Overdose Prevention & Reversal

Opioid related overdose deaths have continued to increase following the introduction of fentanyl into the national drug supply and the increased isolation that resulted from the COVID-19 pandemic. Evidence-based and research-informed prevention activities have been found to be effective in overdose prevention by increasing accessibility to treatment services, improving the navigation of systems of care, engagement in early intervention, and practicing harm reduction strategies. 

Websites

Good Samaritan Law

The Good Samaritan Drug Overdose Act of 2015 prevents punitive actions against health professionals and any person who administers naloxone or calls 911 to assist someone who may be overdosing on opiates. It also provides immunity to persons seeking medical treatment for an opioid overdose for themselves or someone else.

Stop Overdose

To address the increasing number of overdose deaths related to both prescription opioids and illicit drugs, the Centers for Disease Control and Prevention (CDC) created a website to educate people who use drugs about the dangers of illicitly manufactured fentanyl, the risks and consequences of mixing drugs, the lifesaving power of naloxone, and the importance of reducing stigma around recovery and treatment options.

Tools & Resources

International Overdose Awareness Day spreads the message about the tragedy of drug overdose death and that drug overdose is preventable.

A guide from the American Psychological Society with information for practicing psychologists on opioids, their use, and effective treatments.

This comprehensive guide provides information and recommendations regarding general health, safer use practices, common viral, fungal, parasitic, and other injection-related infections, overdose and overamp, tapering, withdrawal, medications for opioid use disorder, and seeking medical care.

Peer support services (PSS) are a valuable component of a growing number of overdose response and linkage to care initiatives that can be implemented and supported by local and state health departments. This toolkit is for local and state health departments and community partners who are exploring opportunities to implement or enhance PSS within overdose response and linkage to care initiatives. This toolkit provides information, resources, tools, actionable steps and real-world examples informed by the latest research, subject matter experts and experiences from diverse settings across the country.

To help public health practitioners prevent overdose, the National Council for Mental Wellbeing, in partnership with the Centers for Disease Control and Prevention, developed these resources and tools for overdose prevention.

Toll-free national overdose prevention, detection, life-saving crisis response and medical intervention services for people who use drugs while alone. Never Use Alone’s peer operators are available 24-hours a day, 7 days a week, 365 days a year.

Guides to opioid safety and how to use overdose reversal medications.

This guide was developed in recognition of the need to center community engagement throughout the efforts to address the opioid overdose crisis. This guide exists to help communities decrease opioid overdose deaths; it includes tools and real-world examples that can be used to build and strengthen community coalitions that work to reduce opioid overdose deaths.

Naloxone Distribution in Nevada guidelines and best practices for community based organizations.

A Nevada provider’s guide to prescribing Naloxone to patients who use opioids.

This guide was drawn from HEALing Communities Study (HCS) learnings to-date and expert insights to provide guidance regarding implementation of ORCCA menu strategies.

This toolkit provides guidance to a wide range of individuals on preventing and responding to an overdose. The toolkit also emphasizes that harm reduction and access to treatment are essential aspects of overdose prevention.

Publications

This document provides information on xylazine, a non-opioid veterinary tranquilizer used as an additive in illicit drug supplies, notably in combination with heroin and fentanyl. It discusses the effects of xylazine use, including sedation and potential risks such as hypotension and bradycardia. The document also emphasizes harm reduction interventions for individuals who may encounter xylazine in the drug supply, including the use of naloxone for responding to overdoses and the importance of wound identification and treatment.

There are strategies that can assist community leaders, local and regional organizers, non-profit groups, law enforcement, public health, and members of the public in understanding and navigating effective ways to prevent opioid overdose in their communities. Use this information as a reference for evidence-based practices that have been successfully implemented in the U.S.

Fueled by drugs like heroin, fentanyl and the misuse of prescription pain pills, the opioid epidemic in our country has impacted countless families. To help address this, the Partnership for Drug-Free Kids created a new eBook — Heroin, Fentanyl & Other Opioids: A Comprehensive Resource for Families with a Teen or Young Adult Struggling with Opioid Use. Parents and families need to be prepared with the knowledge and skills to identify opioids, spot early use and take action effectively.

Posters & Infographics

Be Prepared – (Poster)

This poster illustrates being prepared for an overdose emergency by having an opioid overdose reversal medication on-hand, just like people commonly have a fire extinguisher on-hand for a fire emergency. 
Download or request hard copies
Opioid Trifold Brochures

Opioid Trifold Brochures

Opioid Information Brochures for Providers or Consumers help educate on opioids and opioid use, including effects of opioid use, pregnancy and opioid use, medications for opioid use including opioid overdose reversal medications, and treatment options for persons using opioids.
Download or request free hard copies
Medications for opioid overdose, withdrawal, and addiction Medications for opioid overdose, withdrawal, and addiction are safe, effective, and save lives. The National Institute on Drug Abuse supports research to develop new medicines and delivery systems to treat opioid use disorder and other substance use disorders, as well as other complications of substance use (including withdrawal and overdose), to help people choose treatments that are right for them. Medications approved by the U.S. Food and Drug Administration for opioid addiction, overdose, and withdrawal work in various ways. Opioid Receptor Agonist: Medications attach to and activate opioid receptors in the brain to block withdrawal symptoms and cravings. Opioid Receptor Partial Agonist: Medications attach to and partially activate opioid receptors in the brain to ease withdrawal symptoms and cravings. Opioid Receptor Antagonist: Medications attach to and block activity of opioid receptors in the brain. Antagonist medications that treat substance use disorders do so by preventing euphoric effects (the high) of opioids and alcohol and by reducing cravings. Antagonist medications used to treat opioid overdoses do so by reversing dangerous drug effects like slowing or stopping breathing. Adrenergic Receptor Agonist: A medication that attaches to and activates adrenergic receptors in the brain and helps alleviate withdrawal symptoms. Four cards show medications prescribed to reduce opioid use and cravings. Methadone is available in daily liquid or tablets. Naltrexone is available in a monthly injection. Buprenorphine available in daily tablet and weekly or monthly injection. Buprenorphine/naloxone is available in daily film that dissolves under the tongue or tablet. One card shows medication prescribed to treat withdrawal symptoms. Lofexidine is available as a tablet taken as needed. Two cards show medication used to reverse overdose. Naloxone is available as an emergency nasal spray or injection. Nalmefene is available as an emergency nasal spray or injection.

Medications for Opioid Use Disorder (MOUD) Infographic 

This infographic shows different types of medications approved by the U.S. Food and Drug Administration for opioid overdose, withdrawal, and addiction.
Download the infographic

Webinars & Online Learning

The Compassionate Overdose Response Summit and Naloxone Dosing Meeting, held on March 18-19, 2024, was a two-day summit where naloxone experts built consensus on the definition of a compassionate bystander overdose response.

This short animation from SAMHSA depicts how Naloxone, an opioid overdose-reversal medication, works in the body.

Test your knowledge on what causes drug overdoses and how to save a life using naloxone.

In this recorded webinar, panelists provide a brief overview of Xylazine, a substance newly found in illicit drug supplies, and its impacts on the unsheltered community. Panelists will share their lived expertise with xylazine, its effects, organizational best practices for wound care, overdose response, and harm reduction. 

Current News & Research

The Mobile Emergency Recovery Intervention Trial (MERIT)

The Mobile Emergency Recovery Intervention Trial (MERIT) is a grant-funded research study that is evaluating the effectiveness and long-term outcomes of an ER-based intervention for opioid overdose patients treated in Nevada’s Emergency Departments (EDs). The research is currently ongoing.

Published Papers:
  1. Wagner, K.D., Oman, R.F., Smith, K.P., Harding, R., Dawkins, A.D., Lu, M., §Woodard, S., Berry, M.N., Roget, N.A. (2019). “Another tool for the tool box? I’ll take it!”: Feasibility and acceptability of mobile recovery outreach teams (MROT) for opioid overdose patients in the emergency room. Journal of Substance Abuse Treatment. 108:95-103 https://doi.org/10.1016/j.jsat.2019.04.011
  2. McGuire, A., Ray, B., Watson, D., Carter, J., Wagner, K., Powell, K., Smith, K., Robinson, L., Cooperman, N., Treitler, P. (2019) Emergency department-based peer support for opioid use disorders: Emergent functions and forms. Journal of Substance Abuse Treatment. 108:82-87  https://doi.org/10.1016/j.jsat.2019.06.013
  3. Wagner, K.D., *Mittal, M.L., Harding, R.W., Smith, K.P., Dawkins, A., Wei, X., §Woodard, S., Roget, N.A., Oman, R.F. (2020) “It’s gonna be a lifeline”: Findings from focus group research to investigate what people who use opioids want from peer-based post-overdose interventions in the emergency department. Annals of Emergency Medicine. 76(6): 717-727 https://doi.org/10.1016/j.annemergmed.2020.06.003
  4. Smith, K.P., Oman, R.F., Lu, M., Dawkins, A.D., Harding, R.W., Hepworth, K., Wagner, K.D. (2021). The Mobile Emergency Recovery Intervention Trial (MERIT): Protocol for a 3-Year Mixed Methods Observational Study of Mobile Recovery Outreach Teams in Nevada’s Emergency Departments. Plos ONE. 16(10): e0258795. https://doi.org/10.1371/journal.pone.0258795
  5. *Kirk, M.R., Dawkins, A.D., Wei, X., *Ajumobi, O., §Lee, L.C., Oman, R., §Woodard, S., Wagner, K.D. (2023) What makes a peer? Characteristics of certified peer recovery support specialists in an emergency department-based intervention. PlosOne (Accepted July 31, 2023, e-pub December 7, 2023). https://doi.org/10.1371/journal.pone.0289920