Naloxone Training and Distribution Programs

Drug overdose and poisoning are leading causes of injury-related death in the U.S., largely driven by opioid overdoses. To combat this, widespread use of naloxone has become a critical strategy. Naloxone is an emergency medication that can rapidly reverse the effects of opioid overdoses. Naloxone can be administered by trained individuals, including healthcare providers, first responders, and laypeople. Studies have shown that naloxone distribution and education programs can reduce opioid overdose death rates in communities.

In response to the opioid epidemic, the U.S. Department of Health and Human Services, in collaboration with the Federal Office of Rural Health Policy, launched the Rural Opioid Overdose Reversal (ROOR) Program in 2015. Through this initiative, 18 grant recipients in 13 states were awarded $100,000 over a one-year period to purchase and distribute naloxone kits in rural areas, which were used to reverse opioid overdoses.

Experts recommend using Good Samaritan drug overdose laws as a way to reduce overdose deaths. These laws can support naloxone expansion programs by offering immunity from criminal prosecution for prescribing naloxone, seeking emergency assistance during an overdose, or administering naloxone. All 50 states and the District of Columbia have enacted legislation to expand access to naloxone for community members.

Examples of Rural Naloxone Expansion Programs

Project DAWN: Deaths Avoided With Naloxone is a community-based overdose education and naloxone distribution program from Ohio that provides participants with education about overdose and training on how to administer naloxone.

Considerations for Implementation

Rural programs that implement naloxone distribution initiatives frequently highlight the importance of establishing contracts and memoranda of understanding with key community partners. These partners include pharmacists, primary care providers, law enforcement, and hospitals.

Community involvement is also important for the success of naloxone initiatives. Programs report that engaging the community early helps address attitudes, perceptions, and stigma surrounding opioid use disorders. Involving the community during program development has helped rural initiatives have greater success in tailoring solutions to local needs and overcoming implementation barriers.

For programs that involve laypersons in naloxone administration, training and access is essential. Proper training is needed for laypeople to recognize the signs of opioid overdose and to safely and correctly administer naloxone. Most states have passed laws that facilitate layperson access to and use of naloxone in emergency situations. Additionally, the Food and Drug Administration's approval of a nasal spray version of naloxone, alongside the injectable form, has increased its accessibility. The nasal spray is often preferred by non-medical personnel, including law enforcement officers, who may be hesitant to administer injections.

Program Clearinghouse Examples

Resources to Learn More

Evidence-Based Guidelines for EMS Administration of Naloxone
Document
Describes evidence-based guidelines and a model protocol for emergency medical services (EMS) administration of naloxone to people with a suspected opioid overdose.
Author(s): Williams, K., Lang, E., Panchal, A., et al.
Citation: Prehospital Emergency Care, 23(6), 749-763
Date: 4/2019

Legal Interventions to Reduce Overdose Mortality: Naloxone Access Laws
Document
Summarizes the characteristics of naloxone access laws that have been enacted across states to reduce opioid overdose.
Author(s): Lieberman, A. & Davis, C.
Organization(s): The Network for Public Health Law
Date 10/2024

Opioid Overdose Reversal Medications (OORM)
Website
Provides information about opioid overdose and opioid overdose reversal medications like naloxone and nalmefene.
Organization(s): Substance Abuse and Mental Health Services Administration

SAMHSA Overdose Prevention and Response Toolkit
Document
Offers information about opioid use disorder and various strategies to help prevent opioid overdose. Offers resources for first responders, prescribers, and patients and families.
Organization(s): Substance Abuse and Mental Health Services Administration
Date: 2025