Opioid overdose and naloxone awareness

Pharmacy teams may encounter opioid overdose in community settings, particularly where supervised consumption, substance misuse services, homelessness outreach, or take-home naloxone supply operate. Overdose can also occur in people prescribed opioids, especially when combined with alcohol, benzodiazepines, gabapentinoids, or illicit drugs.

When to suspect opioid overdose

Resuscitation Council UK first-aid guidance advises suspecting opiate or opioid poisoning if:

• the person is breathing slowly
• breathing is irregular or absent
• the person is extremely drowsy or unresponsive
• the pupils are very small

Immediate response

• Call 999: state you suspect an opioid overdose.
• If the person is unresponsive and not breathing normally: start CPR.
• Give naloxone if you are trained and it is available: follow the product instructions and your local protocol.
• Reassess using ABCDE: the person may improve only temporarily.
• Observe until the ambulance arrives: do not let the person wander off if they wake.

Naloxone can temporarily reverse opioid-related respiratory depression but does not remove the need for ambulance care. Some opioids outlast naloxone and breathing can deteriorate again after an initial response.

A pharmacy service note on take-home naloxone

In suspected opioid overdose the immediate life threat is slow or absent breathing. Call 999, start CPR if needed, give naloxone if trained, and keep watching the person until ambulance crew take over.