NALOXONE

1. Try to wake them up:

• Shake them gently (if you feel comfortable doing so) and shout their name, or say something like “Hey! Are you okay?”
• You can also rub your knuckles hard on their breastbone (sternum rub) for a few seconds, this is uncomfortable and may get a response if they’re just deeply sedated.

2. Check for breathing and responsiveness:

• If they’re not breathing or gasping immediately Call 911 right away and say someone is not breathing. You don't need to mention drugs or overdose.

3. Administer naloxone (Narcan):

• If you have nasal spray naloxone, tilt their head back and spray it into one nostril.
• If it’s an injectable form, give it into a major muscle like the thigh or upper arm. Clothes do not need to be removed.
• Stay with them and be ready to give a second dose in 2–3 minutes if they don’t respond.

4. Provide rescue breathing if needed:

• If they’re not breathing but have a pulse, give one breath every 5–6 seconds.
• If you’re trained in CPR and they have no pulse, start chest compressions. Remember that (the main priority is getting oxygen into their lungs to prevent brain damage and death.) Chest compressions (CPR) are meant for cardiac arrest, when the heart has stopped beating. In most opioid overdoses:
  • The heart is still beating (even if it is extremely hard to feel, find a pulse) so compressions aren’t needed yet.
  • Doing compressions without rescue breathing doesn’t fix the oxygen problem caused by opioids.
  • Rescue breathing saves lives in opioid overdose. It treats the actual cause which is a lack of oxygen due to slowed/stopped breathing.

5. Stay until help arrives:

Naloxone wears off in 30–90 minutes, and the person can go back into overdose as naloxone does not remove drugs from a person's body.

Try to keep them awake and monitor their breathing.

Why cold showers are dangerous during an overdose:

• It wastes time that you could be giving naloxone and doing rescue breathing.
• It doesn’t reverse an overdose. Opioids affect the brain’s ability to breathe, and cold water won’t change that.
• It increases the risk of injury or shock, especially if the person is unconscious, they can hit their head, choke, or go into shock from the cold.

What to do instead:

1. Try to wake them with a sternum rub (knuckle rub to the chest).
2. Call 911 
3. Give naloxone (Narcan) right away.
4. Start rescue breathing or CPR if needed.
5. Stay with them give them a second dose of naloxone if they don’t wake up in 2–3 minutes.

• It doesn’t help. Overdoses aren’t caused by what’s left in the stomach, they happen because opioids slow or stop breathing by affecting the brain.
• It can make things worse. If the person is unconscious or not fully awake, they can choke on their vomit or inhale it into their lungs (called aspiration), which can be deadly.
• It wastes precious time. The best thing you can do is respond quickly with naloxone and breathing support.

What to do instead:

1. Try to wake them up shout their name, shake them, or perform a sternum rub.
2. Call 911.
3. Give naloxone (Narcan).
4. Check their breathing if they’re not breathing or breathing very slowly, give rescue breaths.
5. Stay with them and be ready to give another dose of naloxone in 2–3 minutes if needed.

1. Nasal Spray (Narcan, generic naloxone spray)

• Most commonly recognized by the general public and some people who are uncomfortable with syringes prefer this version of naloxone.
• Comes as a single-use, pre-filled device.
• Sprayed into one nostril while the person lies on their back.
• No needles, no assembly.
• Works in 2–3 minutes; a second dose can be given if needed.

2. Injectable Naloxone (vials or ampoules)

• Drawn up with a syringe and injected into a muscle (thigh, upper arm, or butt).
• More affordable and often used in harm reduction programs or clinics.
• Requires basic training on measuring and injecting.
• Removal of clothes not needed to administer. 

3. Auto-Injector (EVZIO — discontinued in the U.S. but still sometimes seen)

• A talking auto-injector device that gives verbal instructions.
• Designed for use in emergencies like an EpiPen.
• Rarely used now due to high cost and limited availability.