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Post-Overdose Care in the

Emergency Department 

Naloxone – Provider Facing

Naloxone is an opioid antagonist reversing the respiratory depression that occurs during an opioid overdose.  Naloxone is safe, effective, and has no potential for abuse. In Michigan, it can be dispensed by a Pharmacy without a prescription.

The nonmedical use, abuse, and intoxication from prescription and illicit opioids are a frequent problem encountered in the emergency department. Recent studies have shown decreased mortality in communities with take home naloxone programs. As such, the emergency department provides a promising opportunity for opioid harm reduction measures through overdose education, substance abuse treatment referral, and take home naloxone (THN).

Sample Protocol

Take Home Naloxone (THN) for High-Risk Patients

  • Download this sample Take Home Naloxone (THN) protocol for high-risk patients and edit it for use in your emergency department.
  • This is a sample clinical protocol developed by a stakeholder committee and the University of Michigan Injury Prevention Center. Sites will need to evaluate whether this is appropriate for their ED and obtain proper committee approval before use.
  • See the MidMichigan Health protocol as an example of how adapt the sample protocol to work for your health system.
  • Michigan OPEN/MEDIC: Step by step guide for how to implement a Take Home Naloxone program in your ED

Overview of Take Home Naloxone for Opioid Overdose: A Harm Reduction Strategy

NIH Naloxone for Opioid Overdose: Life-Saving Science (PDF) or website

  • Learn about the life-saving science behind naloxone – how naloxone works, where it can be purchased, barriers and facilitators to prescribing naloxone and much more.

Preventing fatal opioid overdose among your patients

  • Access this two-page handout to learn more about overdose prevention messages, assessing risk, and naloxone options.

How to Prescribe Naloxone for Your Patients

 

Prescribe to Prevent

  • This website has the information prescribers need to start prescribing and dispensing naloxone, including patient education information for discharge.
  • Includes specific information for primary care clinic, emergency department, and substance use disorder providers.

Auto-injector

  • Use this sample prescription to prescribe a naloxone auto-injector.

Intramuscular injectable naloxone

  • Use this sample prescription to prescribe intramuscular injectable naloxone.

Intranasal Spray

  • Use this sample prescription to prescribe intranasal spray naloxone.

Harm Reduction Coalition: Overdose Prevention & Naloxone Manual

  • This manual outlines how to develop and manage an overdose prevention and education program, with or without a take-home naloxone component.

Naloxone Cost Comparison

  • Review the relative costs of different types of naloxone. Cost to the Consumer is based on their insurance’s prescription co-pay.

Understanding Naloxone Administration in the Field

 

AMA: How to use naloxone (video)

  • Watch this video from the American Medical Association for step-by-step instructions on administering the different forms on naloxone.

Opioid Safety and Naloxone –Take A.C.T.I.O.N. and Save a Life

Access this handout for instructions on administering intranasal spray, EVZIO auto-injector, and intramuscular naloxone.

Get Naloxone Now: Save a Life

  • This online resource trains people how to effectively respond to an opioid overdose emergency.

Take Action

  • Take Action offers print resources on naloxone for discharge and training materials for staff including videos.

How to Talk to Your Patients About Prescribing Naloxone

 

Introduction to naloxone for people taking prescribed opioids

  • This video demonstrates how to introduce the topic of naloxone to people taking prescribed opioids.

Introduction to naloxone for people with injection drug use or opioid use disorders

  • This video demonstrates how to introduce the topic of naloxone to people with opioid use disorders.

Locate Pharmacies Approved to Dispense Naloxone in Michigan

 

Find pharmacies in Michigan approved to dispense naloxone

  • Download an excel spreadsheet listing all pharmacies approved to dispense naloxone in Michigan including their address.

Michigan Department of Health & Human Services Interactive map

  • Access an interactive map showing pharmacies approved to dispense naloxone in Michigan.

Request free Narcan from NEXT Distro

  • Free mail-order Narcan is available to patients from NEXT Distro

Naloxone Access & Overdose Good Samaritan Laws

 

Naloxone access card

  • Bring this card to any state registered pharmacy to get naloxone.

Michigan Standing Order Information Packet-Naloxone Prescription for Opioid

  • Learn more about Michigan’s Standing Order to dispense naloxone

Drug Overdose Immunity and Good Samaritan Laws

  • Learn about access to naloxone and immunity, nation Good Samaritan Laws, diversion, treatment, and criminal penalties.

Legal Interventions to Reduce Overdose Mortality: Naloxone Access and Overdose Good Samaritan Laws

  • Access a detailed overview of characteristics of state naloxone access laws and state overdose Good Samaritan laws in the U.S.

Naloxone Distribution in the Emergency Department

 

Webinar: ACEP: E*QUAL: Emergency Quality Network. Opioid Initiative Wave I – Overdose Prevention & Naloxone Distribution

  • View this presentation for a comprehensive look at the research on ED-based naloxone distribution.