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Naloxone Rescue for Opioid Overdose


Surgeon General’s Advisory on Naloxone and Opioid Overdose

Naloxone Can Save a Life

FAQs  Pharmacies Distributing Naloxone  Toolkit for Pharmacists

naloxone vials

Naloxone, also called Narcan, can very quickly restore normal breathing for a person whose breathing has slowed down or stopped because of an overdose of prescription opioids or heroin.

Naloxone only works for opioid drugs, including heroin, morphine, oxycodone (e.g. OxyContin, Percocet), oxymorphone (e.g. Opana), methadone, hydrocodone (e.g. Vicodin), codeine and fentanyl.


Oregon law allows lay people to carry and use naloxone on others

You can be prepared to save the life of someone in need. Ask your healthcare provider or a pharmacist about naloxone if you believe you or someone you know may be at risk of an overdose.


Reverse Overdose Oregon campaignReverse Overdose Oregon logo

The Oregon Health Authority has a campaign to help employers reverse opioid overdoses. Reverse Overdose Oregon marks the latest in Oregon’s ongoing efforts to address the opioid epidemic through direct, comprehensive interventions.


Frequently Asked Questions

Read our FAQs to learn about naloxone training, how to get naloxone and more.

If your question is not answered here, please contact Chris.Sorvari@dhsoha.state.or.us

1.      What is naloxone?
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 does naloxone look like?
Naloxone comes in two FDA-approved forms: injectable and prepackaged nasal spray. 
 
3.      What does naloxone 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, naloxone can counter the overdose effects, usually within minutes.

4.      How do I get naloxone?

    1. If you are taking prescription opioids, ask your health care provider or pharmacist for a naloxone prescription. Your health insurance might cover the cost of naloxone.
    2. If you are in treatment for substance use, ask your counselor for help getting naloxone. You might get naloxone at no cost from a local program
    3. If you want to have naloxone on hand for someone else, ask your pharmacist for a prescription, health insurance usually will not cover this.
    4. If you are actively using opioids and involved with a syringe exchange or other harm reduction services, you can get naloxone at no cost.

 
5.      Will insurance cover naloxone?
Many insurance plans will cover naloxone 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 does naloxone cost?
The price of naloxone 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 naloxone?
Naloxone training 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 naloxone to ask about trainings near you.

8.      What are my risks if I use naloxone on someone?
Oregon has a Good Samaritan law that protects individuals from civil prosecution if they give someone naloxone 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 naloxone do I give a person?

      1. People cannot overdose on naloxone, but with more naloxone comes more withdrawal symptoms (from the drug causing the overdose). 
      2. Many opioids last longer than naloxone 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 naloxone than you have on hand.
      4. Because naloxone may not bring someone out of overdose completely, it is very important to call 911 right away and not wait to see if the naloxone 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 naloxone 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 naloxone?
Allergic reactions to 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 naloxone?
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 naloxone?
First, confirm that your naloxone 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 24 months to 36 months. For all other forms of naloxone, follow the manufacture's expiration date. 

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

  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. ​

Prescribers

1.      Why should I prescribe naloxone?
Accidental opioid overdose is preventable, and naloxone saves lives. Co-prescribing naloxone in primary care settings can significantly reduce emergency department visits, and may help patients become more aware of the potential hazards of opioid misuse.
 
2.      Who is able to prescribe naloxone?
Naloxone is not a controlled substance and can be prescribed by anyone with a medical license. Any pharmacist can prescribe it as well.

 
3.      Who should get naloxone?
All patients of any age with factors that increase risk for overdose, such as history of overdose, higher dosages (≥50 MME daily), concurrent benzodiazepine use, or history of substance use disorder.

Anyone otherwise at risk of experiencing or witnessing an opioid overdose (Insurance coverage will vary.)

More information:
CDC Guideline recommendation #8: Use Strategies to Mitigate Risk
Detailed clinician guidance and instructions for co-prescribing naloxone: http://prescribetoprevent.org/
Providers' Clinical Support System for Prescribing Naloxone to Patients for Overdose Reversal 

​1. What do pharmacists need to do to prescribe naloxone to patients?

Pharmacists can prescribe naloxone for anyone requesting it. Visit the Board of Pharmacy for detailed information on prescribing naloxone including naloxone FAQs.

Please consider using materials from the Naloxone Toolkit for Oregon Pharmacists. This toolkit includes posters, fact sheet, and bag stuffers (scroll down to “Resources" section).



1.      What do we have to do to have naloxone on-site for staff to use (but not distribute)?
If your organization has a MD, DO, NP or PA on staff, these clinicians may order naloxone for you to have onsite or to carry on outreach activities.  If you do not have a staff member with prescribing capabilities, a pharmacist may prescribe naloxone to a person or an organization. A map of pharmacies confirmed to distribute naloxone can be found here.

If you do not have an MD, DO, NP, or PA on staff and are located in Multnomah, Clackamas, or Washington County, you may have a staff member attend the Naloxone Train-the-Trainer class sponsored by Multnomah County. Organizations who have a representative attend the training are able to purchase naloxone through the Multnomah County Pharmacy. Contact Kelsi Junge (kelsi.junge@multco.us) for more information
 
Under Oregon law, organizations' staff and volunteers may have naloxone on-site or carry naloxone with them in the event of an opioid overdose.  Any staff or volunteer of a social service agency may administer naloxone, even if this naloxone was not distributed to that person, to reverse an opioid overdose (ORS 689.684).  Additionally, those staff are protected against civil liability as long as there is reasonable cause to believe the person is experiencing an opioid overdose (ORS 689.681).

2.      What training do our staff need to use naloxone?
Naloxone training 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.

 
3.      Do staff need to be certified in CPR to administer naloxone or to train others to administer naloxone?
While CPR training may be beneficial to your staff and organization, it is not required for staff or trainers to be CPR certified.

4.      How can our organization get naloxone?
There are a few ways to get naloxone for your organization.

  1. Check Save Lives Oregon to see whether or organization is eligible to order naloxone and other harm reduction supplies at no cost.
  2. Call local pharmacies and ask if you can purchase naloxone from them.
  3. Call your local health department to see whether there are other naloxone sources in your area.
  4. Conduct an online search for companies that sell naloxone (this would be for bulk purchases). The Oregon Health Authority cannot recommend private companies.

     

5.      Are there any purchasing programs specifically for public safety or law enforcement?
Law enforcement, fire departments, and EMS may qualify for reduced price naloxone.  For more information feel free to reach out to Oregon HIDTA's Public Health Analyst, Erin Porter, erin.porter@dpsst.oregon.gov. Public safety may also be able to purchase naloxone through Save Lives Oregon.  Although there are no additional training requirements for public safety, the Multnomah County Sheriff's Office created a naloxone training video for law enforcement.

 

6.      Is starting a naloxone distribution program right for my organization?

If your agency or organization works with clients at risk for opioid overdose, starting a distribution program might be right for you. A naloxone distribution program includes distributing take-home naloxone kits to clients.  To distribute naloxone, an organization much first legally obtain naloxone (OAR 855-019-0460), which can be done by working with a prescriber within your organization, a local pharmacy, or contacting your local public health agency to see if they offer resources.

 

Here are some questions to consider when starting a program:

  1. Have you identified a legal pathway to obtaining naloxone?
  2. What data will you collect from participants (i.e., demographics, substance use history, overdose experiences)?
  3. Will you offer training to your clients and staff on how to recognize and reverse an opioid overdose?
  4. How (and when) will you have your naloxone supplies available?
  5. Do you know how to order supplies for naloxone kits?
  6. Where will you store the naloxone kits? ​

 Download all FAQs for printing (pdf) - updated September 1, 2021

 Naloxone Training Protocol

 Opioid Overdose Toolkit from SAMHSA

Call 911 for drug overdose

It's very important that you call 911 any time someone has a drug overdose.

If you use naloxone, the effects are temporary and the person still needs medical attention. After the medication wears off, the person could fall back into a coma.

If you call police or 911 to get help for someone having a drug overdose, Oregon law protects you from being arrested or prosecuted for drug-related charges or parole/probation violations based on information provided to emergency responders.

 Read the Good Samaritan Law (pdf)


Oregon Pharmacies Distributing Naloxone

 View Listing of Oregon Pharmacies that Distribute Naloxone (pdf)

If you would like to add a pharmacy to the list and map, please contact lisa.m.shields@state.or.us.


Toolkit for Pharmaciststoolkit

Posters, bag stuffers and information sheets for pharmacists can be downloaded and printed from the list of resources below. (Click the plus sign to view the list).

Oregon Pharmacists can now prescribe naloxone and the necessary supplies for administration to a person or organization who has completed an approved training. House Bill 4124 was signed into law in 2016 with the intent of increas​ing access to the life-saving opiate overdose reversal drug through pharmacists and certain organizations.

Posters, bag stuffers and information sheets for pharmacists can be downloaded and printed below. All files are in PDF format.

Training

Information Sheet

Posters - 11x17"

English:

Spanish:

Bag Stuffers - 3 per sheet, 8.5x11"

 
​​

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