Opioid overdose is a significant problem across the country including New York State. Widespread misuse of prescription opioids and heroin continues to be a serious problem. One tool in preventing opioid overdose morbidity and mortality is increasing access to naloxone.
Naloxone (Narcan) is a prescription medicine that reverses an overdose by blocking heroin or other opioids in the nervous system for 30 to 90 minutes. Naloxone is administered by injection or intranasally. It is successfully prescribed and distributed to opioid users, their families and friends in at least 19 states. Thousands of individuals participating in these programs have safely and successfully reversed overdoses. As of the end of 2010 over 50,000 people in the United States had received naloxone kits and over 10,000 overdose reversals had been reported.
A new life-saving law took effect in 2006, making it legal in New York State for non-medical persons to administer naloxone to another individual to prevent an opioid/heroin overdose from becoming fatal. The New York State Department of Health (NYSDOH) registers eligible agencies and providers to operate an Opioid Overdose Prevention Program and provides the required supplies for free. These programs train individuals how to respond to suspected overdoses including the administration of naloxone, which is provided free as part of the training.
- Registration with the NYSDOH authorizes physicians, Nurse Practitioners and Physician
Assistants to prescribe naloxone to people at risk of witnessing an overdose and authorizes an agency (or individual clinician) to order free intramuscular naloxone kits from the NYSDOH.
- Each opioid overdose program must have a program director and a clinical director who are responsible for complying with the program requirements and insuring the quality of the training performed by the agency. The clinical director must be an MD, PA, or NP. Agencies that do not have medical providers on staff may hire someone for this function for a limited number of hours.
- Sample policy and procedures are available to simplify integration into an agencies existing policy and procedures.
- Any competent staff member or volunteer can do the training on overdose prevention and response; the prescribing clinician need not be present. Train the Trainer sessions are available as is an educational curriculum.
- Naloxone is a prescription medication, thus governed by NYS prescribing regulations. The prescribing clinician must have a face to face encounter with each recipient, provide a prescription (serving as a label) and a record of the recipients identifying information as well as a note that the recipient has been trained. This can be done in less than a minute. Prescription medications may only be dispensed by a licensed prescriber, nurse or pharmacist.
- Agencies in New York City may register with the New York City Department of Health and Mental Hygiene in order to be eligible to order free intranasal naloxone kits.
Implementation varies among agencies according to their needs and settings (syringe access programs, drug treatment programs, primary care, in-patient hospital units, etc.). Trainings can be tailored to individuals, groups, or classrooms, and may vary in length from 10 - 50 minutes. A 12 minute DVD can be used supplemented by hands on demonstration.
The Harm Reduction Coalition works under contract with the NYSDOH to provide assistance in implementing opioid overdose prevention programs. We can help by training staff, discussing the application for NYSDOH registration, and helping to determine training needs of staff and clients.
Contact the Harm Reduction Coalition: for more information and assistance in establishing an overdose prevention program:
Sharon Stancliff, MD: Stancliff@harmreduction.org
(212) 213-6376 ext 39
Bill Matthews, RPA-C: Matthews@harmreduction.org
(212) 213-6376 ext 38
Overdose prevention resources
Harm Reduction Coalition
Many resources under “Overdose”
New York State Department of Health
Includes sample curriculum, policy & procedures, a list of registered agencies
New York City Department of Health and Mental Hygiene
The NYCDOH&MH training video is easily seen here: