Opioid overdose can happen with heroin and with opioid medicines such as oxycodone. When it happens, the people nearby are often the only ones who can help in time. Naloxone is a medicine that can temporarily reverse the effects of an opioid overdose. Knowing what it is and where to get it could make a real difference.
This guide covers the signs of an opioid overdose, what to do and how naloxone works. It draws on the Australian Government Department of Health, Healthdirect Australia and the Alcohol and Drug Foundation. It is general information only. In an emergency, always call triple zero.
What naloxone is and how it works
The Australian Government describes naloxone as a drug that can temporarily reverse an opioid overdose or adverse reaction. It works by blocking opioids such as heroin and oxycodone from attaching to receptors in the brain. It comes as a nasal spray or an injection. The Alcohol and Drug Foundation adds that it can be given by anyone, including family, friends and bystanders.
Naloxone only works on opioids. The Alcohol and Drug Foundation says it will not reverse overdoses from other drugs such as alcohol or benzodiazepines. It also says naloxone will not harm someone who has not taken an opioid. If you are unsure what was taken, call triple zero and tell the ambulance officers what you know.
Signs of an opioid overdose
Opioids are depressant drugs, which means they slow the body down. Healthdirect and the Alcohol and Drug Foundation describe similar warning signs. A person may be unconscious. They may also be awake but unable to respond. Look out for the following.
- Slow, shallow or irregular breathing
- No breathing at all
- Choking or gurgling sounds
- Pale, cool or clammy skin
- Small pupils
- Vomiting
- A slow or irregular pulse
The Australian Government notes that a person who has overdosed is unlikely to be able to give themselves naloxone. That is why it matters that the people around them know what to do. A carer, partner or housemate is often the one on hand. If you are a parent with concerns about a teenager, this advice for parents who fear their teenage child is taking drugs is a good starting point.
What to do if you think someone has overdosed
The Alcohol and Drug Foundation sets out clear steps for someone who is not responding or not breathing. Use naloxone if you have it. Call triple zero and ask for an ambulance. Check whether anyone nearby knows CPR.
Place the person in the recovery position and stay with them until help arrives. Healthdirect says to start CPR if they stop breathing. When the ambulance arrives, tell the officers what drugs were taken and how much, if you know. Healthdirect also advises not to make the person vomit or give them food or drink.
Why you still need an ambulance
Naloxone wears off. The Australian Government says it lasts about 30 to 90 minutes. Once it wears off, the person can overdose again. That is why calling triple zero is vital even if they wake up.
The Alcohol and Drug Foundation explains that a dose can be repeated if there is no response after a few minutes. It also says to stop once the person responds, as more naloxone can bring on unpleasant withdrawal. Ask a pharmacist or doctor to show you how your device works.
How to get naloxone for free
Since 1 July 2022, naloxone has been free and available without a prescription through the national Take Home Naloxone program. The Australian Government says it is for anyone who may experience or witness an opioid overdose or adverse reaction. That includes people at risk of overdose and their carers, friends and family. Details are on the Department of Health page about the Take Home Naloxone program.
All participating pharmacies across Australia supply it. Each state and territory also chooses other sites. These can include hospital pharmacies, alcohol and drug treatment centres, needle and syringe programs and custodial release programs. Pharmacies outside the program may sell it over the counter for a fee.
Is it worth keeping some at home?
The program is open to the family and friends of people who may overdose. The Alcohol and Drug Foundation points out that the World Health Organization recommends naloxone for people likely to witness an overdose. That includes family and friends of someone with an opioid dependence. You can ask your doctor or pharmacist about it.
Overdose risk and mixing drugs
The Alcohol and Drug Foundation says most accidental overdose deaths happen when several drugs are taken together. That includes alcohol and medicines. It also warns that illegal drugs may contain other drugs the user does not know about. Healthdirect makes a similar point, noting that illegal drugs are unregulated so their strength is hard to predict.
The foundation reports that opioids were involved in 981 overdose deaths in Australia in 2023. That works out to about 3 deaths a day. In the national pilot run in New South Wales, South Australia and Western Australia, naloxone was used at least 1,649 times. The Australian Government says the final report estimated the pilot helped save about 3 lives a day.
More detail on overdose signs and first steps is set out on the Alcohol and Drug Foundation page about overdose and drug emergencies. It covers stimulant overdose as well as opioids. It is worth reading before you ever need it.
Naloxone as part of a wider recovery plan
Naloxone is a safety measure. It does not treat dependence on opioids. For that, people usually need ongoing support from health professionals. This closer look at addiction treatment and rehab covers common questions people ask. A GP is a good first contact, as they can talk through treatment options and refer people on to other services.
Recovery also tends to involve daily habits that support wellbeing. Some people look at how mindfulness works with the 12 steps. Others keep a notebook to track their thoughts and progress. Small tools like positive affirmations for addiction recovery can sit alongside professional care, though they are not a replacement for it.
Frequently asked questions
Do I need a prescription for naloxone?
Not through the Take Home Naloxone program. Since 1 July 2022 it has been free and available without a prescription at participating sites. Pharmacies outside the program may sell it over the counter for a fee.
Can naloxone reverse an alcohol overdose?
No, it cannot. The Alcohol and Drug Foundation says naloxone only reverses opioid overdoses. It will not reverse overdoses from alcohol or benzodiazepines, so call triple zero straight away in any suspected overdose.
How long does naloxone last?
The Australian Government says it lasts about 30 to 90 minutes. The person can overdose again once it wears off. Always call an ambulance and stay with them.
Who can give naloxone?
Anyone can give it, including family, friends and bystanders. The Alcohol and Drug Foundation notes that it comes as a nasal spray or a prefilled injection. A pharmacist or doctor can explain how the device you have works.
This article is general information only and is not medical advice. It does not replace care from a doctor or paramedic. Please speak with a doctor or qualified health professional about your own health or the health of someone you care for.
