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Opioid Overdose Rescue with Naloxone Auto-Injector

Medicine instructions

Close-up view of hands holding naloxone auto-injector.

  • Keep two auto-injectors with you at all times.

  • Store auto-injectors at room temperature, away from light.

  • Keep auto-injectors out of the heat or cold--for example, do not store in your car--otherwise naloxone will lose its effectiveness.

  • If you use an auto-injector or your auto-injectors expire, contact your provider as soon as possible for a replacement.

  • Contact your pharmacy about the proper disposal of your auto-injectors.

  • Be sure to properly dispose of used auto-injectors; they cannot be reused.

Step 1 Check for a response.

Give person a light shake, say person’s name, firmly rub person’s sternum (bone in center of chest where ribs connect) with knuckles, hand in a fist.

Image of a man lying on his back with a fist rubbing his sternum.

If person does not respond (i.e. wake up and stay awake) give naloxone and call 911.

Step 2 Give naloxone--Call 911.

  • Pull auto-injector from case and follow voice instructions (see page 8 for detailed instructions).

  • When calling 911, give the address and say the person is not breathing.

How to give naloxone

  1. Pull the auto-injector from the outer case.

  2. When you are ready to use the auto-injector, pull firmly to remove the red safety guard (do not touch the black base).

  3. Place the black end against the middle of the outer thigh, through clothing if necessary.

  4. Press firmly and hold in place for 5 seconds.

Step 3 Airway open.

Make sure nothing is in the person’s mouth.

  • If overdose is witnessed (for example, you see the person stop breathing) ...

Rescue breathing

Woman giving an unconscious man rescue breaths.

  1. Place face shield (optional).

  2. Tilt head back, lift chin, pinch nose.

  3. Give 1 breath every 5 seconds.

  4. Chest should rise.

  • If collapse is unwitnessed (for example, you find someone not breathing)

Chest compressions

Man giving unconscious person chest compressions.

  1. Place heel of one hand over center of person’s chest (between nipples).

  2. Place other hand on top of first hand, keeping elbows straight with shoulders directly above hands.

  3. Use body weight to push straight down, at least 2 inches, at rate of 100 compressions per minute.

  4. Place face shield (optional).

  5. Give 2 breaths for every 30 compressions.

Step 4 Consider naloxone again.

Two situations in which to consider naloxone again:

  • If person doesn’t start breathing in 2-3 minutes give second dose of naloxone.

  • If person starts breathing after first dose, because naloxone wears off in 30 to 90 minutes, a second dose may be needed if person stops breathing again.

    • Be sure to stay with person until emergency medical staff take over or for at least 90 minutes to make sure person doesn’t stop breathing again.

Step 5 Recovery position.

If the person is breathing but unresponsive, put the person on his/her side to prevent choking if person vomits.

Person moving unconscious man’s arm into a bent position over the shoulder.

Person moving unconscious man’s knee and shoulder to position him on his side.

Image of unconscious man lying on his side.

How to use naloxone auto-injector* 

1. Pull the auto-injector from the outer case.

Close-up view of hands holding naloxone auto-injector.

2. Pull firmly to remove the red safety guard (do not touch the black base).

Illustration of one hand holding the auto injector and the other removing the red safety guard.

3. Place the black end against the middle of the outer thigh, through clothing if necessary, then press firmly and hold in place for 5 seconds.

 Illustration of hand delivering medicine to person's outer thigh.

4. If no reaction in 2-3 minutes or if the person stops breathing again, give the second dose of naloxone using new auto-injector.

Illustration of a stopwatch showing 5 seconds has passed.

*This guide is not meant to replace the auto-injector instructions. Please review the instructions included with your auto-injector.


Consider seeking long-term help at your local VA substance use disorder treatment program:

  • Local Emergency Services: 911

  • National Poison Hotline: 1-800-222-1222

  • Veterans Crisis Line: 1-800-273-TALK (8255) or text - 838255

Author: StayWell Custom Communications
Last Annual Review Date: 2/1/2017
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