National Coalition Against Prescription Drug Abuse

Try to wake up the person

• Shake them and shout their name if you know it.
• If no response, perform a sternal rub and/or squeeze their trapezius muscle.
• If they are still not breathing or responding and have cold and clammy skin, assume it is an overdose. Take action!

Administer Naloxone Nasal Spray

• Tilt the person’s head back.
• Remove the Naloxone nasal spray from its packaging and gently insert the nozzle into one of their nostrils.
• Press the plunger firmly to administer the first dose of Naloxone.
• Wait 2-3 minutes and administer the second dose of Naloxone in the other nostril if the person is still not breathing on their own.

Call 911

• Report only what you see, not what you think happened.
• Avoid words like “drugs” and “overdose.”
• When they arrive, tell EMS what drugs were used if known, and the amount of Naloxone given.
• Bystanders who respond to an overdose and administer Naloxone have limited immunity under California’s Good Samaritan Law that includes being under the influence yourself and possession of paraphernalia and drugs in small amounts for personal use.

Monitor Breathing

• If breathing is erratic or stopped, perform rescue breathing or CPR (if trained) in between administering the first and second dose of Naloxone nasal spray.
• Be sure to place a protective barrier between your mouth and theirs.
• Administer a second dose of Naloxone in 2-3 minutes in the other nostril if still not breathing.
• Place in recovery position once they begin to breathe on their own.

Stay with the Person

• Stay with the person until EMS arrives if possible. Place in recovery position if you need to leave before they arrive.
• As they wake up, calmly explain what happened and create space around them.
• Naloxone wears off in 30 to 90 minutes and if opioids are still present, they may overdose again.
• It is important that they go to the ED for assessment and support, but if they refuse to go, they should be monitored for up to 4 hours in case of overdose again.
• If they do overdose again, repeat the same overdose reversal steps.