How to Give Naloxone, Step by Step

How do you give someone naloxone?

Giving naloxone follows the same short sequence whether you have a nasal spray or an injection. Try to wake the person and call 911. If they do not respond and their breathing is slow, shallow, or stopped, give the naloxone. Then help them breathe, stay with them, and give a second device if there is no response after a few minutes. Naloxone is an opioid antagonist that rapidly reverses an opioid overdose, and 911 should always be called even after it works 1Ref 1National Institute on Drug Abuse (2024).Naloxone DrugFacts.Naloxone is an opioid antagonist that rapidly reverses an opioid overdose; its effect lasts only about 30 to 90 minutes so the overdose can recur; 911 should always be called..

The whole sequence is: check response, call 911, give naloxone, support breathing, stay, and re-dose if needed.

Naloxone only reverses opioids. It cannot hurt someone who does not have opioids in their system, so when breathing is dangerously slow and the cause is unclear, it is still reasonable to give it. This page describes the public-health administration steps and deliberately states no milligram amount — each product is packaged as a single ready device, and the number to remember is written on the box that person was given, not here.

How to recognize an opioid overdose

An opioid overdose is a breathing emergency. The clearest signs are that the person will not wake up to shouting or a firm shoulder shake, and their breathing is very slow, shallow, gurgling, or has stopped. Lips and fingertips can turn blue or gray, the skin can look pale and clammy, and the pupils may be tiny. The body may go limp.

This is different from someone who is very sedated but still rousable and still breathing normally — knowing overdose from nodding out is the judgment call bystanders worry about most. The safe rule is that if you cannot wake the person and their breathing is not normal, treat it as an overdose and act. Illicitly manufactured fentanyl is now a leading driver of overdose deaths and is often mixed into or sold as other drugs, so an overdose can happen to someone who did not knowingly take an opioid at all 2Ref 2Centers for Disease Control and Prevention (2024).Fentanyl — Overdose Prevention.Illicitly manufactured fentanyl is a leading driver of U.S. overdose deaths and is often mixed into or sold as other drugs, so an overdose can occur in someone who did not knowingly take an opioid and more than one dose may be needed.. When in doubt, calling 911 and giving naloxone is the response that does no harm.

Giving naloxone nasal spray, step by step

The nasal spray is the form most bystanders carry, and it is built to be given by someone with no medical training. Lay the person on their back. Peel open the package and hold the device with your thumb on the plunger and your first two fingers on either side of the nozzle. Insert the tip into one nostril until your fingers touch the bottom of the nose, then press the plunger firmly all the way in. Each device delivers its full contents in a single press — there is nothing to measure.

After giving it, roll the person onto their side into the recovery position so they cannot choke if they vomit, and call 911 if you have not already. FDA-approved overdose-reversal medications are designed for exactly this kind of rapid bystander use 3Ref 3National Institute on Drug Abuse (2024).Overdose Reversal Medications.FDA-approved overdose-reversal medications (including nasal spray and injectable forms) exist and are designed for rapid use, following the instructions on the specific product.. If there is no response after a few minutes and you have a second device, give it into the other nostril. Do not wait to see a full recovery before calling for help — emergency responders should always be on the way.

Giving injectable naloxone

Some naloxone comes as an injection rather than a spray, and the technique is what matters, not a measured amount. The injectable form is given into a muscle — the outer thigh works well and can be given through clothing in an emergency. Draw up the contents of the single vial or use the prefilled device as it comes, insert the needle straight into the muscle, and push. As with the nasal spray, each unit is packaged as one ready dose, so there is no calculation to do under pressure.

After the injection, place the person in the recovery position, support their breathing, and make sure 911 has been called. FDA-approved reversal medications include more than one product and form, and the steps printed on the specific kit a person was given are the ones to follow 3Ref 3National Institute on Drug Abuse (2024).Overdose Reversal Medications.FDA-approved overdose-reversal medications (including nasal spray and injectable forms) exist and are designed for rapid use, following the instructions on the specific product.. If breathing has not improved after a few minutes and another unit is available, it can be given again while you wait for responders.

Why you stay, breathe for them, and may need a second dose

The most dangerous mistake is walking away after naloxone appears to work. Naloxone's effect lasts only about 30 to 90 minutes, which is often shorter than the opioid it is reversing — so the overdose can return once the naloxone wears off, and the person can stop breathing again 1Ref 1National Institute on Drug Abuse (2024).Naloxone DrugFacts.Naloxone is an opioid antagonist that rapidly reverses an opioid overdose; its effect lasts only about 30 to 90 minutes so the overdose can recur; 911 should always be called.. That is why 911 should always be called and why someone should stay with the person the entire time.

Between doses, the single most life-saving thing a bystander does is help the person breathe. If breathing is absent or barely there, rescue breaths — tilting the head back, pinching the nose, and giving slow breaths into the mouth — keep oxygen moving to the brain until the naloxone or the paramedics take over. Because so much of the current drug supply contains potent illicitly manufactured fentanyl, more than one dose is sometimes needed before breathing returns 2Ref 2Centers for Disease Control and Prevention (2024).Fentanyl — Overdose Prevention.Illicitly manufactured fentanyl is a leading driver of U.S. overdose deaths and is often mixed into or sold as other drugs, so an overdose can occur in someone who did not knowingly take an opioid and more than one dose may be needed.. Giving a second device when the first does not work is expected, not a sign you did something wrong.

After it is over: recovery, and getting naloxone in advance

Once breathing returns, keep the person on their side, stay with them, and let the paramedics evaluate them even if they feel fine — because the overdose can recur as the naloxone fades. Naloxone can also bring on sudden, uncomfortable withdrawal, so a person may wake up agitated or sick; staying calm and keeping them from using again right away is part of keeping them safe.

The best time to get naloxone is before you ever need it, and getting naloxone is easier than many people expect — it is available without a prescription in pharmacies across the country, and many community programs give it away free. Surviving an overdose is also a moment when treatment can change what happens next: medications for opioid use disorder are the evidence-based standard of care and are not simply trading one addiction for another 4Ref 4National Institute on Drug Abuse (2024).Medications for Opioid Use Disorder.Medications for opioid use disorder are an evidence-based standard of care and are not simply substituting one addiction for another.. To find treatment and support without going through a commercial helpline, the federal government maintains neutral locators for programs and prescribers 5Ref 5Substance Abuse and Mental Health Services Administration (2024).Treatment Locators: Mental Health, Drug, Alcohol Issues.SAMHSA maintains official, neutral government locators for treatment programs and prescribers, an alternative to commercial helplines.. One overdose reversed is a life saved; connecting to care is how it stays saved.