An opioid antidote is a medication designed to reverse the effects of an opioid overdose. It rapidly counteracts the life-threatening impact opioids have on the body. Timely administration can help restore breathing, preventing severe harm or death.
How Opioid Antidotes Work
Opioid antidotes, like naloxone, function as opioid receptor antagonists. They bind to opioid receptors in the brain, displacing opioids such as heroin, fentanyl, or oxycodone. Naloxone has a strong affinity for these receptors.
This displacement rapidly blocks the effects of opioids on the central nervous system. It quickly reverses respiratory depression—the dangerous slowing or stopping of breathing caused by an overdose. The medication acts swiftly, within two to three minutes after administration, to restore normal breathing. Naloxone only works if opioids are present in the person’s system and has no effect otherwise.
Recognizing an Opioid Overdose
Recognizing an opioid overdose is crucial for immediate assistance. Signs include severely slowed or stopped breathing, which can be shallow or irregular. Pupils may become extremely small, often described as pinpoint.
The individual might be unresponsive, unable to wake up even when shaken or shouted at. Other signs include choking, gurgling, or a snore-like noise, sometimes called a “death rattle.” The body can appear limp, and the skin may be pale, cold, and clammy. Lips and fingernails might turn blue or purple, while individuals with darker skin tones may show grayish or ashen discoloration.
Administering an Opioid Antidote
Administering an opioid antidote requires quick action. Immediately call emergency services, providing your exact location. Check for a response by shaking the person.
For a nasal spray, remove it from the box, peel back the tab, and hold it with your thumb on the plunger and fingers on either side of the nozzle. Tilt the person’s head back, support their neck, and gently insert the nozzle tip into one nostril until your fingers meet the bottom of the nose. Press the plunger firmly to deliver the entire dose without priming or testing the device. If there is no response within two to three minutes, or if breathing stops again, administer a second dose in the other nostril using a new device.
When using an auto-injector, remove the safety cap and immediately place the injector against the outer mid-thigh, pressing firmly and holding for five seconds. Once the dose is given, roll the person onto their side into the recovery position to prevent choking. Stay with the individual until emergency medical services arrive, continuing to monitor their breathing and providing rescue breaths if trained and necessary.
Accessing Opioid Antidotes
Opioid antidotes like naloxone have become increasingly accessible to the public. Naloxone nasal sprays are now approved for over-the-counter purchase without a prescription. They can be found at pharmacies nationwide.
Community-based opioid overdose prevention programs and local health departments also provide naloxone, sometimes free of charge or at a reduced cost. Many states have enacted Good Samaritan laws, which offer legal protections to individuals who administer naloxone or seek emergency medical help for someone experiencing an overdose. These laws aim to encourage people to intervene in overdose situations without fear of criminal prosecution for certain drug offenses.