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this post was submitted on 11 Mar 2025
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You Should Know
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You should also know that one dose often isn't enough, and they may re-overdose when it wears off, so at the very least stay with them until emergency services show up. Also, there is a moderate chance they will be violent when you resuscitate them, so be weary. Do not get on your knees for example, keep at least one foot planted so that you can rapidly extricate yourself if they come up angry.
I recommend watching Juno's entire playlist on naloxone harm reduction. they're a harm reduction educator and substance user and they have more intimate knowledge than the sterile pamphlets that medical institutions put out.
people often get agitated because you're forcing them into acute opioid withdrawal by administering too much naloxone. the nasal type that most civilians have access to contains 4 mg vs the 0.4 mg intramuscular that EMS workers administer. this comes out to a 5 times higher dose than strictly necessary. source:
Based on a relative bioavailability of 50%, an initial 2 mg Naloxone Hydrochloride Nasal Spray dose would be considered equivalent to 1 mg IM dose and a 4 mg Naloxone Hydrochloride Nasal Spray dose would be equivalent to 2 mg IM dose, which corresponds with the maximum recommended initial dose in adult clinical guidelines.
I can't say there's an easy alternative but anyone who's able should contact harm reduction orgs to get trained in administering intramuscular naloxone. nasal works too, but be mindful that the person you're "helping" is gonna have probably the worst day of their life.
people should also be aware there's a lot of seemingly helpful information out there influenced by copaganda warning civilians that substance users are dangerous/violent and to stay away/call the cops. this is a fucked up way to do harm reduction and really dehumanizing to substance users.
edit: replaced precipitated withdrawal with acute opioid withdrawal.
Great advice, the site covers this.
Just to note that injections bring their own risks and require additional training.
Nasal Nalaxone doses are much higher to make them easier to administer and to ensure the Nalxone can make it though the mucus membrane.
If you give Nalaxone / Narcan to an experienced opioid user (someone with chemical dependency) Be ready to run as they could come out of it VERY mad. They are going to miserable, sick and until the Nalaxone is gone not going to be able to relieve their symptoms.
I would argue just like Juno did that the naloxone dose being too high has nothing to do with ease of administration as that's already ensured by the spray being so easy to use. it looks more like severe negligence and ableism from the pharma companies to me.
as far as I understand, accounting for the nasal route only having 50% bioavailability, shouldn't a nasal spray have a maximum of 0.8 mg of naloxone? Juno said that there are people working on putting lower doses on the market for general distribution.
they also mention that it's possible to stop the overdose without ruining someone's high but that probably requires more educated training than most harm reduction resources offer. sounds to me like people are shifting blame from themselves forcing someone into withdrawal to the substance user being "violent" (this is extremely rare and mostly a rumor started by copaganda and ableist healthcare workers).
Is it handy to have some even if you're not a user and aren't regularly around users? What else does the course cover? I took a brief look on the website and couldn't find an FAQ or something like that.
Yes. At least keep some in your home where you know where it is. You never know when grandma might forget that she's already taken her pain meds, or a kid drinks too much of the wrong cough syrup, or (and I mean this in the least judgemental way possible) a friend hides their habit from you. Or literally any of those things (or a million other possibilities) happens to your next door neighbor.
What you said.
No one in my house uses opiates, but you never know what may happen.
Free supplies make the "Should I just in case" a no-brainer
If you're Canadian, you can walk into most pharmacies and they will give you a kit for free and provide brief training on the spot.
I can't remember which website it was but you can also get it for free, delivered by mail in Ontario.
Avoid storing it in extreme heat or cold since it degrades the naloxone. But degraded "carcan" is better than none.
Another hail Canada moment. Hoping y’all don’t let the bully win this week. Someone has to stand up to him.
Damn, I feel sorry for calling you guys our hat all the time! (Thats awesome)
Apparently you can get Narcan from weed shops too. My father told me he scored some for free when he went a few days ago. I don't know why he got it, because he doesn't use opioids, but I guess it's good to have on hand in case someone else needs it.
Sometimes local festivals will have tents giving out OD kits too, worth keeping an eye out. That's how I've kept my house stocked haha
In Oakland, some bars have it and give it away. If you’re in a city that has a large unhoused population, it’s prudent to notice whether establishments in your area may do the same.
Straight from the west, Oakland is the best -- Too $hort
Word.
Even though I stopped taking opiates for pain management, I still keep a supply of naloxone. It's just too easy to keep around when it's so easy for people to OD.