Naloxone provides a significant opportunity to save lives because opioid overdoses tend to happen gradually, rather than suddenly. Opioids include pain-relieving drugs legally prescribed by a medical professional such as oxycodone, morphine, codeine and fentanyl, as well as illegal drugs such as heroin. During an overdose, opioids slow down or stop a person’s breathing, which may eventually result in death (see ‘Signs of opioid overdose’ below). However, it is possible to prevent death by administering naloxone to reverse the effects of the overdose. For this reason it is best to avoid using opioids alone, as naloxone can only help if someone can administer it quickly.
Opioids are responsible for over three deaths in Australia per day (Australian Bureau of Statistics). Prescribed opioids account for 70 per cent of opioid-induced deaths either by accident or through misuse. In 2018 the highest number of heroin-induced deaths was seen since 2000.
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What is naloxone?
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Who is naloxone for?
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Take home naloxone in NSW
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Where can I get naloxone?
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Signs of opioid overdose
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Pharmaceutical opioid use
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More information
What is naloxone?
Naloxone is a drug that reverses the effects of an opioid overdose. In technical terms naloxone is a short-acting opioid antagonist that stops the central nervous system slowing down, giving a person experiencing an overdose the ability to breathe normally again. Naloxone only works if a person has opioids in their system.
Naloxone is available in a very easy to use nasal spray, and as a pre-filled injection. Until recently, naloxone has only been administered by medical staff or emergency service officers. Now, with basic training it can be administered by anyone.
Who is naloxone for?
Naloxone is for anyone at risk of overdosing on opioid drugs or anyone who may witness an opioid overdose.
People in the following circumstances should consider keeping a supply of naloxone close by:
- People on high doses of opioid pain medicines
- People who use opioid drugs
- People returning to opioid use after a period of stopping or quitting
- People who use opioids in combination with other drugs or medicines
- People who use illicit drugs, including cocaine or other stimulants (illicit drugs may contain unexpected substances, including opioids)
Family, friends or loved ones of people who use opioid drugs.
Take home naloxone in NSW
Take home naloxone programs, for people at risk of witnessing or experiencing an opioid overdose, have been established in Australia and internationally to increase awareness of naloxone, and reduce harm and death from overdose. Having naloxone at home enables community members to access the medicine quickly when and where they need it to treat an opioid overdose.
Take Home Naloxone is now available from an increasing number of community pharmacies, public alcohol and other drugs services and some non-government health and welfare services across NSW.
Naloxone is also available on prescription by a doctor or over the counter from a community pharmacy.
Where can I get naloxone?
Naloxone in the form of the Nyxoid® nasal spray and Prenoxad® pre-filled syringe are available for free without a prescription from registered community pharmacies, Needle and Syringe Programs (NSP) and participating non-government organisations (NGOs) and private services in NSW.
Pharmacies
Find your local participating pharmacy.
Tip: With the list open use the search function (Ctrl and F keys) to find your postcode or suburb.
Pharmacies list (PDF)
NSW Needle and Syringe Programs
Naloxone is also available from some Needle and Syringe Program (NSP) sites across NSW. Please contact your local NSP service to confirm naloxone availability.
Needle and Syringe Program sites
NGOs and private services
Find your local participating non-government organisations (NGOs) and private service.
NGOs & private services list (PDF)
Information about overdose
Opioid overdose can happen to anyone. Even small amounts of opioids may cause some people to overdose — for example, new users or those who have started using again after a period of stopping or quitting. Overdose can occur when using illegal opioids or when using pharmaceutical opioids, particularly when not used as prescribed by a doctor.
When a person overdoses, they may show the following signs:
- quick onset of very slow, difficult or shallow breathing, there may also be snoring
- cold and clammy skin and low body temperature
- confusion
- fainting
- slow heartbeat
- muscle twitching
- gurgling sound in the throat from vomit or saliva
- bluish skin and nails because of low oxygen
- coma and death
If you suspect someone has overdosed phone 000 (triple zero) immediately and tell the operator that the person has overdosed (the police will usually not come unless the person dies or becomes violent).
Always phone 000 (triple zero) for an ambulance and tell the operator that the person has overdosed (the police will not usually come unless the person dies or becomes violent).
Please note: the take home naloxone program includes instructions to perform rescue breathing and chest compressions. Before following this advice, refer to the Australian Resuscitation Council for NSW Health recommended advice during the COVID-19 pandemic.
You should also:
- put an unconscious person on their side, in the recovery position
- try to stay calm
- remove a pharmaceutical opioid patch immediately if on the skin, check their breathing, clear their airway
- do mouth-to-mouth resuscitation if they stop breathing
- administer naloxone (Nyxoid® or Prenoxad®) if available - NSW Health provides instructions for administering Nyxoid® and Prenoxad®
- stay with the person
- Do not inject the person with anything other than naloxone — no other substance will work against the opioid and can cause more harm
- Do not put them under the shower
- Do not put anything in their mouth as it can cause choking and stop them from breathing. Even if someone fits (has a seizure or convulsions), the best thing to do is move things from around them, so they don't hurt themselves
To help prevent overdose:
- avoid using opioids by yourself
- use pharmaceutical opioids only as prescribed
- do not mix opioids with other drugs - opioids can be particularly dangerous if used with alcohol, sleeping tablets, antidepressants or anti-anxiety medication or if already intoxicated
- if you start using opioids again after a period of stopping, have a much smaller amount than usual the first few times, as your resistance will have gone down
- if you've never used opioids you will have a low tolerance to how they affect you and a higher risk of side effects and overdose
- after a shot or spray of naloxone you should be taken to an emergency department, as naloxone only works for a short time
- after a shot or spray of naloxone, opioids are still in your body – the effect of opioids will return in a little while – using more opioids will put you at high risk of overdosing again
- if using illegal opioids like heroin, try a small amount first to test the strength, you might overdose even if you think you'll be okay
Pharmaceutical opioid use
There is a high risk of accidental overdose from pharmaceutical opioids such as fentanyl when used other than by your doctor's instructions, due to its potency and very fast action once inside the body. For example, fentanyl patches that attach to the skin can cause fatal overdose when heat is applied over the top, or if someone does not keep track of how much and how often it is being taken.
If you are prescribed a pharmaceutical opioid only use it as prescribed by your doctor and pay attention to any warning or caution advice.
More information
Check out the
A-Z of Drugs listing and
Support Services pages, including the
NSW Opioid Treatment Program page for further information.
For further enquiries on the take home naloxone Intervention in NSW email
MOH-naloxone@health.nsw.gov.au.
Information for NSW public health services, Medically Supervised Injecting Centres (MSIC) and non-government and private service providers can be found at health.nsw.gov.au/aod/programs/Pages/naloxone. For information on the Commonwealth Government Take home naloxone pilot visit
health.gov.au/initiatives-and-programs/take-home-naloxone-pilot.
For free and confidential advice give an Alcohol and Drug Information Service (ADIS) counsellor a call on
1800 250 015, they are available 24 hours, 7 days a week to provide confidential support and advice.
