Naloxone and Opioid Overdose Response: A Guide for Healthcare Staff
Naloxone can reverse an opioid overdose. Learn how it works, the signs to look for, the response steps and what healthcare staff should know.
Naloxone is a medicine that can reverse an opioid overdose, and recognising an overdose quickly can save a life. Healthcare staff in hospitals, clinics, care homes and community services may be the first people to find someone who has overdosed, whether the person is a patient, a visitor or a member of the public. This guide explains how naloxone works, the warning signs, the response steps recommended by US public health agencies and what to check for in your own workplace. It is general education and does not replace your employer’s clinical protocols or hands-on life support training.
What is naloxone?
The Centers for Disease Control and Prevention (CDC) describes naloxone as a life-saving medication that can reverse an overdose from opioids, including heroin, fentanyl and prescription opioid medications. It comes as a prefilled nasal spray and as an injectable form that is given into the muscle or under the skin. Both can be used without medical training. In 2023 the US Food and Drug Administration approved a nasal spray naloxone product for over-the-counter sale, which has made it easier for organisations and individuals to keep supplies on hand.
How does it work?
Naloxone is an opioid antagonist. It blocks opioids from acting on the receptors that slow breathing. Public health sources report that it can restore normal breathing within two to three minutes. Its effect is temporary, and more than one dose is often needed, so the person must be watched closely and must receive medical care even if they wake up.
Signs of an opioid overdose
The CDC lists these warning signs:
- Small, constricted pupils.
- Loss of consciousness or being unable to wake the person.
- Slow, weak or absent breathing.
- Gurgling or choking sounds.
- A limp body.
- Cold, clammy skin.
- Discoloured lips and fingernails.
What to do
- Call 911 immediately, or follow your facility’s emergency response procedure.
- Give naloxone if it is available, using the device instructions.
- Keep the person awake and breathing. If they are not breathing normally, follow your life support training.
- Place them on their side if they are not responsive but breathing.
- Stay with them until emergency responders arrive. The CDC advises supervision for at least four hours or until emergency services arrive, because an overdose can return as naloxone wears off.
If the person does not respond, further doses may be needed, according to the instructions for the product you use and your protocol. Document what you did and when.
Is it safe to use if you are not sure?
The CDC states that naloxone will not harm someone who is overdosing on drugs other than opioids, which makes it appropriate to use when you are uncertain. That matters in practice, because people increasingly use more than one substance.
Legal protection
The CDC notes that Good Samaritan laws exist in most states to protect people who are overdosing, and anyone who helps them in an emergency, from arrest or charges, or both. The detail varies by state, and healthcare employees also have their own professional duties, so check your state law and your employer policy.
What should healthcare organisations do?
- Decide where naloxone is stored and make sure staff can find it quickly.
- Include overdose response in induction and refresher training.
- Check expiry dates and replace used stock.
- Record overdoses and responses in line with policy.
- Link with substance use services and recovery support so that the person is not left without follow-up care.
Records about substance use treatment may be subject to extra confidentiality rules. Our guide to 42 CFR Part 2 and substance use records explains how to handle them. For wider practice, see our guides to substance misuse awareness for care staff and dual diagnosis.
Frequently asked questions
Can anyone give naloxone?
Both nasal and injectable forms can be used without medical training, according to the CDC. Your employer may have additional rules for staff.
Do I still call 911 after giving naloxone?
Yes. The effect is temporary and the person needs medical evaluation.
What if it is not an opioid overdose?
Naloxone will not harm a person overdosing on non-opioid drugs.
Why practice and drills matter
Overdoses are stressful, and people freeze. Short drills help staff recall where the naloxone is stored, how to open and use the device and who calls for help. Pair practice with a simple checklist at the point of storage. Share what you learn from real events at team meetings, in a way that does not blame individuals.
Reducing stigma and supporting recovery
People who have overdosed deserve the same respect as any other patient. Use non-judgemental language, offer information about treatment and recovery services, and make sure follow-up care is arranged. Naloxone reverses the immediate emergency, but it does not treat the underlying substance use disorder, so linking the person to ongoing support is part of good care.
Key takeaways
- Naloxone reverses opioid overdose and works in minutes, but the effect is temporary.
- Always call for emergency help and stay with the person.
- Check your state law, your employer policy and your life support training.
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Learnsignal Healthcare Education Team
The Learnsignal Healthcare Education Team creates CPD and compliance training content for nurses, allied health professionals, and care providers, drawing on current regulatory guidance from bodies including NMBI and equivalent professional regulators.
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