How to Use a Naloxone Kit — And Why You Should Carry One

Naloxone reverses an opioid overdose in minutes. Kits are free in British Columbia, need no prescription, and the training takes ten minutes. Here is how to recognise an overdose and what to do.

British Columbia has been in a declared public health emergency over the toxic drug supply since 2016. The supply is unpredictable enough that an overdose can happen to someone who has used the same amount, from the same source, for years. Naloxone is the thing that buys time.

Who should carry a kit

Anyone who might be near someone experiencing an overdose. That includes people who use opioids, but it also includes partners, parents, siblings, friends, coworkers, landlords, and people who work anywhere the public goes. Most kits that save a life are carried by somebody else.

You do not have to explain why you want one. You do not need a prescription or a health card, and you do not need to be a patient at the pharmacy you get it from.

Recognising an overdose

The signs to look for:

• ✓Breathing that is very slow, shallow, or has stopped — this is the one that kills
• ✓Unresponsive — will not wake to shouting or a hard sternal rub
• ✓Lips or fingertips turning blue or grey
• ✓Pinpoint pupils
• ✓Snoring, gurgling or choking sounds — this is not sleep
• ✓Limp body, clammy skin

If you are unsure whether it is an overdose, treat it as one. Naloxone does nothing at all if opioids are not involved, so giving it when you are not certain causes no harm.

What to do

1. 1Try to wake them. Shout their name, rub your knuckles firmly on their breastbone.
2. 2Call 911. Say the person is not breathing. Do this early — naloxone buys time, it does not replace paramedics.
3. 3Give naloxone. Nasal spray: nozzle into one nostril, press the plunger firmly. Injectable: into the muscle of the outer thigh or upper arm, through clothing if needed.
4. 4Give rescue breaths if you are able, one every five seconds. Breathing is what has stopped, so this matters more than chest compressions in an opioid overdose.
5. 5Wait two to three minutes. If there is no response, give a second dose. Kits contain more than one for this reason.
6. 6Stay with them. Put them in the recovery position — on their side, top knee forward — so they cannot choke if they vomit.

Will you get in trouble for calling 911?

The Good Samaritan Drug Overdose Act gives legal protection from charges for simple drug possession — and from breach of conditions related to simple possession — to anyone who calls 911 at an overdose, and to everyone else at the scene, including the person who overdosed.

Fear of police is one of the main reasons people delay calling, and delay is what turns a survivable overdose into a fatal one. Call.

After naloxone works

Naloxone wears off in roughly 30 to 90 minutes. The opioids in the person's system may last considerably longer, which means they can go back into overdose after appearing to recover. Do not leave them alone, and do not let them refuse an ambulance lightly.

The person may also wake up in sudden, unpleasant withdrawal — sometimes frightened, sometimes angry. That is the naloxone doing exactly what it should. Stay calm and explain what happened.

Keeping your kit useful

• ✓Carry it. A kit in a kitchen drawer helps nobody. Bag, glovebox, jacket pocket.
• ✓Check the expiry once a year. Bring it in when it is close and it will be replaced free.
• ✓Replace it after use, free, no questions and no explanation required.
• ✓Show someone else how it works. The person who needs to use it is rarely the person who expected to.

Getting one

Walk into Argyle Pharmacy any day we are open and ask at the counter. Nasal or injectable, free, with about ten minutes of hands-on training. Bring whoever else in your household should know how to use it.

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