Naloxone and Opioid Overdose First Aid: How to Respond and Save a Life
An opioid overdose can happen to anyone — and a bystander who calls 911, starts CPR, and gives naloxone can be the difference between life and death.
If someone is unresponsive and not breathing normally after a suspected opioid overdose: (1) try to wake them and check breathing; (2) call 911 and start CPR without delay — chest compressions at 100–120/min plus rescue breaths; do not delay CPR to find naloxone (ILCOR/AHA/Canadian Red Cross); (3) give naloxone as soon as it won’t interrupt good CPR — nasal spray into one nostril, or an injection into the outer thigh; (4) keep going and give another dose per the package if there’s no response; (5) once they’re breathing on their own, put them in the recovery position and stay until paramedics arrive. Naloxone is harmless if opioids aren’t involved, so when in doubt, give it.
Opioid overdoses have become one of the most pressing public health emergencies in Canada, and they reach far beyond any one community. Overdoses happen to people who use street drugs, but also to people taking prescription painkillers, to teenagers experimenting, to seniors, and to people who have no idea a substance was contaminated with fentanyl. In other words, this is something any of us could witness — at home, at work, or in public.
The good news is that responding to an opioid overdose is a skill anyone can learn. With a free naloxone kit and a few first aid basics, an ordinary bystander can keep someone alive until paramedics arrive. This guide explains how to recognize an overdose, how to respond step by step, where to get a kit in Ontario, and how the law protects you for helping.
What Naloxone Is
Naloxone (also known by the brand name Narcan) is a safe, fast-acting medication that temporarily reverses the effects of an opioid overdose. It works by knocking opioids off the brain’s receptors, which can restore normal breathing within a few minutes. It comes in two common forms: a nasal spray and an injectable kit given into a muscle.
Two reassuring facts make naloxone something anyone can carry: it only affects opioids, and it is harmless if opioids are not involved (Canadian Red Cross). That means if you’re not certain whether an unconscious person has overdosed on opioids, giving naloxone won’t hurt them — so when in doubt, give it.
Source: Canadian Red Cross (naloxone reverses opioid effect and is harmless if no opioids are present); European Resuscitation Council 2025 First Aid.
What Counts as an Opioid
Opioids include prescription painkillers (such as oxycodone, hydromorphone, morphine, codeine, and fentanyl patches), methadone, and street drugs like heroin and illicitly manufactured fentanyl. Fentanyl and its analogues are extremely potent and increasingly found mixed into other drugs without the user’s knowledge, which is a major reason overdoses have risen so sharply.
Recognizing an Opioid Overdose
The hallmark of an opioid overdose is breathing that slows and then stops. Watch for:
- Slow, shallow, irregular, or stopped breathing — the most dangerous sign
- Unresponsiveness — you can’t wake the person, even with a firm shake or shout
- Pinpoint pupils — pupils shrunk to tiny dots
- Blue or grey lips, fingertips, or skin (or ashen/grey on darker skin)
- Gurgling, choking, or snoring-like sounds
- Limp body and cold, clammy skin
Source: European Resuscitation Council 2025 First Aid (suspect opioid overdose with slow/irregular/absent breathing, deep drowsiness or unresponsiveness, and pinpoint pupils).
Step-by-Step: Responding to an Opioid Overdose
A widely taught memory aid is SAVE ME — Stimulate, Airway, Ventilate, Evaluate, Medication (naloxone), Evaluate again. The single most important rule sits underneath it: for anyone unresponsive and not breathing normally, call 911 and start high-quality CPR without delay — and do not delay CPR to find or give naloxone (ILCOR 2025; AHA 2024; Canadian Red Cross). Here it is in plain steps.
1Try to wake them and check breathing
Shout their name and shake their shoulders. Rub your knuckles firmly on their breastbone. If they don’t respond, check their breathing for no more than 10 seconds — look, listen, and feel. No response and abnormal or absent breathing means act now.
2Call 911 and start CPR — without delay
Call right away, or direct someone specific to call, and tell the dispatcher you suspect an overdose and the person isn’t breathing normally. For anyone unresponsive and not breathing normally, start CPR immediately — chest compressions at 100 to 120 per minute together with rescue breaths. Because an opioid overdose kills by shutting off the drive to breathe, getting oxygen moving is the first priority, and you should not delay CPR to find or give naloxone.
Source: ILCOR 2025 CoSTR & AHA 2024 opioid-emergency sequence — call EMS, provide high-quality CPR (compressions plus ventilation), then administer naloxone; CPR is not delayed for naloxone. Compression rate 100–120/min per ILCOR 2025 BLS.
3Give naloxone
As soon as it can be done without interrupting good CPR, give naloxone. For the nasal spray: insert the nozzle into one nostril and press the plunger firmly to release the full dose. For the injectable kit: draw up the dose (or use the pre-filled device) and inject into a large muscle — the outer thigh or upper arm — through clothing if necessary. If a second rescuer is present, one gives naloxone while the other continues CPR.
Source: European Resuscitation Council 2025 First Aid (intranasal naloxone, or an IM autoinjector if trained); AHA 2025 BLS (naloxone provided it does not interfere with high-quality CPR).
4Reassess and give another dose if needed
Keep doing CPR and reassess breathing and responsiveness. Naloxone typically starts to work within a few minutes — the Canadian Red Cross describes restored breathing in about two to five minutes. If there’s no improvement, give a second dose (in the other nostril for the spray, or a fresh injection) following the package instructions for repeat timing. Powerful opioids like fentanyl can require multiple doses to reverse.
Source: Canadian Red Cross (onset about two to five minutes); European Resuscitation Council 2025 First Aid (reassess with ABCDE; repeat dose per the package instructions). Exact dose and repeat timing follow product labeling and local take-home-naloxone programs.
5Recovery position and stay
Once breathing is restored and the person is breathing normally on their own, roll them onto their side (the recovery position) so their airway stays clear if they vomit. Stay with them and keep monitoring until paramedics arrive — even if they wake up.
Where to Get a Free Naloxone Kit in Ontario
In Ontario, naloxone kits are available free and without a prescription from many pharmacies, as well as from public health units, community health centres, and harm reduction programs (Government of Ontario / Health Canada). Both nasal spray and injectable kits are offered, and staff will walk you through how to use it when you pick it up.
Because overdoses can happen to anyone, more households, workplaces, schools, and community organizations are choosing to keep a kit on hand — the same way they’d keep a fire extinguisher or an AED. If you, a family member, a friend, or a colleague is at any risk, carrying naloxone is a simple, judgment-free precaution.
The Law Protects You for Helping
One of the biggest reasons people hesitate to call 911 during an overdose is fear of police involvement. The Good Samaritan Drug Overdose Act (Government of Canada) addresses this: it provides legal protection from charges for simple drug possession — and from breaches of conditions like bail or parole related to that possession — for the person who calls for help and anyone else at the scene when emergency services arrive.
The message is simple: call 911 without fear. The law is designed to make sure that the instinct to save a life always wins.
Responding With Compassion
An overdose is a medical emergency, not a moral failing. The person in front of you is someone’s child, partner, parent, or friend, and they deserve the same urgent, non-judgmental care as anyone whose heart has stopped or who is choking. Treat them with dignity, act quickly, and remember that your willingness to step in is exactly what gives them a chance.
A Sensitive Topic — and an Important One
Opioid use and overdose touch many families, often quietly. If you or someone you care about is struggling with substance use, this is a difficult and serious subject, and support is available — reaching out to a doctor, a local harm reduction or addiction service, or a trusted person is a meaningful first step. Carrying naloxone and knowing how to use it isn’t an endorsement of anything; it’s simply being ready to help a person in their most vulnerable moment.
Build the Skills That Save Lives
Naloxone reverses an overdose, but the breathing support and CPR that keep a person alive in those critical minutes are hands-on skills best learned by practising them. A Life Safe first aid and CPR course gives you that confidence — rescue breathing, CPR, and the recovery position — so that whatever the emergency, you can act. Pair it with a free naloxone kit and you’re ready for one of the most common life-threatening events in our communities today.
Frequently Asked Questions
What are the signs of an opioid overdose?
Slow, shallow, irregular, or stopped breathing, unresponsiveness, pinpoint pupils, blue or grey lips and fingertips, gurgling or choking sounds, a limp body, and cold clammy skin. The breathing is the most dangerous sign — opioids slow and then stop breathing, which is what makes an overdose fatal (European Resuscitation Council 2025 First Aid). If you can’t wake someone and their breathing is abnormal, treat it as an overdose, call 911, start CPR, and give naloxone if available.
How do you use naloxone?
It comes as a nasal spray or an injection. For the spray, insert the nozzle into one nostril and press the plunger firmly. For the injectable kit, inject the dose into a large muscle like the outer thigh, through clothing if needed. Because the immediate danger is lack of oxygen, call 911 and start CPR without delay for anyone unresponsive and not breathing normally, then give naloxone as soon as it won’t interrupt good CPR (ILCOR/AHA). Reassess and give another dose per the package instructions if there’s no response. Naloxone only works on opioids but is harmless if opioids aren’t involved.
Where can I get a free naloxone kit in Ontario?
Free kits are available without a prescription from many pharmacies and from public health units, community health centres, and harm reduction programs (Government of Ontario / Health Canada). Both nasal spray and injectable kits are offered, and staff will show you how to use it. Because overdoses can happen to anyone — including people on prescription painkillers — many households and workplaces now keep a kit on hand.
Can I get in trouble for calling 911 during an overdose?
The Good Samaritan Drug Overdose Act (Government of Canada) protects people who call 911 to report an overdose — and anyone at the scene — from simple drug possession charges and related breaches of bail or parole conditions for that possession. It’s designed to remove the fear that stops people from calling. Always call 911, because naloxone can wear off before the opioids do and the overdose can return.
Be Ready to Save a Life
Naloxone reverses an overdose — but rescue breaths and CPR are what keep a person alive in the minutes that matter. Life Safe’s hands-on first aid and CPR courses give you the confidence to act in any emergency, in any community.
Find a class near you: Toronto • Downtown Toronto • East York • Hamilton • Welland • Guelph
Sources & medical review
Reviewed by Milos Radojcic (Canadian Red Cross / Heart & Stroke / Lifesaving Society First Aid & CPR Instructor, 10+ yrs). Clinical content aligned with the ILCOR 2025 international consensus and the American Heart Association (2024/2025) opioid-emergency sequence (call EMS, high-quality CPR with breaths, then naloxone; CPR is not delayed for naloxone), the European Resuscitation Council 2025 First Aid guidance (recognition, intranasal naloxone, reassess with ABCDE, repeat per package), and the Canadian Red Cross and Heart & Stroke Foundation of Canada. Naloxone onset (about two to five minutes) per the Canadian Red Cross; exact dose and repeat timing follow product labeling and local take-home-naloxone programs. Kit access per the Government of Ontario / Health Canada naloxone programs; legal protection per the Government of Canada Good Samaritan Drug Overdose Act. Last reviewed July 2026.