Overdose and Naloxone Awareness Course: Lessons 2026

Lesson 1: Opioids and overdose

Opioids are drugs that relieve pain and slow down the body, including breathing. Examples are fentanyl, heroin, morphine, codeine and oxycodone. Many street drugs are mixed with fentanyl or other powerful substances, so a person may not know what they took.

An overdose (also called drug poisoning) happens when a person takes more than their body can handle. With opioids, the main danger is that breathing slows or stops. Without oxygen, the brain can be damaged within minutes. An overdose is always an emergency.

People who use drugs are members of our communities. Use respectful language such as "a person who uses drugs". Your job is to keep the person alive and get help, not to judge.

Signs of an opioid overdose

Hard to wake, or cannot be woken even when shaken or shouted at
Slow, weak or no breathing
Choking, gurgling or snoring sounds
Blue, purple or grey lips or nails
Very small (pinpoint) pupils
Cold, clammy skin
Dizziness, confusion, extreme drowsiness, trouble walking or talking
Sometimes a stiff body or seizure-like movements

Lesson 2: Responding step by step

Health Canada sums up the response in four steps: know the signs, call 9-1-1, give naloxone, stay until help arrives. Here is how that looks on duty.

Check the scene. Look for needles, other people or hazards. Put on gloves.
Check for a response. Speak loudly and say their name if you know it. If there is no answer, rub your knuckles hard on the middle of their chest.
Call 9-1-1. Put the phone on speaker. Send someone to bring the naloxone kit and an AED.
Check breathing. Look at the chest rise and fall.
Give naloxone. Follow the steps for the kit you have.
Breathe or do CPR. If they are not breathing normally, give care as you were trained. Heart & Stroke 2025 guidelines say to start CPR and give naloxone without delaying CPR.
Stay. Repeat naloxone if there is no response in 2 to 3 minutes.

Alberta's kit insert teaches rescue breaths with the barrier: tilt the head back, lift the chin, pinch the nose and give one breath every 5 seconds, about 24 breaths in 2 minutes.

If the person is breathing, place them in the recovery position and keep checking.

Place the arm nearest you out at a right angle, elbow bent.
Bring the far arm across the chest, back of the hand against their near cheek.
Bend the far knee up, foot flat on the ground.
Roll them toward you onto their side; tilt the head back to keep the airway open.

Lesson 3: Naloxone

Naloxone is a fast-acting medicine that temporarily reverses an opioid overdose. It pushes opioids off the brain's receptors so the person can breathe again. It only works on opioids, but it still helps when opioids are mixed with other drugs.

Kit type	How it is given	What is in an Ontario workplace kit
Nasal spray	Spray into one nostril	Two 4 mg/0.1 ml doses, rescue breathing barrier, non-latex gloves
Injectable	Into the thigh (preferred) or upper arm muscle, through clothing if needed	Two 0.4 mg/1 ml vials or ampoules, two safety syringes, breathing barrier, gloves

Naloxone can start working within a few minutes.
If there is no response after 2 to 3 minutes, give another dose.
It lasts about 30 to 120 minutes. Many opioids last longer, so breathing can stop again. Always call 9-1-1 and stay.
It has no effect on a person who has not taken opioids.

Workplace kits

Rules differ by province. For example, since June 1, 2023, Ontario's Occupational Health and Safety Act requires an employer to have a naloxone kit when there is a risk that one of its own workers may overdose at work, with a trained worker nearby. Many other employers choose to carry kits. Know where your site's kit is and check the expiry date.

Lesson 4: The law and your safety

Good Samaritan Drug Overdose Act

This federal law came into force on May 4, 2017. It encourages people to call for help. It protects anyone who seeks emergency help during an overdose, including the person overdosing and others at the scene, from:

Charges for simple possession of a controlled substance
Breaching conditions related to simple possession, such as pre-trial release, probation, conditional sentence or parole

It does not protect against outstanding warrants, drug production or trafficking, or other crimes. You can tell people this to encourage them to stay and call.

Protecting yourself

Wear gloves and use the breathing barrier.
Do not touch, taste or smell suspected drugs. Never pick up needles with bare hands.
If skin is exposed, wash with soap and water. Do not use alcohol sanitizer or bleach on skin.
Do not touch your eyes, nose or mouth until you have washed.

Lesson 5: After naloxone

When a person wakes up, they may be confused, sick or upset because naloxone can cause sudden withdrawal. Some people become agitated. Stay calm, give them space, and explain simply: "You stopped breathing. I gave you naloxone. Paramedics are coming."

Stay with the person and keep checking breathing.
Discourage them from using more drugs; the naloxone will wear off.
Tell paramedics what you saw, how many doses you gave and at what times.
Write your report: times, signs, actions, doses and who took over care.
Replace used kit items and tell your supervisor.
Talk to someone after a hard call. Use your employee assistance program if you have one.