Naloxone is a life-saving medicine that temporarily reverses the effects of opioid overdose. It is a safe medicine that cannot be misused for recreational purposes. The NSW Health Take Home Naloxone Program supplies naloxone to people in the NSW community who may need it. Opioids include pain-relieving drugs legally prescribed by a medical professional such as oxycodone, morphine, codeine and fentanyl, as well as illicit drugs such as heroin.
Naloxone reverses the effects of opioids. However, NSW Health also encourages people who use stimulant drugs, and their friends, to routinely carry naloxone. This is because illicit
drugs including MDMA, cocaine, ketamine, some vape refills and counterfeit pharmaceutical products may be contaminated with opioids, which can result in accidental 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 overdose. For this reason, it is best to avoid using opioids while alone, as naloxone can only help if someone can administer it quickly.
In 2022, opioids were the most common drug type associated with unintentional drug-induced deaths in Australia, contributing to just under half of these deaths.
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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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Nitazenes
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More information
What is naloxone?
Naloxone is a medicine that reverses the effects of an opioid overdose. In technical terms naloxone is a short-acting opioid antagonist that stops the central nervous system from 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 an easy to use
nasal spray, and as a
pre-filled injection. 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.
Synthetic opioids including nitazenes and fentanyl have recently been detected in illicit substances sold as MDMA, ketamine, some vape refills, cocaine, and counterfeit pharmaceutical products. Because of this, anyone who uses illicit substances, is a friend, family member or carer of someone who uses illicit substances should carry naloxone.
People in the following circumstances should consider keeping a supply of naloxone close by:
- People who are prescribed opioid pain medicines and their friends and family,
- People who use opioid drugs,
- People who use any illicit drugs including opioids, stimulants (like cocaine and MDMA), ketamine and counterfeit pharmaceuticals,
- 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.
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 access to and 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.
You can
order Take Home Naloxone online from NSW Users and AIDS Association (NUAA) if you live in NSW.
Naloxone is also available for free over the counter from participating community pharmacies, needle and syringe programs, or on prescription by a doctor.
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 participating community pharmacies, Needle and Syringe Programs (NSP) and participating non-government organisations (NGOs) and private services in NSW.
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NUAA Postal Take Home Naloxone: NSW residents can order Nyxoid or Prenoxad online. You will need to watch an instructional video and complete a multiple choice quiz before you place an order.
- View the Australian Government
map of THN Program participating sites where you can access naloxone for free. You should call the site you intend to visit in advance to confirm they have naloxone in stock.
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).
You should also:
- try to stay calm
- check their breathing, clear their airways
- administer naloxone (Nyxoid® or Prenoxad®) if available - NSW Health provides instructions for administering Nyxoid® and Prenoxad®
- put an unconscious person on their side, in the recovery position
- 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
- 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.
Nitazenes
Nitazenes are extremely potent synthetic opioids that may be longer acting than many and more likely to decrease or stop breathing than other opioids. They can be up to 500 times more potent than heroin.
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.
Nitazenes have been found in vapes and counterfeit tablets such as benzodiazepines, and in drugs thought to be heroin or MDMA.
The risks of overdose are increased if you:
- Use drugs alone
- Use nitazenes or other opioids if you have not used them before
- Use drugs again after a break
- Use with other drugs (like alcohol, benzodiazepines, ketamine, or GHB)
- Use a new batch.
Naloxone can temporarily reverse an overdose from opioids. Nitazenes often require multiple doses of naloxone. Always phone 000 (triple zero) for an ambulance 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.
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.
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.
