Opioid Overdose Reversal Medications

1.      What are opioid overdose reversal medications (OORM)?
OORM, or naloxone, is an easy-to-use, life-saving drug that can reverse the effects of an opioid overdose when administered in time. It's also known as Narcan.™

2.      What do OORM look like?
OORM, or naloxone, comes in two FDA-approved forms: injectable and prepackaged nasal spray. 
 
3.      What do OORM do?
Opioids (such as heroin, fentanyl, and some types of painkillers) can slow your breathing. If you take too much, your breathing could stop, and you could die. If given soon enough, OORM can counter the overdose effects, usually within minutes.

4.      How do I get opioid overdose reversal medications (OORM)?

1. If you are taking prescription opioids, ask your health care provider or pharmacist for an OORM prescription. Your health insurance might cover the cost of OORM. You might be able to find coupons for OORM online. 
2. If you want to have OORM on hand for someone else, ask your pharmacist for a prescription, health insurance usually will not cover this. 
3. Over the Counter NARCAN® nasal spray 4mg. Find a retailer near you by visiting https://narcan.com/buy.​
   
4. If you are in treatment for substance use, ask your counselor for help getting OORM. You might get OORM at no cost from a local program. 
   
5. If you are actively using opioids and involved with a syringe exchange or other harm reduction services​, you can get OORM at no cost.
   
6. For other low or no-cost OORM, click here. 
   

5.      Will insurance cover naloxone?
Many insurance plans will cover OORM prescriptions written by health care providers or pharmacists for use on the person with health insurance. Check with your insurance provider for coverage information.

 
6.      How much do OORM cost?
The price of OORM varies and might change over time. Call your pharmacy to get a current price. You might be able to find coupons for naloxone online.
 
7.      What training do I need to use OORM?
Training on the use of OORM is not required in Oregon; however, it is strongly recommended that you use the following online training tools to ensure the safe and effective use of naloxone.

1. Watch the OHA online training videos or read the OHA training protocol
2. Contact your local syringe exchange programs, social service agencies, and public health departments that distribute OORM to ask about trainings near you.
   

8.      What are my risks if I use OORM on someone?
Oregon has a Good Samaritan law that protects individuals from civil prosecution if they give someone OORM in a good faith effort to reverse opioid overdose. It is important to learn how to use naloxone safely through the online training resources described above.
 
9.      How many doses of OORM do I give a person?

1. People cannot overdose on OORM, but with more OORM come more withdrawal symptoms (from the drug causing the overdose). 
2. Many opioids last longer than OORM so a person can go back into an overdose after receiving naloxone.
3. If someone has used fentanyl or there is fentanyl in the drugs, they may need more OORM than you have on hand.
4. Because OORM may not bring someone out of overdose completely, it is very important to call 911 right away and not wait to see if the medication works.  
5. Review the OHA training protocol for the steps you should take when someone is overdosing such as rescue breathing and chest compressions.   

 
10.  Can OORM be given to someone younger than 18?
Always follow the dosage instructions labeled on medications. The Oregon Board of Pharmacy Laws and Rules do not specify permitted or prohibited age groups or list age exclusions for naloxone distribution or prescribing.  More information on Oregon laws/rules:

ORS 689.681 Opiate overdose; treatments; administration of naloxone; rules

ORS 689.682 Prescription of naloxone

ORS 689.684 Administration of naloxone by certain persons; rules

OAR 855-019-0460 Naloxone - Delivery of Care and Prescribing

 
11.  Can people have an allergic reaction to OORM?
Allergic reactions to OORM, or naloxone, are very rare. Call 911 if someone experiences an allergic reaction to naloxone, such as hives or swelling in the face, lips, or throat. They should not drive or perform other potentially unsafe tasks.
 
12.  How do I store OORM?
Follow the manufacturer's instructions for storing naloxone.  If instructions are not available, the Centers for Disease Control & Prevention (CDC) recommends keeping naloxone in the original box or storage container, protected from light, and stored at room temperature (59-77°F or 15-25°C) until ready for use. 

13.  How do I dispose of expired OORM?
First, confirm that your OORM is truly expired. If you have Adapt Narcan™ (naloxone hydrochloride) nasal spray, the US Food and Drug Administration has approved an extension of its shelf life from 36 months to 48 months. For all other forms of OORM, follow the manufacture's expiration date.  ​

There are a couple of options for what to do with expired OORM:

1. You can keep your expired kits and use them for training purposes. If you use your expired kits for training, please make sure to mark the kits clearly as “expired and not for use." 
   
2.  ​You can discard your expired kits safely at any medication disposal location.  Go to Take Meds Seriously Oregon to find disposal locations near you.  You can also call your local pharmacies and public health department for information on local disposal options.
   
3. You can donate your expired kits to a local harm reduction or syringe service program. To find a program in your area, click here​.