. They could drown.
DO NOT induce vomiting or give the individual something to eat or drink. They could choke.
DO NOT give over-the-counter drugs or vitamins (eg, No-Doz or niacin). They don’t help.
Step 1 - Rub to wake
Rub your Knuckles on the bony part of the chest (sternum) to try to get them to wake up and breathe.
Step 2 - Call 911
- The address and where to find the person
- A person is not breathing
- When medics come tell them what drugs the person took if you know
- Tell them if you gave Naloxone
Step 3 - If the person stops breathing, give breaths mouth to mouth or use a disposable breathing mask
- Put them on their back
- Pull the chin forward to keep the airway open put one hand on the chin, tilt the head back, and pinch the nose closed
- Make a seal over their mouth with yours and breathe in two breaths. The Chest, not the stomach, should rise
- Give one breath every 5 seconds
Step 4 - Give naloxone (discard any opened naloxone within 6 hours of using) Injectable naloxone: inject into the arm or upper outer top of thigh muscle 1cc at a time always start from a new vial
The best place to inject naloxone is into the upper outer top of the thigh as shown here.
Intranasal naloxone: squirt half the vial into each nostril, pushing the applicator fast to make a fine mist.
Step 5 - Stay with the person and keep them breathing
- Continue giving mouth to mouth breathing if the person is not breathing on their own after that administration of naloxone
- Give second dose of naloxone after 2-5 minutes if they do not wake up and breath more than 10-12 breaths a minute
- Naloxone can spoil their high and they may want to use again, make sure they are aware that overdosing is still possible when naloxone wears off
Step 6 - Place the person on their side
People can breathe in their own vomit and die. If a person is breathing put them on their side to prevent this. Naloxone can induce vomiting, this position will help protect them from inhaling that vomit.
Step 7 - Convince the person to follow the paramedics advice
If paramedics advise to proceed to an emergency room then heath care staff can
- Relive symptoms of withdrawal
- Prevent a second overdose
- Observe and administer naloxone as needed
- Assess threat of the person for other overdoses brought on by drugs other than opioids
Step 8 - What if police show up?
Tennessee Overdose Naloxone Law allows bystanders to administer naloxone if they suspect an overdose.