Naloxone is a life-saving medicine that temporarily reverses the effects of opioid overdose.
However, it is strongly encouraged that all people who use stimulant drugs to routinely carry naloxone. This is because illicit stimulant drugs including MDMA, cocaine and methamphetamine may be contaminated with opioids, which can result in accidental opioid overdose. People who have friends or family members who use stimulant drugs should also carry naloxone.
The following groups of people are strongly advised to carry naloxone:
- People hosting or going to a party where drugs will be present,
- People attending festivals or music events where drugs will be present,
- People who use any illicit drugs including opioids, stimulants (like cocaine and MDMA), ketamine and counterfeit pharmaceuticals,
- People who are prescribed opioid pain medicines and their friends and family,
- 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,
- Family, friends and carers of people who use illicit drugs or are prescribed opioids,
- First aid trained workers who might witness an overdose in the course of their work.
What is naloxone?
Naloxone is a medicine that reverses the effects of an opioid overdose. It 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. However, if you are unsure if a person is experiencing an opioid overdose, it is best to administer naloxone as there are no negative effects of naloxone if they have not used an opioid.
Naloxone is available in an easy-to-use nasal spray, and as a pre-filled injection. With basic training, it can be administered by anyone. If you are planning to take naloxone with you to a music festival or entertainment venue, the nasal spray is a good option.
Take home naloxone in NSW
Take home naloxone programs have been established across Australia and internationally to increase awareness of and access to naloxone, and to 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.
You can view the most up to date information about take home naloxone here.
Where can I get naloxone?
Naloxone in the form of the Nyxoid® nasal spray and Prenoxad® pre-filled syringe is available for free without a prescription from participating community pharmacies, Needle and Syringe Programs (NSP) and participating non-government organisations (NGOs) and private services in NSW.
- You can order Take Home Naloxone online from NSW Users and AIDS Association (NUAA) if you live in NSW.
- Use this map to find services that supply take home naloxone for free. You should call the organisation in advance to ensure naloxone is in stock.
- Naloxone is also available from some Needle and Syringe Program (NSP) sites across NSW. Please contact your local NSP service to confirm naloxone availability.
What is an opioid overdose?
During an overdose, opioids slow down or stop a person's breathing, which may result in death (see 'Signs of opioid overdose' below). It is possible to prevent an overdose death by administering naloxone to reverse the effects of the opioid.
Signs of opioid overdose
Opioid overdose can happen to anyone. Even small amounts of opioids may cause some people to overdose — for example, an illicit drug sold as cocaine, MDMA or ketamine that is contaminated with a very small amount of a synthetic opioid can cause an overdose.
When a person overdoses on opioids, 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
- pale or cold skin, blue or grey lips and fingertips
- coma and death
Responding to opioid overdose
If you suspect someone has overdosed phone 000 (triple zero) immediately and tell the operator that the person has overdosed. The effects of naloxone may wear off, and ongoing doses and hospital treatment may be needed. The police will usually not come unless there is a death or violence.
What to do:
- try to stay calm
- check their breathing, clear their airway
- administer naloxone if available - NSW Health provides instructions for administering Nyxoid® and Prenoxad®
- put an unconscious person on their side, in the recovery position
- if they stop breathing, use rescue breathing if you know how
- remove a pharmaceutical opioid patch immediately if on the skin
- stay with the person
What NOT to do
- 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
Nitazenes
Nitazenes are extremely potent synthetic opioids. Nitazenes are dangerous and vary in strength – some nitazenes are so strong that there is no safe dose. The purity of the drug can also vary within a single batch. They can be up to 500 times more potent than heroin.
Nitazenes have been detected across every state in Australia and have been found in a wide range of substances sold as other illicit drugs. Several NSW public drug warnings regarding nitazenes have been issued for a variety of substances.
Naloxone can temporarily reverse an overdose from nitazenes. Follow the steps above - Responding to opioid overdose – if you think someone has overdosed on nitazenes. Nitazenes often require multiple doses of naloxone.
Fentanyl test strips do not detect nitazenes.
More information
Check out the A-Z of Drugs listing and Support Services pages, including the NSW Opioid Treatment Program page for further information.
Information for NSW public health services, the Medically Supervised Injecting Centre (MSIC) and non-government and private service providers can be found at health.nsw.gov.au/aod/programs/Pages/naloxone.
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