Naloxone
OPEN is working to reduce opioid-related deaths by expanding access to naloxone among high-risk populations. Our strategy is to collaborate with organizations and institutions across Michigan to distribute naloxone and get this life saving medication into the hands of patients, family members, caregivers and communities who are at high risk of opioid overdose.
What is Naloxone?
- Naloxone (Narcan®) is a drug that rapidly and temporarily reverses the dangerous effects of an opioid overdose.
- It works if you have opioids in your body such as fentanyl, heroin & prescription opioids.
- Naloxone can be given every 2-3 minutes until the person breathes again.
- A person cannot get high or become addicted to naloxone.
- Effective Only for 30 – 120 minutes.
What are the different types of naloxone?
| Intramuscular | Nasal Spray (Narcan) | |
|---|---|---|
| Appearance |  |  |
| Duration of Action | 30-90 minutes | 20-120 minutes |
| Repeat Dosing | Every 2-3 minutes | Every 2-3 minutes |
| Strength | 0.4mg/mL | 4mg |
| Assembly Supplies Needed | #2, 3 mL syringe w/ 23-25 gauge 1-1.5 inch IM needles | None |
| SIG for Suspected Overdose | Inject 0.4 mg (1 mL) IM x1. Repeat every 2-3 minutes until patient is responsive or EMS arrives | 1 actuation in one nostril x2. Repeat every 2-3 minutes until patient is responsive or EMS arrives |
| Storage | -Protect from light -Room temperature - 68 °F to 77 °F | -Protect from light -Room temperature - 68 °F to 77 °F -Excursion allowed between 41 °F and 104 °F -Freezes at temperatures below 5 °F and the device will not spray. Leave the device at room temperature for 15 minutes to thaw |
| How is it Supplied | Single dose flip top vial | Carton contains 2 blister packages of 4mg single use nasal spray |
| Disposal | Sharps container | Any waste container that is away from children |
| Direct Cost | $30-40 | $169 |
How to use Naloxone
Instructions for Narcan® Intranasal Spray
Michigan law protects you from liability when giving naloxone and calling 911 for someone who is experiencing an overdose.
 | |  |
| Step 1: Peel from packaging. | Step 2: Place the nozzle in the nose. | Step 3: Push the plunger to spray. |
Intranasal Naloxone for Laypeople
Intramuscular Naloxone
Safety Reminders:
- Do not spray test spray
- Do not delay calling 911
- Do not inject the person with anything
- Do not put the person in a bath or shower
- Do not give the person anything to drink
- Do not pour water over the person’s face
Take A.C.T.I.O.N. Training Courses
OPEN offers free, online and self-paced training to learn how to help someone experiencing an overdose.
FIRST RESPONDER TRAINING
First responders are key players in responding to our country’s opioid overdose epidemic. Take our First Responder Training to learn how to reverse an overdose.
COMMUNITY LAYPERSON TRAINING
Allies, community leaders, and those wanting to impact and save lives: take our Community Layperson Naloxone Training and learn how to take A.C.T.I.O.N to reverse an overdose.
Take A.C.T.I.O.N.
When someone is experiencing an overdose, every second matters. Knowing what to do—and quickly—can help save a life and give a person another opportunity for recovery.
 | A | Arouse (3 S's) |
|
 | C | Check for signs of overdose |
|
 | T | Telephone 911 |
|
 | I | Intranasal Naloxone |
|
 | O | Oxygen |
|
 | N | Naloxone again |
|
Overdose Rescue Training Program
This program offers training sessions to those wanting to learn more about naloxone administration.Where to Access Naloxone
HARM REDUCTION AGENCIES
- Many community organizations distribute naloxone and other harm reduction materials for free.
MAIL ORDER SERVICES
- If you are unable to access in-person naloxone distribution in your area, Next Distro offers naloxone shipped directly to your home in discreet packaging.
- Available in English and Spanish.
PHARMACIES
- Naloxone can also be purchased at certain approved pharmacies without a prescription.
- MDHHS maintains a list of all the pharmacies approved to dispense naloxone through the standing order.
FIND NALOXONE NEAR ME
The pharmacies below have a standing order for naloxone. Pharmacists can dispense naloxone for a fee. Select your county below to see a specialized, shareable brochure on where to find naloxone near you:
Implementing Naloxone in Emergency Departments
Prescribing naloxone to patients in the emergency department (ED) setting is recommended, legal, and within the scope of practice, carrying no more liability than the prescribing of other medications. ED-based naloxone distribution is impactful and cost effective. Organizations face several obstacles when establishing a program, including educating and training staff and lack of resources required to effectively introduce and sustain these evidence-based practices. This detailed guide is designed to facilitate implementation of your unique ED tailored naloxone distribution program.
Emergency Department Naloxone Implementation Guide
Learn how to facilitate and implement unique and tailored naloxone distribution programs in your Emergency Department.
Getting Started With Naloxone Distribution
- Create urgency to solve the problem
- Secure Project Sponsorship
- Set and Implement Project Aims
It is important to develop a team of members familiar with all the different aspects of building an ED naloxone program. Your team members can provide process improvement expertise and serve as champions for the work, advocating for naloxone distribution as a critical harm reduction intervention.
- Recruit Multidisciplinary Champions
- Physician Champion
- Nurse Champion
- Pharmacist Champion
- Social Work Champion
- IT Champion
- As you form your multidisciplinary team with support from ED leadership, meet to discuss the following:
- What competing ED priorities may prevent this project from getting started
- Who will order naloxone for ED distribution? Or prescribe it?
- Who will distribute naloxone to the patients?
- Where will naloxone be stored and dispensed from?
- Who will make the kits?
- Who will educate staff on patient risk factors, overdose response, and naloxone use?
- Who will educate patients on patient risk factors, overdose response, and naloxone use?
- What is the role of in-house recovery specialists or addiction counselors?
- Should the ED partner with outside agencies?
- What is the funding source for naloxone?
- Identify a sustainable funding source(s) for NRKs
- Identify Naloxone Rescue Kit Components
Developing your Naloxone Distribution Protocol
Currently, no validated screening tools exist for acute care settings. The CDC and other studies have recommendations for identifying patients at higher risk for overdoses (see Box 2). Your team should decide which patient population will be targeted to receive naloxone rescue kits.
EHR prompts are associated with increased naloxone distribution for patients after overdoses. Work with your IT department to build order sets and alerts to facilitate the process.
By teaching your multidisciplinary team how to educate patients, anyone can address patient questions or concerns.
Consider the patient’s health literacy level as well as any reading or comprehension issues.
OPEN offers several free patient education resources (link or jump to resources section?).
Ideal Standard:
- Naloxone medication
- Pair of nonlatex gloves
- Barrier mask
- Blue kit label with a QR code to access patient video training
- Patient education brochure
- Local pharmacies participating in Michigan’s naloxone standing order program
- SUD treatment resources (not shown, site-specific, but required by law).
OPEN + MEDIC
OPEN partners with MEDIC to increase access to naloxone by supplying emergency departments with take-home naloxone kits. Learn more about our partnership.
Emergency Department Naloxone Distribution Program
The Emergency Department Naloxone Program provides participating emergency departments in Michigan with naloxone rescue kits.OPEN'S RESOURCES
Resources
Emergency Department Naloxone Implementation Guide
Learn how to facilitate and implement unique and tailored naloxone distribution programs in your Emergency Department.
