Naloxone has been used in Canada for over 40 years and is on the World Health Organization’s list of Essential Medicines. Naloxone has no intended effect on someone that has not taken opioids. Naloxone cannot get a person high and does not have an effect on opioid cravings.
Naloxone has no effect on someone who has no opioids in their system. It will not help anyone who is not experiencing an overdose, but it will not hurt them either.
Remember that the goal of providing naloxone is to help the individual who has overdosed breathe until the first response team arrives and medical professionals can take over.
Get a new kit! Simply go to the place where you got the first one and get one that is new. If you bring in the old kit, that’s great because the program can use it as a demonstrator. If you forget, it is not a big deal.
Visit this website to find out where you can find naloxone kits in British Columbia: https://www2.gov.bc.ca/gov/content/overdose/where-can-i-get-a-naloxone-kit
If it is the only thing you have, use it. Like most other medications, naloxone will start to lose its effectiveness after its expiration date. However, it may be strong enough to reverse an overdose if that is the only kit that is available. It can’t hurt, so use it and continue to perform rescue breathing. See the overdose module for more information.
If naloxone is not properly stored, it may become weaker, but this is a slow process. It should still work and there is no harm in using it if it is the only naloxone around.
Naloxone is effective for about 20 – 90 minutes in the body. So, if you give someone naloxone to reverse an opioid overdose, the naloxone may wear off before the opioids wear off and so the person could go into a state of overdose again. This is why it is important to have a second naloxone dose ready if this happens.
Someone who has become conscious after an overdose may crave opioids again right away, if they feel withdrawal symptoms. It is very important that they do not use again for at least a couple of hours. Ideally, people should receive medical attention, which is why 9-1-1 should always be dialed for an overdose.
Naloxone may cause withdrawal symptoms in people with opioid dependence. This includes but is not limited to the following symptoms:
- nausea, vomiting, diarrhea, stomach pain;
- fever, sweating, body aches, weakness;
- tremors or shivering, fast heart rate, pounding heartbeats, increased blood pressure;
- feeling nervous, restless, or irritable;
- goosebumps, shivering;
- runny nose, yawning.
A typical injection of naloxone is 0.4 mg/mL. A second dose of 0.4 mg/mL is sometimes needed if the first dose does not reverse the overdose and restore breathing.
Each naloxone nasal spray device holds 4 mg of naloxone. The standard dosage of the nasal spray is one spray into one nostril. Repeated doses can be given every 2 to 3 minutes, if needed.
The signs and symptoms of an opioid overdose can continue even after giving someone naloxone. If this happens, give another dose 2 to 3 minutes after the first dose and monitor the person closely until the response team has arrived.
If someone is unconscious because they have overdosed, naloxone is safe to give to this person, but it may not have any effect. If you are unsure of the cause of their unconsciousness, look for signs of an overdose. Giving someone naloxone even if they have not overdosed from opioids is not likely to cause further harm to the person.
Naloxone itself does not make someone behave violently, but naloxone may cause people to experience painful withdrawal symptoms and/or be confused when coming back from an overdose. If someone is angry that you have given them naloxone, tell them that they will likely feel better soon and that the naloxone will begin to fade after about 30 minutes. Even if they are angry in the moment, some may thank you later for saving their life. Know that you are doing the right thing by attempting to save their life.
It is not possible to give someone too much naloxone. Most of the time, the two doses in a naloxone kit will be enough to help someone, if they are experiencing an opioid overdose. If a person is dependent on opioids, the more naloxone they get, the more uncomfortable they will be when they come back from an overdose. Vomiting is a common withdrawal symptom. If you are giving someone naloxone, it is important to make sure they don’t inhale the vomit – this may cause them to choke. If a person is experiencing withdrawal, try to calm them down by letting them know that the withdrawal symptoms or dope sickness will fade.
No, people will not develop immunity to naloxone. It can be used just as effectively as the 1st overdose on subsequent overdoses.
Naloxone will not work on an alcohol overdose (or alcohol poisoning), only on an opioid overdose. If it is an alcohol overdose that also involves opioids, it might help.
Naloxone will not work on a cocaine overdose, only on an opioid overdose. If it is a cocaine overdose that also involves opioids, it might help by dealing with the opioid part of the overdose. Similar to opioid overdoses, 9-1-1 should be called immediately.
No. Naloxone knocks opioids off the receptors in the brain, but the opioids will still be floating around in the body and therefore, in the urine.
To protect yourself from overdosing, you may consider “yo-yoing”. This means injecting yourself with naloxone immediately after using an opioid OR mixing it in with your supply. “Yo-Yoing” is not an excuse to use alone and is not a replacement for resources like safe injection sites. Although naloxone can reverse the effects of an overdose, this is only temporary and you could overdose again after it wears off. In the case of an overdose, you should always follow-up with medical professionals.
Naloxone blocks opioids from having an effect, meaning one of its side effects includes withdrawal symptoms. After being given naloxone, you may feel dope sick and want to use again right away. However, additional opioids will be unlikely to reduce withdrawal symptoms because the naloxone has still blocked your opioid receptors. Instead, after the naloxone wears off (30-90 minutes), you may be at greater risk of a second overdose. It is very important not to use again, and to wait for a few hours. This can help you safely judge your tolerance and manage your overdose risk.