Naloxone and Overdose: How to Save a Life

Signs of an opioid overdose

If you are not sure, act anyway. Naloxone will not harm someone who is not on opioids, and it is safe for people of all ages.

• Will not wake up or respond to your voice or touch
• Slow, shallow or no breathing
• Choking, gurgling or snoring sounds
• Blue, gray or pale lips and nails
• Tiny, pinpoint pupils

What to do: step by step

• Check: yell "Wake up!" and shake them gently. If they do not wake up, act fast.
• Give naloxone: hold the device with your thumb on the bottom of the plunger. Put the tip of the nozzle in either nostril and press the plunger firmly. Do not prime or test it first.
• Call 911. Say someone is not breathing or will not wake up, and give the address. Stay on the line and follow what they tell you.
• Support breathing: try to keep them awake and breathing. If you are trained in rescue breathing or CPR, use it.
• Lay them on their side so they do not choke.
• Wait 2 to 3 minutes. If they do not wake up or breathing does not return to normal, give another dose with a new device in the other nostril. Keep giving doses every 2 to 3 minutes until they wake up. Fentanyl may need more than one dose.
• Stay with them until help arrives, even if they wake up, or for at least 4 hours. Naloxone can wear off before the opioid does. If they get very sleepy again, give another dose.

What to expect when they wake up

Naloxone can bring on sudden withdrawal: feeling sick, shaky, irritable, achy, or nauseous. They may be confused or upset. Stay calm, keep them from using more, and encourage them to get medical care. Naloxone is a temporary treatment, so medical help is still needed.

Colorado's Good Samaritan law

Under C.R.S. 18-1-711, if you call 911, police or a medical provider in good faith to report an overdose, you are protected from arrest and prosecution for certain drug and alcohol crimes connected to that event, like drug possession or underage drinking. The person who overdosed is protected too.

To be covered, you must stay on scene until help arrives, give your name, and cooperate. The law does not protect against other crimes. This is general information, not legal advice. The most important thing is to call.

Fentanyl test strips

Fentanyl test strips can show if fentanyl is in a drug before use. Colorado law (C.R.S. 18-18-426) says testing equipment used to identify or analyze controlled substances is not drug paraphernalia. A negative test does not mean a drug is safe. Never use alone, and keep naloxone nearby.

Where to get naloxone in Colorado

Keep naloxone where people can find it, check the expiration date, and tell friends and family where it is.

• Pharmacies: naloxone nasal spray is sold over the counter, with no prescription needed. Stop the Clock Colorado reports that over 200 Colorado pharmacies carry it.
• Free sites: the Save a Life Colorado map (savealifecolorado.org), from CU Anschutz, shows pharmacies, health departments, nonprofits, kiosks and vending machines, including hundreds of places that give it out free.
• Your local public health department or harm reduction program.
• Insurance: ask your pharmacist or insurance plan what your cost will be.