Naloxone reverses overdose and saves lives

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Opioid overdose is a serious global issue, including in Australia.

In 2023, opioid drugs were involved in 981 overdose deaths in Australia.

That’s about 3 deaths per day.¹

Australia has taken steps to reduce the harm caused by overdose by expanding access to naloxone - an opioid overdose-reversal medication.²

Naloxone is also used globally, and the World Health Organization (WHO) recommends it as a key part of its strategy for opioid harm reduction.³

What is an opioid overdose?

Opioids include legal prescription drugs such as codeine, as well as illegal drugs like heroin.

An opioid overdose happens when a person has more of an opioid drug, or a combination of opioids and other drugs, than their body can handle.^{4, 5}

Taking a combination of drugs together increases overdose risk

Most accidental overdose deaths happen when multiple drugs (including alcohol or medications) have been taken around the same time. This is called polydrug use.^{1, 6-8}

Depending on the drug/s involved, an overdose can cause very unpleasant effects or be life-threatening.^9,10

What are the signs of an opioid overdose?

If you, or someone else, show any of the symptoms of opioid overdose, call triple zero (000) and request an ambulance (emergency services are there to help and can provide instructions over the phone).

Signs can include:

• passed out and non-responsive
• slow breathing, abnormal breathing or not breathing at all
• slow or no heartbeat and pulse
• choking or gurgling sounds
• skin colour changes, especially lips and fingernails:
• typically bluish-purple skin for people with lighter complexions
• or greyish or ashen skin for people with darker complexions
• hypothermia (low body temperature)
• vomiting
• cool or clammy (wet and sweaty) skin
• small ‘pinpoint’ pupils.^11-14

What is naloxone?

Naloxone (also known as Nyxoid®/Narcan®) is a medication that temporarily reverses the effects of opioid overdose including heroin, oxycodone and fentanyl.

Naloxone won’t work on someone who has taken another type of drug like alcohol or benzodiazepines.^15,16

It’s available for free over the counter from some local pharmacies and can be easily administered by anyone including family, friends, or bystanders.^2,17

Naloxone works by binding to the same receptors in the brain as opioids, blocking the drug’s effects.²

This means that when naloxone is given to someone who has taken opioids, it temporarily reverses the effects of opioids on the body.^2,3

This can bring their breathing back to normal and help them wake up.²

Naloxone doesn’t have any intoxicating effects like alcohol and other drugs, and can be safely given in large doses. And if you give it to someone who hasn’t taken an opioid, it won’t harm them.^15,18,19

So, if someone shows signs of overdose:

1. GIVE THEM NALOXONE
2. Call an ambulance by dialling 000.

How do I use naloxone?

Naloxone comes in the form of a nasal spray or injection.²

The naloxone nasal spray is easy to use, follow these steps:

• Remove the nasal spray device from its pack. Each spray contains one dose of naloxone.
• Insert the nozzle of the nasal spray device firmly into one of the person’s nostrils.
• Press the plunger until you hear a ‘click’. This will give the full dose of naloxone.^17,20,21

Make sure you do not press down on the plunger until the device is firmly placed inside the person’s nose.¹⁷

Do not test the device before you use it. The same nasal spray cannot be used more than once - testing it will waste the naloxone.

If you have a naloxone injection or PrenoxadTM or MIN-I-JET injection:

• It contains naloxone in a pre-filled syringe.
• Each box comes with a leaflet with detailed instructions on how to use it.
• When using injectable naloxone, do not give more than one dose at a time.^18,22

Giving multiple doses at once can increase the risk of sending someone into opioid withdrawal.^16,23,24

For detailed information on using Naloxone in response to an overdose, read through these Dovetail resources:

1. Naloxone nasal spray
2. Naloxone pre-filled syringe

What to do after using naloxone

Naloxone takes 2 - 5 minutes to start working and lasts for around 30 to 90 minutes.

But, opioids can stay in the body for a lot longer.

This means the person could overdose again after the naloxone wears off.^2,16

So, it’s important to get medical help after naloxone is used, and make sure the person isn’t left alone.

If you haven’t done so already, call an ambulance by dialling triple zero (000).

If a person does not respond to the first dose of naloxone after 3 minutes - give them a second dose. This can be repeated until the ambulance arrives.²⁰

Sudden withdrawal

If a person is dependent on opioids, or regularly takes opioid medications, they can experience sudden withdrawal symptoms when they are given naloxone (known as precipitated withdrawal).²³

These include:

• nausea
• stomach cramps
• fast heart rate
• fever and sweating
• anxiety and agitation
• muscle twitches
• muscle and bone aches
• diarrhoea.^15,16,23,24

While these symptoms can be very unpleasant, they should go away as the naloxone wears off.^16,23,24

Take home naloxone programs

Naloxone is already widely used in hospitals and by paramedics, and is one of the most effective strategies for reducing opioid overdose deaths.²⁵

As a precaution, the WHO also recommends naloxone is available to people who are likely to witness an overdose. This includes people who have an opioid dependence and their family and friends – it’s sometimes called ‘take home naloxone’.³

Take home naloxone programs save lives and are cost effective.^26,27

It’s especially important for people at high risk of overdose, including those transitioning back into the community after prison or other correctional settings.²⁸

Naloxone access in Australia

In July 2022, Australia launched a national Take Home Naloxone program.

Naloxone is now available for free, without a prescription, for people who may experience or witness an opioid overdose.

This program followed a successful trial in New South Wales, Western Australia, and South Australia.

The trial saved up to an estimated 3 lives per day, and naloxone was used at least 1,649 times to reverse an opioid overdose.

You can access naloxone at participating pharmacies, or with a prescription from your doctor.²

Find out more about Australia’s take-home naloxone program:

• Department of Health website.

Find out where you can access take-home naloxone:

• Australian Department of Health - Where to access naloxone.

Victoria’s take home naloxone program

Victoria’s program supports peer-to-peer naloxone distribution, meaning:

• naloxone can be picked up on someone else’s behalf, like by family, friends, carers, or peers
• It can be shared between people in the community.²¹

Naloxone is also available at 50 needle and syringe providers and the Medically Supervised Injecting Service in North Richmond.²⁹

Call DirectLine on 1800 888 236 or click the link here to find out where you can access take-home naloxone:

• Victoria's Take-Home Naloxone Program.

More information

• For more info about overdose and how to respond, check out our article on overdose awareness.
• To find out more about opioid overdose, download this opioids factsheet.

Getting help

If your use of alcohol or other drugs is affecting your health, family, relationships, work, school, financial or other life situations, or you’re concerned about a someone you care about, you can find help and support.

• Call the National Alcohol and Other Drug Hotline on 1800 250 015 for free and confidential advice, information and counselling
• Use the Path2Help portal to get matched with information and services specific to your needs
• Search our Help and Support database directly to find your preferred supports, by adding your location or postcode and filtering by service type
• If you’re looking for other information or support options, send us an email at [email protected].