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Naloxone Use by Emergency Responders During the Pandemic: A National Survey

The COVID-19 pandemic has overshadowed an ongoing health crisis in the US. The opioid crisis continues and, in fact, is increasing during the pandemic. Many areas of the country are experiencing a rise in the number of opioid overdoses this year. While naloxone can reverse the effects of an overdose, a recent survey on naloxone use by emergency responders during the pandemic shows that there are some concerns among healthcare professionals.

Naloxone Benefits

The medication naloxone is designed to rapidly reverse an opioid overdose. Naloxone is what is known as an opioid antagonist, in that it binds to opioid receptors and blocks the effects of other opioids. It can quickly restore normal respiration when the person who has overdosed experiences has slowed or stopped breathing after overdosing from heroin or prescription opioid pain medications.

The Opioid Crisis in the COVID-19 Pandemic

Opioid use, and most significantly, overdoses have increased significantly in 2020, over the 2019 numbers. Research findings reveal the rise in fatal drug overdoses, pointing to the fact that they were probably boosted by factors related to the COVID-19 pandemic. A survey conducted in late June showed that 13% of respondents had started or increased their substance use to cope with stress or emotions created by the pandemic.

Additional findings from July 2020 demonstrated that drug overdose deaths in the US rose by an estimated 13% over the first half of the year as compared to 2019 numbers. There were some states in the country in which drug-related deaths climbed by over 30%.

Naloxone Use by Emergency Responders

In the spring of 2020, researchers from the Yale School of Medicine conducted an analysis to determine changes in overdose events and naloxone administration practices by emergency medical services (EMS) clinicians. Given the extent of the COVID-19 pandemic, the researchers studied whether EMS clinicians were limiting their use of intranasal naloxone for opioid overdoses.

Between April 29 and May 15, 2020, the researchers surveyed 60 clinicians, 19 of which (32%) were in the Midwest, 17 of which (28%) were in the South, 12 of which (20%) were in the Northeast, and 12 of which (20%) were in the West. One-fifth of the responding communities have experienced an increase in opioid overdoses and other events for which naloxone was administered.

The coronavirus is transmitted through air droplets and could present a risk to EMS clinicians performing procedures such as overdose reversal with intranasal naloxone. The opioid crisis was already causing an average of 128 overdose deaths per day in the US. The COVID-19 pandemic has made that crisis much worse.

Additional findings from the study included:

  • 11 of 60 (18%) respondents indicated that EMS responses for overdose in their area increased
  • 24 (40%) indicated they had decreased compared with the pre-COVID-19 timeframe
  • 11 (18%) indicated that they had discouraged or prohibited the use of intranasal naloxone by their EMS agencies/system
  • 47 (78%) indicated no change in the use of intranasal naloxone use
  • 6 (10%) indicated that EMS services in their area had discontinued intranasal naloxone of their own initiative
  • 6 (10%) indicated that they had authorized EMS clinicians to use intramuscular naloxone to avoid intranasal administration
  • 6 (10%) were considering but had not yet implemented this change
  • Programs in the Midwest and Northeast were more likely to report decreases in overdose compared to those in the South and West

Guidance for Safely Administering Naloxone

With anecdotal reports citing an increase in opioid overdoses during the COVID-19 pandemic, regulations regarding access to medication for opioid use disorder have been loosened somewhat. The US Department of Health and Human Services (HHS) was issued new guidance for naloxone use by emergency responders during the pandemic.

The agency has stated that naloxone can be safely administered when EMS personnel use proper personal protective equipment (PPE) and follow safety measures. These measures include having the patient’s face positioned away from the first responder when possible, keeping a distance of at least 6 feet once the patient regains consciousness, following CDC guidelines for PPE, and washing one’s hands with soap and water for at least 20 seconds after removing PPE.

HHS has emphasized that naloxone saves lives. When emergency responders follow these safety measures, they can safely administer naloxone during the COVID-19 pandemic to those who are experiencing an opioid overdose.


The COVID-19 pandemic has affected us all. When you are struggling with an addiction to drugs or alcohol, the outbreak can be especially challenging. At BRC Recovery, we help you heal your mind and your body while addressing the underlying issues that lead to your addiction. We bring you real change for your life, with proven treatment options that will empower you to recreate and reclaim your life.

During the COVID-19 pandemic, we offer a safe, clean environment so you can continue receiving the highest quality of care. To learn more about our services and to get the help you need, please call BRC Recovery at 1-866-291-2676 to speak to our team.