Respond to an opioid overdose with naloxone

If someone will not wake up and is breathing slowly or not at all, call 911 and give naloxone right away; it will not harm someone who has not taken opioids.

A paramedic arranging supplies outside an ambulance. — Photo: RDNE Stock project / Pexels

Area: SafetyFrom age 16Time to learn: 15 minutes; pharmacists can show you how to use a kitPractise in a class

You will recognize an opioid overdose, give naloxone, support breathing, and stay until help arrives.

SafetyGive naloxone whenever you suspect an opioid overdose; the CDC says it will not harm someone who is overdosing on drugs other than opioids. Always call 911 as well. A certified first aid or naloxone training course lets you practice, including rescue breaths if you are trained.

Why it matters

In the 12 months ending May 2026, an estimated 41,311 overdose deaths in the US involved opioids (CDC provisional data). Naloxone can restore normal breathing within 2 to 3 minutes, and it will not harm someone whose overdose is from other drugs (CDC). In the US it is sold over the counter; in Canada, take-home kits are available at most pharmacies without a prescription.

How to do it

Look for the signs: the person will not wake up or respond to their name; breathing is very slow, only a few times a minute, or has stopped; gasping or gurgling sounds; blue or gray lips or skin.
Shout their name and tap or squeeze their shoulder. If they do not respond, act now.
Call 911. Say the person is not breathing or will not wake up, and give the exact address.
If they are not breathing, or only gasping, start CPR right away (hands-only if you are not trained). Give naloxone as soon as you have it, with as little pause in CPR as possible.
If they are breathing, but slowly or not fully awake, give naloxone. For a nasal spray: lay them on their back, put the nozzle into one nostril, and press the plunger all the way. Follow the picture on the package.
In Canada, many take-home kits contain injectable naloxone, which goes into a large muscle such as the thigh or upper arm. Follow the kit's instructions, and ask the pharmacist to show you when you get it.
If there is no response after 2 to 3 minutes, give another dose. For a nasal spray, use a new device in the other nostril.
If they are breathing but not fully awake, place them in the recovery position.
Stay with them. Naloxone lasts 30 to 120 minutes, which is shorter than most opioids, so breathing can slow again (Health Canada). The CDC says to stay until help arrives or for at least four hours.
When naloxone works, the person may wake up in withdrawal: sick, achy, restless, or upset (SAMHSA). Keep them calm, and turn them on their side if they vomit.
Get naloxone ahead of time. In the US it is sold over the counter; in Canada, take-home kits are at most pharmacies without a prescription, and some provinces give them free. Replace it after the expiry date, or if it was exposed to temperatures below 39°F (4°C) or above 104°F (40°C) (SAMHSA).

Common mistakes

Waiting to see if the person 'sleeps it off'.
Leaving after the person wakes up. The overdose can return when naloxone wears off.
Not calling 911 out of fear of police. In Canada, the Good Samaritan Drug Overdose Act protects you from simple drug possession charges; US protections vary by state.
Delaying CPR to look for naloxone.

You can do this when …you can name four signs of an opioid overdose and walk through the steps on a naloxone training device: check, call 911, CPR if not breathing, naloxone, second dose, recovery position, stay.

Reading is not training. Practise on a manikin or in a supervised class with the American Red Cross or the American Heart Association, or in Canada with the Heart and Stroke Foundation, St John Ambulance or the Canadian Red Cross.