FAQ: Utilizing Naloxone

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The California School-Based Health Alliance (CSHA) recommends all school-based health centers and wellness centers (SBHC/WCs) have naloxone available and staff be trained to use it.

What are naloxone and Narcan?

  • According to the Department of Health Care Service (DHCS), naloxone is a life-saving medication that reverses an opioid overdose in just a few minutes with little risk. It is the generic form of Narcan, a branded formulation which is available for purchase over the counter in most pharmacies and for free from the California DHCS’ Naloxone Distribution Project.
  • Naloxone displaces opioids from the brain’s receptors, ceasing the depressive effects of an opiate and allowing the respiratory system to resume regular functions.

Why should I have naloxone?

  • Among persons aged 14–18 years, overdose deaths increased 94% from 2019 to 2020 and 20% from 2020 to 2021.¹ Youth in California die of overdose more often than the national average.²
  • Because of the high levels of fentanyl contamination in the non-regulated drug supply, even youth who do not regularly experiment with substances can experience an overdose.
  • In the same way that schools have an AED to respond to cardiac emergencies, they can now have naloxone to respond to overdose emergencies.

Is naloxone safe? Is it safe for young people?

  • Yes, it is safe. Unless someone is experiencing an opioid overdose, administering naloxone will have no effect.
  • Per the CDC, naloxone is safe for people of all ages, including infants.³

Who is allowed to administer naloxone?

  • Everyone is legally allowed to administer naloxone. You do not need any special certifications or educational background.
  • California’s Good Samaritan law protects people who administer naloxone from any legal liability. This law has two parts; the first protects bystanders who respond to medical emergencies from criminal and civil liabilities, the second protects individuals both experiencing and responding to opioid overdoses from prosecution for drug use or possession.⁴

Do I need parent/guardian consent to administer naloxone?

  • In California, there is no statute requiring minors to have parent/guardian consent prior to receiving naloxone.

When do I give naloxone?

  • If you suspect an overdose, first check the person’s breathing and try to wake them. If they are not breathing normally and do not respond to yelling and shaking, take your fist and roll your knuckles hard into their sternum in the center of their chest. If that does not rouse them it is likely they are overdosing.
  • When you have tried the steps above OR if their skin has a blue (light complexions) or gray (dark complexions) undertone, immediately administer naloxone.
  • The longer a person is unconscious, the more likely they are to have brain damage or die. Do not wait for emergency workers to arrive; act quickly and administer naloxone.

How do I use naloxone?

  • CSHA has provided you with the nasal spray formulation of naloxone (Narcan), which is used exactly like Flonase and other common allergy medications.
  • Use the QR code below to access a training video that will show you the detailed steps of responding to an overdose with nasal naloxone. We recommend refreshing your knowledge on this process every six months to keep you prepared.

What happens after I give naloxone?

  • Being revived from an overdose with naloxone can be an uncomfortable and disorienting experience. Since all the brain’s receptors are freed at once, the individual goes from being very intoxicated to immediate intense withdrawal. When they regain consciousness they are often disoriented and do not know where they are or what has happened. Vomiting, aggression, and panic attacks are all common reactions to being revived from an overdose.
  • When you revive someone, be prepared to reassure them that they are safe, let them know what happened, and reassure them that you are going to stay until help arrives.
  • Ultimately, overdoses are life and death situations. Temporary discomfort from revival should not dissuade individuals from using naloxone, but knowledge of the effects will help you provide better care.

How should I store Narcan?

  • Narcan should be stored in an easily accessible unlocked location, at room temperature. Keep Narcan out of direct sunlight and avoid freezing as these will decrease its effectiveness.

My Narcan is about to expire. Is it still good? What should I do?

  • Expired Narcan is still effective⁵ and a valuable resource to community organizations, so please do not throw it away.