Training Guide

Guide to Developing and Managing Overdose Prevention and Take Home Naloxone Projects


Fatal overdose is the leading cause of death for people in the U.S. under 50 years old. More than 800,000 people died from fatal overdoses in the U.S. from 1999-2018. The rate of overdose deaths today has increased more than five-fold since 1999. We are experiencing an overdose crisis and overdose deaths are preventable.

Providing overdose prevention, recognition, and response education to people who use drugs, their neighbors, friends, families, and the service providers who work with them is a harm reduction intervention that saves lives. Heroin and other opioid overdoses are particularly amenable to intervention because risk factors are well understood and there is a safe antidote — naloxone.

This training guide outlines the process of developing and managing an Overdose Prevention and Education Program. It covers:

Module 1: Understanding the Basics

  • What is Overdose?
  • What is Naloxone?
  • The Need for Take-Home Naloxone Programs

Module 2: Overdose Prevention Strategies without Naloxone

  • Integrate Overdose Prevention Messages as Standard Practice
  • Develop an Onsite Overdose Response Policy
  • Provide Overdose Response Training to Participants

Module 3: Take-Home Naloxone Program Development

  • Community Assessment, Outreach and Engagement
  • Legal Considerations
  • The Role of Medical Professionals
  • Venues and Tips for Different Settings

Module 4: Program Implementation and Management

  • Funding
  • Purchasing and Storing Naloxone
  • Assembling Kits
  • Data Collection and Paperwork
  • Policy and Procedure Manuals
  • Trainings
  • Outreach Strategies

Module 5: Overdose Prevention and Response

  • Risks and Prevention Strategies
  • Overdose Recognition
  • Responding to Opioid or Depressant Overdose
  • Stimulant Overdose: Overamping
  • Responding to Upper or Stimulant Overdose

Module 6: Frequently Asked Questions

Using this Guide

This training guide is designed to outline the process of developing and managing an Overdose Prevention and Education Program, with or without a take-home naloxone component. Overdose prevention work can be easily integrated into existing services and programs that work with people who use or are impacted by drugs, including shelter and supportive housing agencies, substance use treatment programs, parent and student groups, and by groups of people who use drugs outside of a program setting. It offers practical suggestions and considerations rooted in harm reduction — an approach to drug use that promotes and honors the competence of people who use drugs to protect themselves, their loved ones, and their communities and the belief that people who use drugs have a right to respect, health and access to life-saving tools and information.

This manual begins with a description of how to integrate overdose prevention education into existing programs. Next, it goes into detail about how to develop and manage a take-home naloxone program. The manual uses case studies of existing overdose prevention programs to outline main points and provide models. The manual also includes a comprehensive “Overdose Prevention and Response” section which provides details on overdose and its causes and co-factors; overdose recognition basics; and effective responses. An extensive Appendix is available and includes annotated citations of existing research studies, examples of data tracking forms, examples of policies and procedures, examples of PowerPoint presentations for overdose prevention trainings/groups, and other overdose materials.

This manual is simply a guide. It is not meant to be exhaustive nor prescriptive, and there are numerous other resources that go into extended detail about many of the topics covered. We have provided links to these resources whenever possible. Take from this manual the parts that are important and meaningful to you, adapt them how you see fit, leave those pieces that may not apply, and pass on to others what you develop.