BLOG: Naloxone: What It Is, How to Get It, and How to Use It
By: Sophie Stone, Deputy Press Secretary
May 17, 2016
On January 10, 2018, Governor Tom Wolf declared the opioid epidemic a statewide disaster. Under this declaration, emergency service providers are now able to leave naloxone behind after a 911 visit. Centralized Coordinating Entities (CCE) can contact the Pennsylvania Commission on Crime and Delinquency (PCCD) to obtain naloxone for first responders under their jurisdiction. For more information, visit PCCD’s website.
Updated with the paragraph above: February 15, 2018, 12:23 PM
In 2014, nearly 2,500 Pennsylvanians died from a drug overdose. Heroin and opioid overdose are the leading cause of accidental death in Pennsylvania, killing more individuals each year than motor vehicle accidents.
Governor Tom Wolf joined Pennsylvania Physician General Dr. Rachel Levine today at the Rite Aid Pharmacy in Lemoyne to remind Pennsylvania residents and pharmacists that a doctor’s prescription is not needed to obtain the life-saving opioid overdose antidote drug naloxone — but many in Pennsylvania may still be unaware how they can access this life-saving medication.
Let’s take it from the top.
What is Naloxone?
Naloxone is a medication that can temporarily reverse an overdose that is caused by an opioid drug (prescription pain medication or heroin).
When given during an overdose, naloxone blocks the effects of opioids on the brain and restores breathing within two to eight minutes. Naloxone has been used safely by medical professionals for more than 40 years and has only one function: to reverse the effects of opioids on the brain and respiratory system in order to prevent death. Naloxone has no potential for abuse – a person can’t get high or become addicted to it – and it is safe to use. Naloxone does not work to reverse overdose from other types of substances.
How do I get it?
Anyone can access this medication by obtaining a prescription from their family doctor or by using the standing order — a prescription written for the general public, rather than specifically for an individual — issued by Rachel Levine, M.D., Pennsylvania Physician General. The standing order is kept on file at many pharmacies, or may be found here.
Naloxone prescriptions can be filled at most pharmacies, but you should call your pharmacy to make sure they stock it. Although the medication may not be available for same day pick up, it can often be ordered and available within a day or two. There is no limit to the number of fills that can be obtained for naloxone.
What are the different types of naloxone?
Two of the most common ways that naloxone is administered are intranasal (nasal spray) and the auto-injector. Please note, not all pharmacies stock both forms and insurance coverage may vary depending on the type of medication being purchased and each individual insurance plan. Check your insurance prescription formulary or call your benefits manager to determine if the medication is covered by your particular plan or if your purchase of the medication will be an out-of-pocket cost.
The only approved FDA naloxone nasal spray is supplied as a single 4 mg dose of naloxone hydrochloride in a 0.1 ml nasal spray device. The device requires no assembly, so no specialized training is required to administer the dose. Non-medically trained individuals can administer this device. Do not prime or test the device prior to administration as this is not necessary. The device only delivers a single nasal spray dose of naloxone hydrochloride.
The Auto-injector comes in a manufactured dosage form (similar to an epi-pen) and has a recorded message to talk you through giving the medication.
How do I pay for naloxone?
Insurance companies vary in how they cover naloxone and other drugs used to treat an opioid overdose. Prior to having a naloxone prescription filled with a pharmacy, consumers are encouraged to check with their insurance carriers to find out whether naloxone is a covered benefit under their policy, and, if so, what form of naloxone is covered, and any cost-sharing amounts that may apply under their policy.
If I’m a Medical Assistance Recipient, what do I need to know for accessing naloxone?
Fee-for-service and managed care organizations (MCOs) will pay for naloxone dispensed under the standing order for medical assistance recipients. Pennsylvania Medical Assistance will make the payment for naloxone for any eligible Medical Assistance recipient.
Per 55 Pa Code, Chapter 1121 – Pharmaceutical Services – §1121.52, pharmacists can treat the standing order as a verbal order for Medical Assistance recipients.
The Evzio Auto-Injector is covered by Medical Assistance, but requires prior authorization. Generic naloxone is covered without the need for prior authorization.
The Medical Assistance co-pay does not apply for the naloxone products.
How old do I need to be to purchase Naloxone?
The age of consent for alcohol and drug treatment in Pennsylvania is age 14. Thus that would be the age that someone could obtain the Naloxone. This is also subject to a pharmacy’s policies as well as insurance and billing issues.
How do I use it?
In addition to talking to your healthcare provider or the pharmacist about how to use naloxone, individuals giving this medication to someone should take online training ahead of time.
Training is available at one of the Department of Health approved training sites: Get Naloxone Now or PA Virtual Training Network. These easy to understand, brief trainings explain how to recognize the signs and symptoms of an opioid overdose, what to do in the event of an overdose, and instruct on how to give naloxone.
While it is not necessary to obtain a training certificate in order to purchase naloxone, learning these important details will help you respond properly in the event of an overdose and also meet the immunity requirements of PA Act 139.
In addition, it may be helpful to review the First Responder Toolkit for more details about how to use naloxone if you are the first to respond at an overdose emergency.
Will I get in trouble for using naloxone?
Through the ‘Good Samaritan’ provision of Act 139, friends, loved ones and bystanders are encouraged to call 911 for emergency medical services in the event an overdose is witnessed and to stay with the individual until help arrives. The provision offers certain criminal and civil protections to the caller so that they cannot get in trouble for being present, witnessing, and reporting an overdose.
Physicians are permitted to write third party prescriptions for naloxone for family members of addicts. You are immune from liability for giving naloxone if you believed the person was suffering from an opioid overdose (heroin or prescription pain medication) and you called for medical help/911 after giving the medication.
What do I do if I am a first responder at the scene of an overdose?
What are the Do’s and Don’ts in responding to an opioid overdose?
DO support the person’s breathing by administering oxygen or performing rescue breathing.
DO administer naloxone.
DO put the person in the “recovery position” on their side, if he or she is breathing independently.
DO stay with the person and keep him/ her warm.
DON’T slap or try to forcefully stimulate the person — it will only cause further injury. If you are unable to wake the person by shouting, rubbing your knuckles on the sternum (center of the chest or rib cage), or light pinching, he or she may be unconscious.
DON’T put the person into a cold bath or shower. This increases the risk of falling, drowning or going into shock.
DON’T inject the person with any substance (salt water, milk, “speed,” heroin, etc.). The only safe and appropriate treatment is naloxone.
DON’T try to make the person vomit drugs that he or she may have swallowed. Choking or inhaling vomit into the lungs can cause a fatal injury.
Where can I get trained to administer naloxone?
For EMS agencies licensed through the Department of Health, and for certified EMS providers, training will be provided through the Department of Health’s Learning Management System.
For law enforcement, fire departments, and other persons not currently licensed by the Department of Health:
- For training of law enforcement officers by law enforcement officers: The PA Virtual Training Network training on naloxone can aid every law enforcement agency and professional in the Commonwealth of Pennsylvania. In order to access PAVTN.net, you must be registered as a member of the site. Typically, officers are registered by their departments to complete courses.
- For friends, family, and all other non-licensed, non-certified fire or EMS agencies and providers: visit GetNaloxoneNow.org or PAVTN – Other First Responders and General Public.
- For Chester County Law Enforcement only: Visit Good Fellowship Ambulance and EMS Training Institute.
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