Naloxone After Rehab: Getting a Kit and Planning Use

Naloxone is a medicine that can reverse an opioid overdose, and the time to get a kit is before it is needed. A single 4 mg naloxone nasal spray is the standard community dose, a second dose can be given after 2 to 3 minutes if the person does not respond, and 911 should be called in every case. People leaving opioid treatment are often the people for whom a kit matters most, because a period without opioids lowers tolerance. This guide covers the practical side: where to get a kit, where to keep it, and how to make sure someone else knows how to use it.

Why a Naloxone Kit Belongs in a Discharge Plan

Residential treatment is meant to be a turning point, and most people who finish a stay go home intending never to use again. A good discharge plan still prepares for the possibility that someone will. That is not pessimism. Recovery from opioid use disorder is a long process, and the weeks after a stay in treatment carry real overdose risk for the reasons below.

Lost tolerance: After days or weeks without opioids, the body no longer handles the amount it once did, so a previously familiar dose can now suppress breathing.

Unpredictable supply: Illicit pills and powders can contain fentanyl without any visible sign, which means the strength of a single pill or line cannot be judged by looking at it.

Using alone: A person who uses in a bedroom or bathroom with nobody nearby has no one to call 911 or give naloxone if breathing slows.

Mixed substances: Alcohol, benzodiazepines and other sedatives add to the breathing suppression caused by opioids, so a combination can be dangerous even when each substance seems manageable alone.

The National Institute on Drug Abuse explains how naloxone works and why it is used in overdose response on its naloxone research page. The Centers for Disease Control and Prevention publishes overdose prevention guidance at cdc.gov, including information on recognizing and responding to an overdose.

Where to Get Naloxone in California

Naloxone is now easier to obtain than it used to be. The nasal spray form was approved by the U.S. Food and Drug Administration for over-the-counter sale in March 2023, so many pharmacies and some retail stores carry it on the shelf. In California, pharmacists can also furnish naloxone under a statewide standing order, and many county programs, community organizations and harm reduction groups distribute kits at no cost. Availability and price change, so call ahead before you go.

A short checklist for getting your kit:

• Ask your treatment team to confirm where to pick one up before your discharge date, so the kit is in hand on day one at home.
• If you have insurance, ask the pharmacy whether the plan covers naloxone and what the copay would be. Coverage varies by plan.
• Pick up two kits if you can, one for home and one to carry, since a kit in a closet is no help in a car or at work.
• Check the expiration date printed on the package and put a reminder in your phone for that month.

Where to Keep It and Who Should Know

A pattern that people who work in this field describe is that a kit gets bought and then goes into a drawer, a glove box or a bag that nobody else knows about. The person who needs it cannot reach for it during an overdose, so the useful question is not “do I own naloxone” but “could the person standing next to me find it in thirty seconds.”

Keep the kit somewhere visible and shared, such as a kitchen shelf or beside the front door, and keep it out of extreme heat, since a hot car can degrade the medicine. Tell at least one person where it is. If you share a home, show them the device. A nasal spray is designed for use by someone without medical training, and a two-minute walkthrough is usually enough.

If you also have a buprenorphine prescription at home, store it separately and securely, and see our storage checklist for buprenorphine at home. If you have leftover pills from before treatment, our disposal checklist walks through safe options.

What an Overdose Response Looks Like

This is general educational information, not a replacement for training. A short class from a pharmacy, health department or community group is worth the time. Signs of an opioid overdose can include a person who cannot be woken, slow or stopped breathing, gurgling or snoring sounds, blue or gray lips or fingertips, and very small pupils. The basic steps are widely taught:

• Call 911 and say that someone is not breathing. California has a Good Samaritan law intended to protect people who call for help, though you should not rely on it as legal advice.
• Give one naloxone dose by placing the nasal spray in one nostril and pressing the plunger.
• If the person has stopped breathing, give rescue breaths or chest compressions if you have been trained to.
• If there is no response after 2 to 3 minutes, give a second dose in the other nostril using a new device.
• Stay until help arrives, and lay the person on their side if they are breathing but not awake.

Naloxone can wear off sooner than some opioids, particularly long-acting ones, so a person who wakes up still needs emergency medical evaluation. Do not assume the danger has passed. Naloxone can also trigger sudden withdrawal symptoms, which are very uncomfortable but are not the same danger as an overdose.

Today’s Action: A Five-Minute Check

If you, a family member or a friend has been through opioid treatment, do this today. First, look at your home and find out whether a naloxone kit is there. Second, if it is, check the expiration date and confirm one other person knows where it is. Third, if it is not, call a local pharmacy and ask whether naloxone is in stock and what it costs with your insurance. At your next appointment with a prescriber or treatment provider, ask this exact question: “Can you write down where I can get naloxone near my home and who can show my family how to use it?”

Naloxone Is Not the Whole Plan

Naloxone reverses an overdose in the moment, but it does not treat opioid use disorder. Medications such as buprenorphine, methadone and extended-release naltrexone are used as part of treatment for many people, and they are discussed on our page about medication-assisted treatment. Treatment is most effective when it addresses the whole person. For people who also live with depression, anxiety, trauma or insomnia alongside a substance use disorder, integrated care for both conditions matters, and our page on dual diagnosis treatment explains how co-occurring conditions are handled alongside addiction treatment. Annandale is a small, private residence, and a stay is described in more detail on our residential treatment page.

Families sometimes worry that keeping naloxone in the house sends the message that they expect a relapse. It does not. It is the same logic as keeping a fire extinguisher in the kitchen: you hope to never use it, and you are glad it is there if you must. A kit at home also tells the person in recovery that the people around them are prepared to help rather than judge.

When to Reach Out for Help

If you or someone you know is using opioids and wants help stopping, or if you are not sure what level of care is appropriate, you can speak with our admissions team at (855) 778-8668. The Substance Abuse and Mental Health Services Administration also runs a free, confidential national helpline at 1-800-662-HELP (4357), described at samhsa.gov. If you are having thoughts of harming yourself, call or text 988 to reach the Suicide and Crisis Lifeline. In an emergency, call 911 immediately.

Stopping alcohol or benzodiazepines suddenly can cause seizures and other serious complications, and withdrawal from those substances requires medical supervision. Please do not attempt it alone. To speak with someone about next steps, call (855) 778-8668.

This article is for educational purposes only and is not medical advice, diagnosis or treatment. It does not replace guidance from a licensed clinician. Naloxone products, availability, coverage and laws change, so confirm current details with a pharmacist or your local health department.