Opioid Overdose Response and Prevention

Free naloxone nasal spray and fentanyl test strips are available 24/7 at the Arlington County Department of Human Services Crisis Intervention Center and are accessible to Arlington residents through the mail via an online form or by emailing narcan@arlingtonva.us. Arlington County also holds free online and in-person naloxone trainings each month.  

Naloxone is also available to anyone statewide at pharmacies (no prescription needed) as well as over the counter at local retailers, typically costing between $35-$45 for two doses. 

Free naloxone nasal spray, fentanyl test strips, and other harm reduction supplies across Massachusetts can be located using the MA Harm Reduction Program Locator map.  

Naloxone is also available to anyone statewide at pharmacies (no prescription needed) as well as over the counter at local retailers, typically costing between $35-$45 for two doses. While it is not necessary to get a prescription to access naloxone, some health insurance plans cover the cost of prescription naloxone. More information on accessing naloxone through a pharmacy can be viewed on the Massachusetts Department of Public Health website. 

Mecklenburg County residents can request naloxone nasal spray by emailing HLT-OverdoseDatatoAction@mecklenburgcountync.gov/. Naloxone is also available via standing order at many pharmacies statewide  and is available at most syringe exchange sites across the state.

Naloxone may only be distributed through drug treatment agencies. Drug treatment agencies are allowed to distribute naloxone to specific populations which include outreach workers, hostel managers, drug users at risk, carers, friends, or family members of a drug user at risk, and/or any individual working in an environment where there is a risk of overdose for which the naloxone may be useful. For more information about naloxone regulations, visit naloxone.org.uk.  

Free naloxone nasal spray is available for pickup through Miami-Dade County Department of Health health centers during normal business hours. Free naloxone and fentanyl test strips are also available through community distribution sites across the state which can be found by utilizing ISaveFL’s online database.  

Free naloxone nasal spray, fentanyl test strips, and other harm reduction supplies across Massachusetts can be located using the MA Harm Reduction Program Locator map.  

Naloxone is also available to anyone statewide at pharmacies (no prescription needed) as well as over the counter at local retailers, typically costing between $35-$45 for two doses. While it is not necessary to get a prescription to access naloxone, some health insurance plans cover the cost of prescription naloxone. More information on accessing naloxone through a pharmacy can be viewed on the Massachusetts Department of Public Health website. 

Free naloxone kits are available 24/7 at the front desk of the Highland Hospital Emergency Department and the San Leandro Hospital Emergency Department. Free naloxone, fentanyl test strips, and other harm reduction supplies are also available at other community organizations across Alameda Country, a list of which can be found here.  

Naloxone is also available to anyone statewide at pharmacies (no prescription needed) as well as over the counter at local retailers, typically costing between $35-$45 for two doses. 

Free naloxone nasal spray and intramuscular naloxone are available at syringe exchange sites throughout Maine. Free naloxone is also available at other community distribution sites across the state which can be found by utilizing Maine Drug Data’s Naloxone Map.  

Naloxone is also available to anyone statewide at pharmacies (no prescription needed) as well as over the counter at local retailers, typically costing between $35-$45 for two doses. The state health insurance plan, Maine Care, will cover the full cost of naloxone.  

Free naloxone nasal spray and fentanyl test strips available across Washington can be located by using the Stop Overdose map. Harm reduction vending machines containing free naloxone and fentanyl test strip are also available throughout King County. 

Naloxone is also available to anyone statewide at pharmacies (no prescription needed) as well as over the counter at local retailers, typically costing between $35-$45 for two doses. 

Santa Clara County offers daily, free, brief, in-person naloxone training and naloxone kit distribution at three different clinics across the county. Residents of Santa Clara County can also order free naloxone kits through the mail via an online order form.  

Naloxone is also available to anyone statewide at pharmacies (no prescription needed) as well as over the counter at local retailers, typically costing between $35-$45 for two doses. 

Free naloxone kit distribution locations available across Ontario can be found by using the Ontario Naloxone Kit Map. There is no prescription needed to get a naloxone kit, however, not all pharmacies carry kits, so please call the pharmacy in advance or refer to the map.  

Free naloxone, fentanyl test strips, and other harm reductions supplies available across British Columbia can be found by using the BC Centre for Disease Control Services Locator.   

Possible warning signs of an opioid overdose include: 

• Small, constricted “pinpoint pupils” 
• Falling asleep or loss of consciousness 
• Slow, shallow breathing 
• Choking or gurgling sounds 
• Limp body 
• Discolored skin, especially in lips and nails (may appear blue on lighter skin tones and gray on darker skin tones) 

Reference: Centers for Disease Control and Prevention, 2023 

If you are concerned for the health or safety of someone due to possible opioid overdose, call for emergency medical help immediately and administer naloxone (Narcan) if possible.  

To request emergency medical help, call: 

• Boston (on-campus): call Northeastern University Police Department (NUPD) at 617.373.3333  
• Boston (off-campus): call 911, then alert NUPD at 617.373.3333    
• Oakland: call 911, then notify Department of Public Safety at 510.430.5555    
• Other U.S. Locations: call 911    
• London: call 999, then notify NUPD’s Global Safety Office at 617.373.2121    
• Global Locations: call local emergency services, then notify NUPD’s Global Safety Office at 617.373.2121   

The video below reviews possible signs of opioid overdose and how to respond: 

To respond to a possible opioid overdose, follow these steps adapted from the Massachusetts Department of Public Health (2024): 

1. Check for overdose signs: 

• Not breathing well 
• Turning blue (lighter skin tones)/grey (darker skin tones)
• Not reacting when you rub your knuckles on their chest 

2. Call for emergency medical help: 

• Boston (on-campus): call Northeastern University Police Department (NUPD) at 617.373.3333  
• Boston (off-campus): call 911, then alert NUPD at 617.373.3333    
• Oakland: call 911, then notify Department of Public Safety at 510.430.5555    
• Other U.S. Locations: call 911    
• London: call 999, then notify NUPD’s Global Safety Office at 617.373.2121    

• Say “someone isn’t breathing or is unresponsive” 
• Stay until help arrives, even if they seem better. 

3. Give Narcan 

• Push pump only after tip is in nose. 
• If no response in 3 minutes, give another dose. 

4. Give rescue breaths 

• Make sure mouth is clear. 
• Tilt head back, lift chin, pinch nose. 
• Give 1 breath every 5 seconds for 3 to 5 minutes. 
• Video tutorial on rescue breathing 

5. Stay until help arrives. 

• If breathing well, put on side 

(Image from First Aid for Free, 2024)

• If not breathing well, repeat Steps 3 and 4. 
• Stay until help arrives. 

Download copies of wallet sized overdose response cards from the Massachusetts Department of Public Health. 

This video provides a brief overview of how to respond to a possible opioid overdose using Narcan nasal spray (1:02): 

This video provides a more thorough demonstration on how to respond to an opioid overdose with Narcan nasal spray from Mass General Brigham (3:08): 

Free Narcan, fentanyl test strips, rescue breathing masks, and educational materials can be picked up at the Office of Prevention and Education at Northeastern on the Boston campus (307 Ell Hall; Monday through Friday, 9:00 am to 4:00 pm ET except for university holidays). See the Accessing Narcan and Fentanyl Test Strips section above for more information. 

The Massachusetts Department of Public Health offers guidance on the proper storage and shelf life of Narcan brand naloxone nasal spray to ensure the doses are most effective. Navigate to the “Product Information” of their Naloxone FAQ website to learn more. 

In cases of a drug or alcohol emergency, the primary con­cern is the health and safety of the individual(s) involved. 

Northeastern University has a Medical Amnesty policy. If a student calls on behalf of another student experiencing a medical emergency, that student should remain with the student experiencing the emergency until medical assistance arrives. As long as the student complies with all directives, there will be no disciplinary action taken related to the violation of possession or consumption of alcohol or drugs.   

Overdose Good Samaritan laws exist in most US states and many countries “to protect those who are overdosing and anyone assisting them in an emergency from arrest, charges, or a combination of these” (Centers for Disease Control and Prevention, 2024). 

Learn more about local Overdose Good Samaritan Laws: 

• United States: Overdose Good Samaritan Laws by state (Network for Public Health Law, last updated May 2023, pp. 3-33) 
• Canada: Good Samaritan Drug Overdose Act 

As described by SAMHSA (2024), “fentanyl test strips are small strips of paper that can be used to determine if drugs have been mixed or contaminated with fentanyl, providing people who use drugs and communities with important information about fentanyl in the illicit drug supply so they can take steps to reduce their risk of overdose.” 

Remember when using fentanyl test strips that there is always a risk for a false result. 

Follow these steps from the Centers for Disease Control and Prevention to test a substance using a fentanyl test strip. 

View this instructional video from the New York City Department of Public Health to learn how to test different kinds of substances using fentanyl test strips (8:54): 

Download wallet sized fentanyl test strip instruction cards from the Massachusetts Department of Public Health. 

Free Narcan, fentanyl test strips, rescue breathing masks, and educational materials can be picked up at the Office of Prevention and Education at Northeastern on the Boston campus (307 Ell Hall; Monday through Friday, 9:00 am to 4:00 pm ET except for university holidays). See the Accessing Naloxone and Fentanyl Test Strips section above for more information.

Harm reduction is an evidence-based approach that aims to equip people who use alcohol and/or other drugs with tools and information to reduce the risk of harms associated with use (SAMSHA, 2023). 

According to the Substance Abuse and Mental Health Services Administration (2024), “an opioid overdose can occur when a person: 

• Overdoses on an opioid drug, such as heroin or morphine 
• Overdoses on methadone 
• Accidentally takes an extra dose 
• Misuses a prescription opioid or opioid-based pain medication in way that was not as prescribed by their physician 
• Mixes opioids with other prescriptions, alcohol, or over-the-counter medications. Overdoses can be fatal when mixing an opioid with anxiety treatment medications or derivatives of Benzodiazepine, such as Xanax or valium. 
• Uses medication prescribed for someone else. Children are particularly vulnerable to accidental overdoses if they take medication not intended for them.” 

According to the Massachusetts Department of Public Health, there are several factors that can increase a person’s risk of opioid overdose, including (but not limited to): 

• Changes in tolerance from not using or using less. 

• Changes in the drug supply. 

• Mixing opioids with respiratory depressants or “downers” such as alcohol or benzodiazepines (benzos). 

• Mixing opioids with stimulants, such as cocaine and methamphetamine. 

• Having chronic health conditions such as, HIV, Hepatitis C, lung disease, heart disease, or other health concerns. 

• History of past overdoses. 

If you take medication, review SAMHSA’s guidance on reducing the risk of an opioid-related overdose while taking medication. 

Learn more about harm reduction strategies to reduce the risk of overdose from the Massachusetts Department of Public Health. 

Massachusetts SafeSpot Helpline

• Toll free 24/7 helpline: 800.972.0590 
• Connects individuals using drugs alone with a trained operator who can call for help in case of overdose 

Massachusetts Substance Use Helpline

• Free 24/7 helpline: 800.327.5050 
• Free and confidential statewide, public resource for finding substance use harm reduction, treatment, recovery, and problem gambling services 

Massachusetts Harm Reduction Program Locator

Syringe Service Program Locator

• Map that includes the location addresses, services provided, hours of operation, and contact information of harm reduction programs and syringe service programs in Massachusetts

Victory Programs

• Free harm reduction supplies, counseling, and hygiene kits
• Locations available throughout Boston

National Harm Reduction Coalition Resource Finder

• Map and database for community organizations and resources that support safer drug use across the US

North American Syringe Exchange Network  

• Free directory that includes harm reduction and syringe exchange program locations across the US. This directory is intended to be used to assist people seeking harm reduction services to locate an agency by service, city, state, and/or zip code

National Overdose Response Service

• Free 24/7 helpline 1.888.688.6677 
• Free overdose prevention hotline for Canadians that provides confidential, non-judgmental support for you, whenever and wherever you use drugs 

Supervised Consumption Site Locator

• Map of locations of supervised consumption sites, non-supervised consumption sites offering drug checking, and treatment and support services across Canada

Lifeguard Connect App

• App available on Android and iOS created in conjunction with British Columbia Emergency Health Services
• Features include a resource locator, a use alone timer that can automatically connect you with emergency services if needed, local drug alerts, CPR and naloxone use guides, and connection to local crisis lines and local 24/7 nurses’ lines 

Ontario Harm Reduction Distribution Program Supply Locator

• Map of harm reduction programs and supply distribution sites across Ontario

We Are With You Needle and Syringe Service Locator

• Map of needle exchange and syringe service programs across England

United States Opioid Treatment Program Directory (SAMSHA) 

• Directory of opioid treatment programs available throughout the United States

SAMSHA US National Helpline 

• Free 24/7 helpline: 1.800.662.4357 
• Free, confidential treatment referral and information service for individuals and families 

Material Aid and Advocacy Program

• Resource guide listing drug treatment and recovery programs across Massachusetts
• Provides support in connecting with treatment resources in the community

Massachusetts Substance Use Helpline 

• Free 24/7 helpline: 800.327.5050 
• Free and confidential statewide, public resource for finding substance use harm reduction, treatment, recovery, and problem gambling services 

We Are With You UK  

• Free, non-judgmental drug, alcohol, and mental health support and services across England and Scotland  
• Online chat available with trained recovery workers 7 days a week  

FRANK UK 

• Free 24/7 helpline: 0300 123 6600 
• Free, confidential advice and resources helpline 
• Search tool to help locate local drug and alcohol support services 

Alcohol and Drug Information and Referral Service

• Free 24/7 helpline: 604-660-9382 
• Free, confidential, multilingual information and referral regarding community resources for people in BC dealing with substance use and addiction issues including information about detox, counselling, and treatment programs 

ConnexOntario 

• Free 24/7 helpline: 1.866.531.2600 
• Free, confidential health services information for people experiencing problems with alcohol and drugs, mental illness or gambling by connecting them with services in their area.