Incorporating overdose education and naloxone distribution (OEND) into clinical practice has been strongly recommended by the CDC , World Health Organization , and the American Society of Addiction Medicine. This page is designed to provide treatment providers with brief pieces of information and available resources to help them establish OEND within substance use, mental health, and medical settings.
After an overdose, use the first meeting as an opportunity to:
– Start the OEND conversation about use patterns and fluctuations in risk
– Acknowledge the patient’s struggle with substance use
– Discuss a harm reduction approach to drug use and recovery
– Highlight naloxone as a way to keep the patient alive to pursue treatment
– Emphasize this as standard practice; not a personal judgement
* Educate families & friends when possible – remember, if people are unresponsive due to an overdose, they will not be able to administer naloxone to themselves!
What to include in the OEND conversation:
(For complete information about how to conduct OEND with patients, request a MO-HOPE provider training *here*)
- Risk Factors
- Talk with the person about what makes them at risk of experiencing an overdose- both in general and on any given day
- Recognize Signs
- Explain what an overdose looks like and provide specific signs/”what to look for” (e.g, unresponsiveness, shallow breathing)
- Reversal Myths
- Discuss reversal myths (e.g., injecting cocaine, placing in a bath of ice)
- Emphasize that the only method to reverse an opioid overdose that has proven to be safe and effective is to administer naloxone.
- Introduce Naloxone:
- Review the basics about naloxone
- Rescue Response
- Outline a specific rescue response:
1. Administer 1 dose of naloxone
2. Call 911 (review 911 Good Samaritan laws)
3. Administer rescue breaths
4. Place person in recovery position if you stop administering rescue breaths or leave the person’s side
5. Give 2nddose of naloxone after 2-3 minutes if 1st dose is not successful
6. Stay with the person until medical help arrives
( Naloxone has an effective time of 30 minutes to an hour, and after that time elapses, the individual can go back into an overdose state.)
- Explain how naloxone can be obtained
- Discuss keeping naloxone readily available and how to store it appropriately
- Prevention Strategies Use the harm reduction approach to discuss overdose prevention
- Use phrases like “If you choose to use…” followed by prevention strategies
– For example: If you choose to use, always have naloxone nearby (and someone who knows how to use it)
*Information provided on this site is not intended to cover everything. There are many places to find helpful information about naloxone and overdose prevention programs.
For additional information on opioid overdose prevention and education:
- Access the SAMHSA Opioid Overdose Toolkit
- Access StopOverdose for additional information specific to treatment providers including talking about overdose, overdose prevention, naloxone, and treatment
- Review the Opioid Overdose Basics including recognizing an opioid overdose, responding to an opioid overdose, and risks and prevention strategies
- Access patient education and training materials here
- Access the Healthcare Professional Toolbox for additional information on understanding overdose and addition, professional development, and patient education resources
For Buprenorphine Waiver- Medication-Assisted Treatment Trainings offered throughout the state of Missouri, visit here.
For clinical support (provided by the American Academy of Addiction Psychiatry in collaboration with others with support from SAMHSA) and training related to opioid use disorder, visit the Provider’s Clinical Support System
For free Continuing Medical Education courses funded by the Substance Abuse and Mental Health Services Administration (SAMHSA), visit here
*For additional information see our Resources Page or access the following links for resources for Overdose Prevention and Harm Reduction, Opioid Use Disorder Treatment, Research and Data, and Legislation and Advocacy.