Administering Medication for Overdose Reversal During COVID-19
Surgeon General’s Advisory on Naloxone and Opioid Overdose
Opioid Overdose Reversal Medications (OORM) Can Save a Life
FAQs Pharmacies Distributing Naloxone Toolkit for PharmacistsReverse Overdose Oregon Toolkit for Schools
Opioid overdose reversal medications (OORM), also called naloxone or Narcan™, can very quickly restore normal breathing for a person whose breathing has slowed down or stopped because of an overdose of prescription opioids or illicit opioids, which includes illicitly manufactured fentanyl and heroin.
Opioid overdose reversal medications (OORM) only work for opioid drugs, including heroin, morphine, oxycodone (e.g. OxyContin, Percocet), oxymorphone (e.g. Opana), methadone, hydrocodone (e.g. Vicodin), codeine and fentanyl.
An overdose is always a medical emergency. Call 911 immediately after administering naloxone to someone, and be aware that it may take multiple doses to reverse an overdose. Oregon's Good Samaritan law protects the caller and the person who has overdosed from being arrested or prosecuted for drug-related charges or parole/probation violations based on information provided to emergency providers.
Oregon law allows lay people to carry and use medication for overdose reversal on othersYou can be prepared to save the life of someone in need.
Ask your healthcare provider or a pharmacist about medication if you believe you or someone you know may be at risk of an overdose. OORM is safe, easy to get, and easy to use. Carrying this medication is no different than carrying an EpiPen for someone with allergies. It simply provides an extra layer of protection for those at a higher risk for overdose.
If you are taking prescription opioids, you can ask your healthcare provider or pharmacist for an OORM, or naloxone, prescription. Health insurance might cover the cost of OORM. If you want to have OORM on hand for someone else, you can ask your pharmacist for a prescription. Health insurance usually will not cover this. OORM may be expensive depending on your insurance coverage, but coupons may be available online to offset the cost.
If you are actively using opioids, you can get medication for overdose reversal and other harm reduction materials such as fentanyl test strips at no cost through syringe service programs. Syringe services are available to everyone that uses drugs, regardless as to whether you inject them. Here is OHA's list of syringe and needle exchange services available in Oregon.
Reverse Overdose Oregon campaign
The Oregon Health Authority has a
campaign to help employers reverse opioid overdoses.
Reverse Overdose Oregon marks the latest in Oregon’s ongoing efforts to address the opioid epidemic through direct, comprehensive interventions.
Frequently Asked Questions
Read our FAQs to learn about how to get medication for overdose reversal, training on its use and more.
If your question is not answered here, please contact ivpp.general@odhsoha.oregon.gov.
1. What are opioid overdose reversal medications (OORM)?
OORM, or naloxone, is an easy-to-use, life-saving drug that can reverse the effects of an opioid overdose when administered in time. It's also known as Narcan.™
2. What do OORM look like?
OORM, or naloxone, comes in two FDA-approved forms: injectable and prepackaged nasal spray.
3. What do OORM do?
Opioids (such as heroin, fentanyl, and some types of painkillers) can slow your breathing. If you take too much, your breathing could stop, and you could die. If given soon enough, OORM can counter the overdose effects, usually within minutes.
4. How do I get opioid overdose reversal medications (OORM)?
- If you are taking prescription opioids, ask your health care provider or pharmacist for an OORM prescription. Your health insurance might cover the cost of OORM. You might be able to find coupons for OORM online.
- If you want to have OORM on hand for someone else, ask your pharmacist for a prescription, health insurance usually will not cover this.
- Over the Counter NARCAN® nasal spray 4mg. Find a retailer near you by visiting https://narcan.com/buy.
- If you are in treatment for substance use, ask your counselor for help getting OORM. You might get OORM at no cost from a local program.
- If you are actively using opioids and involved with a syringe exchange or other harm reduction services, you can get OORM at no cost.
- For other low or no-cost OORM, click here.
5. Will insurance cover naloxone?
Many insurance plans will cover OORM prescriptions written by health care providers or pharmacists for use on the person with health insurance. Check with your insurance provider for coverage information.
6. How much do OORM cost?
The price of OORM varies and might change over time. Call your pharmacy to get a current price. You might be able to find coupons for naloxone online.
7. What training do I need to use OORM?
Training on the use of OORM is not required in Oregon; however, it is strongly recommended that you use the following online training tools to ensure the safe and effective use of naloxone.
- Watch the OHA online training videos or read the OHA training protocol
- Contact your local syringe exchange programs, social service agencies, and public health departments that distribute OORM to ask about trainings near you.
8. What are my risks if I use OORM on someone?
Oregon has a Good Samaritan law that protects individuals from civil prosecution if they give someone OORM in a good faith effort to reverse opioid overdose. It is important to learn how to use naloxone safely through the online training resources described above.
9. How many doses of OORM do I give a person?
- People cannot overdose on OORM, but with more OORM come more withdrawal symptoms (from the drug causing the overdose).
- Many opioids last longer than OORM so a person can go back into an overdose after receiving naloxone.
- If someone has used fentanyl or there is fentanyl in the drugs, they may need more OORM than you have on hand.
- Because OORM may not bring someone out of overdose completely, it is very important to call 911 right away and not wait to see if the medication works.
- Review the OHA training protocol for the steps you should take when someone is overdosing such as rescue breathing and chest compressions.
10. Can OORM be given to someone younger than 18?
Always follow the dosage instructions labeled on medications. The Oregon Board of Pharmacy Laws and Rules do not specify permitted or prohibited age groups or list age exclusions for naloxone distribution or prescribing. More information on Oregon laws/rules:
ORS 689.681 Opiate overdose; treatments; administration of naloxone; rules
ORS 689.682 Prescription of naloxone
ORS 689.684 Administration of naloxone by certain persons; rules
OAR 855-019-0460 Naloxone - Delivery of Care and Prescribing
11. Can people have an allergic reaction to OORM?
Allergic reactions to OORM, or naloxone, are very rare. Call 911 if someone experiences an allergic reaction to naloxone, such as hives or swelling in the face, lips, or throat. They should not drive or perform other potentially unsafe tasks.
12. How do I store OORM?
Follow the manufacturer's instructions for storing naloxone. If instructions are not available, the Centers for Disease Control & Prevention (CDC) recommends keeping naloxone in the original box or storage container, protected from light, and stored at room temperature (59-77°F or 15-25°C) until ready for use.
13. How do I dispose of expired OORM?
First, confirm that your OORM is truly expired. If you have Adapt Narcan™ (naloxone hydrochloride) nasal spray, the US Food and Drug Administration has approved an extension of its shelf life from 36 months to 48 months. For all other forms of OORM, follow the manufacture's expiration date.
There are a couple of options for what to do with expired OORM:
- You can keep your expired kits and use them for training purposes. If you use your expired kits for training, please make sure to mark the kits clearly as “expired and not for use."
- You can discard your expired kits safely at any medication disposal location. Go to Take Meds Seriously Oregon to find disposal locations near you. You can also call your local pharmacies and public health department for information on local disposal options.
- You can donate your expired kits to a local harm reduction or syringe service program. To find a program in your area, click here.
1. What do pharmacists need to do to prescribe naloxone to patients?
Pharmacists can prescribe naloxone for anyone requesting it. Visit the Board of Pharmacy for detailed information on prescribing naloxone including naloxone FAQs.
Please consider using materials from the Naloxone Toolkit for Oregon Pharmacists.pdf. This toolkit includes posters, fact sheet, and bag stuffers:
1. What do we have to do to have opioid overdose reversal medications (OORM) on-site for staff to use (but not distribute)?
If your organization has a MD, DO, NP or PA on staff, these clinicians may order OORM for you to have onsite or to carry on outreach activities. If you do not have a staff member with prescribing capabilities, a pharmacist may prescribe OORM to a person or an organization. A map of pharmacies confirmed to distribute OORM can be found here.
If you do not have an MD, DO, NP, or PA on staff and are located in Multnomah, Clackamas, or Washington County, you may have a staff member attend the Naloxone Train-the-Trainer class sponsored by Multnomah County. Organizations who have a representative attend the training are able to purchase naloxone through the Multnomah County Pharmacy. Contact Kelsi Junge (kelsi.junge@multco.us) for more information
Under Oregon law, organizations' staff and volunteers may have OORM on-site or carry naloxone with them in the event of an opioid overdose. Any staff or volunteer of a social service agency may administer naloxone, even if this naloxone was not distributed to that person, to reverse an opioid overdose (ORS 689.684). Additionally, those staff are protected against civil liability as long as there is reasonable cause to believe the person is experiencing an opioid overdose (ORS 689.681).
2. What training do our staff need to use OORM?
OORM training is not required in Oregon; however, it is strongly recommended that you use the following online training tools to ensure the safe and effective use of naloxone.
3. Do staff need to be certified in CPR to administer OORM or to train others to administer naloxone?
While CPR training may be beneficial to your staff and organization, it is not required for staff or trainers to be CPR certified.
4. How can our organization get OORM?
There are a few ways to get OORM for your organization.
- Check Save Lives Oregon to see whether your organization is eligible to order OORM and other harm reduction supplies at no cost.
- Call local pharmacies and ask if you can purchase OORM from them.
- Call your local health department to see whether there are other OORM sources in your area.
- Conduct an online search for companies that sell OORM (this would be for bulk purchases). The Oregon Health Authority cannot endorse private companies.
- For other low or no-cost OORM, click here.
5. Are there any purchasing programs specifically for public safety or law enforcement?
Law enforcement, fire departments, and EMS may qualify for reduced price opioid overdose reversal medications (OORM). For more information feel free to reach out to IVPP.General@odhsoha.oregon.gov.
6. Is starting an OORM distribution program right for my organization?
If your agency or organization works with clients at risk for opioid overdose, starting a distribution program might be right for you. An OORM distribution program includes distributing take-home naloxone kits to clients. To distribute OORM, an organization much first legally obtain OORM (OAR 855-019-0460), which can be done by working with a prescriber within your organization, a local pharmacy, or contacting your local public health agency to see if they offer resources.
Here are some questions to consider when starting a program:
- Have you identified a legal pathway to obtaining OORM?
- What data will you collect from participants (i.e., demographics, substance use history, overdose experiences)?
- Will you offer training to your clients and staff on how to recognize and reverse an opioid overdose?
- How (and when) will you have your OORM supplies available?
- Do you know how to order supplies for OORM kits?
- Where will you store the OORM kits?
Download all FAQs for printing (pdf) - updated September 1, 2021
Naloxone Training Protocol
Protocolo de
capacitación sobre la naloxona
Opioid Overdose Toolkit from SAMHSA