Naloxone Leave Behind

Scientific Rationale

  • Naloxone rapidly reverses an opioid overdose if given in time.
  • Overdose survivors face an increased risk of fatal overdose in the future.
  • Public Safety personnel may be the first on the scene at an overdose. Ensuring they have access to and training on how to administer and leave-behind naloxone are opportunities to reverse potential future overdoses.

Innovative Strategy

  • Naloxone leave-behind programs go beyond naloxone administration and involve public safety personnel, usually EMS, distributing naloxone to individuals who have experienced an overdose (and/or their social networks) at the scene of a non-fatal overdose.

Potential Benefits to Community

  • Leave-behind naloxone is an opportunity to provide additional naloxone after an overdose to the individual and/or to their social network.
  • If desired by the individual, leave-behind naloxone can offer opportunities to provide additional connections to treatment and harm reduction services to provide information about resources, such as local treatment providers or harm reduction organizations.
  • Leave-behind programs can complement and widen the scope for existing, statewide OEND programs.

Estimated Time from Planning to Implementation

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2-6 months
  • Could be sooner depending on naloxone availability and training for public safety
  • Adding documentation of the leave behind naloxone to the patient care record could take additional time

Operational Considerations

  • Strong relationship with local public safety agencies, and Harm Reduction and/or state OEND programs to source naloxone and provide additional connections to the continuum of care
  • Ensure staff members remember to distribute naloxone during opioid-related calls (e.g. adding a check box reminder to a report)
  • Ensure there is a process to track and report data on the number of kits distributed

Estimated Cost to Implement

  • Price for naloxone will vary.

Publications

  • Scharf BM, Sabat DJ, Brothers JM, Margolis AM, Levy MJ. Best Practices for a Novel EMS–Based Naloxone Leave behind Program. Prehosp Emerg Care. 2021;25(3):418-426. doi:10.1080/10903127.2020.1771490
  • Davis CS, Southwell JK, Niehaus VR, Walley AY, Dailey MW. Emergency medical services naloxone access: a national systematic legal review. Acad Emerg Med. 2014 Oct;21(10):1173-7. doi: 10.1111/acem.12485. PMID: 25308142.

Available Training and Technical Assistance (TTA)

  • Get Naloxone Now – Website with links and resources related to drug use, treatment, and how to get naloxone and training for bystanders and first responders.
  • NEXT Naloxone (naloxoneforall.org) – An online training site for responding to opioid overdoses and include naloxone distribution via mail services. Operates in certain states (refer to website which states are included.)
  • Prevent & Protect – Provides free resources on opioid safety and opioid overdose prevention, for community members, community based organizations, and health departments. Adding documentation of the leave behind naloxone to the patient care record could take additional time