Should employers keep naloxone in the workplace?

Adding  naloxone to first-aid supplies in the workplace can be part of an employer's strategic health and safety plan, but employers should consider the benefits and risks before making a decision.

Naloxone is a medication that can save lives by reversing an overdose from opioids such as heroin, fentanyl, morphine or oxycodone. In March 2023, the U.S. Food and Drug Administration approved Narcan, a brand-name naloxone nasal spray, for over-the-counter, nonprescription use. Because of the relatively easy administration of Narcan and its potential for saving lives, some employers are choosing to keep the medication on hand in the workplace.

In 2018, then-Surgeon General of the United States Jerome Adams recommended that worksites obtain naloxone and train employees on how to use it to save lives.

"For a heart attack, we train employees how to do CPR until the paramedics arrive. Why is that not the case with naloxone and Narcan?" Adams asked. "We need to make these emergency treatments as ubiquitous as knowing CPR and calling for a defibrillator when someone is having a heart attack or using an EpiPen when someone's having an allergic reaction."

It can be difficult for employers to identify the risk of an opioid overdose in their workplace because these drugs are often being used by employees without their employers' knowledge. Opioid overdoses may be more prevalent in certain industries, like construction, whose workers are at risk of opioid addiction because of the high incidence of workplace injuries; however, opioid use and misuse is everywhere and can affect anyone.

Employers can review the following suggested considerations from the Centers for Disease Control and Prevention when deciding whether a workplace naloxone use program is appropriate:

• What liability and legal considerations should be addressed? Does your state's Good Samaritan law cover emergency naloxone administration?
• Do you have staff willing to administer naloxone and be trained on how to do so?
• Has your workplace experienced an opioid overdose or has there been evidence of opioid drug use onsite (such as finding drugs, needles or other paraphernalia)?
• How quickly can professional emergency response personnel access your workplace?
• Does your workplace offer other first-aid or emergency response interventions (e.g., first-aid kits, automated external defibrillators, trained first-aid providers)?
• Are the risks for opioid overdose greater in your geographic location? The National Center for Health Statistics provides data on drug overdose deaths by state in an online dashboard.

Employers that decide to keep naloxone available in the workplace must adopt policies and procedures regarding the training and administration of the drug. Individuals with access to the drug should be trained to recognize the signs of an opioid overdose and taught how to administer the medication properly. Employers can reach out to local government or community organizations involved in combatting the opioid crisis for assistance in locating training for staff on naloxone administration.

Naloxone should not replace regular procedures for contacting emergency services in the event of an overdose in the workplace.

Related resources:

Substance Abuse and Mental Health Services Administration: Opioid Overdose Prevention Toolkit

Naloxone Access: Summary of State Laws

Naloxone Kits Required in Some Workplaces in Ontario