Employers Urged to Stock Opioid Overdose Antidote

Surgeon general says naloxone should be ‘ubiquitous’

Allen Smith, J.D. By Allen Smith, J.D. April 27, 2018

​Worksites should get naloxone, an opioid overdose treatment, and train employees on how to use it to save lives, according to Surgeon General Jerome Adams.

Naloxone may be administered by injection or spray. Narcan is a brand name of naloxone and can be sprayed into the patient's nostrils. Narcan is available without a prescription in most states.

"For a heart attack, we train employees how to do CPR until the paramedics arrive," Adams noted April 19 in Washington, D.C, at Business Health Agenda 2018, a conference sponsored by the National Business Group on Health, speaking about the opioid epidemic. "Why is that not the case with naloxone and Narcan? 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."

Making Naloxone Available at Work

Even before the surgeon general's statement, a few clients of Nancy Delogu, an attorney with Littler in Washington, D.C., made naloxone available at work. They made this decision after employees overdosed on opioids at work.

Delogu knows of one person who overdosed at a customer service facility in a rural area that was far from first responders.

Before making naloxone available, employers should have a workplace safety program in place, according to Delogu. "If you just have a medical kit, this is a big step up," she said. Delogu predicted that more employers will equip themselves with naloxone following the surgeon general's announcement.

Increasingly, state laws shield employers from being liable for administering it, she added.

However, Keith Grossman, an attorney with Hirschfeld Kraemer LLP in Santa Monica, Calif., said that these laws vary from state to state, so employers should become familiar with them.

Opioid use is also an issue for businesses open to the public, such as hotels, restaurants, malls, theaters, stadiums and stores, he noted. Businesses, he said, need to consider how they will react if customers overdose on their premises.

Even if an employer decides not to keep naloxone on hand because the opioid crisis isn't bad in its area, it should revisit this decision periodically, he recommended.

But the crisis is severe in most parts of the country, Delogu said.

Having naloxone onsite may be especially important in certain industries, like construction, whose workers are at risk of opioid addiction because of the high incidence of workplace injuries, said Jenn Betts, an attorney with Ogletree Deakins in Pittsburgh.

Staff Training

Naloxone should be kept under lock and key with access limited to designated, trained staff, Grossman noted.

Some state departments of health can provide training on administering naloxone, Betts said. Employees need to be able to recognize the signs of an opioid overdose, she added.

When one of her client's employees overdosed at work, he began having a seizure, Delogu noted. He was "violently agitated," she said.

Some signs of an overdose:

  • Breathing becomes very slow or irregular, or stops.
  • Heartbeat slows and/or blood pressure drops.
  • Fingernails and lips turn blue or purple.

In addition, the overdosed person may not wake up or respond to someone else's voice or touch. Not all of these signs will be present necessarily.

Betts recommended that employers deciding to stock the overdose treatment adopt policies and procedures regarding the training and administration of the drug.

Don't Rely Too Much on Naloxone

After someone has been administered naloxone, he or she should still seek medical attention, said Delogu, who recommended calling an ambulance so that medical professionals can examine the employee.

She also cautioned against relying too much on naloxone to fight drug use in the workplace. Naloxone is not a cure-all for the drug problem and does not replace a comprehensive drug-prevention policy, she said. If an employer thinks employees are abusing drugs, it should educate employees about addiction and provide a hotline for treatment.

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