Naloxone: the opioid overdose reversal drug

Please note: this article is for information purposes. If you would like a naloxone kit please visit your local service, where we can supply one along with training on the prevention and management of opioid overdose. Training can take as little as 10 minutes. Please email naloxone.info@cri.org.uk if you have any questions or queries regarding Naloxone.

Britain continues to have a high number of drug-related deaths with opioid overdose remaining a major cause of death among drug users. In England and Wales in 2013 there were 765 deaths where heroin or morphine were mentioned on the death certificate: this was an average of two every day.

Naloxone is a drug that can temporarily reverse the effects of an opioid overdose. In short, naloxone saves lives.

What is naloxone?

Naloxone is a drug that can reverse the effects of opioids, and prevent death if used within a short period following an opioid overdose. For many years, naloxone has been used within emergency medical settings to reverse the effects of an opioid overdose and prevent death.

The 2015 the EMCDDA systematic review of the effectiveness of take-home naloxone concluded:

“There is evidence from one interrupted time-series study, involving 2 912 opioid users at risk of overdose in 19 communities followed up for seven years, that educational and training interventions complemented by take-home naloxone decrease overdose-related mortality.”

Naloxone is only effective on opioids, such as:

Heroin
Methadone
Morphine
Codeine
Buprenorphine
Opium
Fentanyl
Pethidine

How does naloxone work?

Naloxone is an opioid antagonist – this means it can temporarily remove opioids from the receptors in the body and prevent the opioids from re-attaching to the receptors for a limited period of time.

Naloxone can rapidly reverse a reduced breathing rate (known as respiratory depression) when caused by an overdose of opioids. Naloxone takes 2-5 minutes to have an effect when injected into a muscle. The effects last for about 20 minutes. This means the use of naloxone can buy critical time while waiting for an ambulance to arrive.

Supplying naloxone

Naloxone can be supplied by:

“Persons employed or engaged in the provision of drug treatment services provided by, on behalf of or under arrangements made by one of the following bodies–
(a) an NHS body
(b) a local authority
(c) Public Health England
(d) Public Health Agency

“It can be supplied to anyone in the course of lawful drug treatment services and only where required for the purpose of saving life in an emergency.”

Naloxone can be supplied to anyone at risk of opioid overdose, as well as their friends, family or other representatives.

Before supplying naloxone to anyone, we provide training on how to recognise opioid overdose, overdose management, and the use of naloxone injection.

PLEASE NOTE: Naloxone should never be considered as a safety net to take extra risks.

How to recognise when someone has overdosed

Symptoms can include:

Deep snoring/‘gurgling’ noises
You cannot wake the person, and they are not responsive to shouting or shaking of the shoulders
A blue tinge to lips, nail beds or other extremities
Not breathing

Key steps to remember

These tips apply to people who have a naloxone kit and have previously received full training. Click here to read the Prenoxad Injection patient information leaflet.

Ensure personal safety first
Call 999 and ask for an ambulance
Check that nothing is obstructing their airways
Place the person in the recovery position
Inject naloxone into the thigh or upper arm muscle

Wait with the victim until the ambulance arrives and safely dispose of the naloxone kit to paramedics

If someone has had an opioid overdose, naloxone will buy precious time. The individual still needs to go to hospital. Always dial 999 for an ambulance.

How to get a naloxone kit

Please visit your local CRI service. Find your nearest service here.

How to get a replacement naloxone kit

When you need a replacement kit due to the current dose being used, lost, damaged, or out of date, you should ideally return to the CRI service where you were originally trained and given the naloxone kit. We can then provide you with a new one if required. If the CRI service where you originally received your naloxone kit is now closed, you can visit another CRI service – find your nearest one here. You can also find a full list of drug services (including other providers) on the Talk to Frank website here.

Other resources

U-turn has created an opiate overdose app containing audio and visual advice on recognising an overdose, assessing risks to yourself, emergency first aid and much more.

Download the U-turn opiate overdose app for iOS

Download the U-turn opiate overdose app for Android

_{Please note CRI does not manage the U-turn app and therefore cannot guarantee that it is accurate or up-to-date.}

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