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Naloxone and Other Opioid Overdose Reversal Agents

Opioid overdose reversal agents are life-saving medications that can reverse an overdose of opioids, including heroin, fentanyl, and prescription opioid medications, when given in time. They are easy to use and small to carry. Naloxone is available in two forms, prefilled nasal spray and injectable, and nalmefene is available in a prefilled nasal spray. For more information on opioid reversal agents, view our Resources section below.

 For frequently asked questions about opioid overdose reversal agents, view FAQs section below.

What's New? 

Naloxone 3 mg and 4 mg spray have been approved as over-the-counter treatments and are available in local pharmacies and online. Naloxone 8 mg nasal spray is available by prescription at pharmacies.

Nalmefene has received Food and Drug Administration (FDA) approval and is available as a prescription medication.

Opioid Overdose Reversal Agents in Alabama

HB208 was signed into law in 2015, providing immunity for prescribing and administering an opioid antagonist, such as naloxone and nalmefene. In 2016, HB379 was signed into law providing the State Health Officer or a county health officer the authority to write a standing order for dispensing an opioid overdose reversal agent.

Read the Standing Order from the State Health Officer on opioid overdose reversal agent distribution for overdose prevention and download the Opioid Overdose Reversal Agent Client form (found on page 6 of the standing order). The Standing Order also allows bulk dispensing to first responders. The Agency Form is found on page 7 of the Standing Order.

The State Health Officer's opioid overdose reversal agent Standing Order can be used for naloxone, both prescription and over-the-counter, if required by insurance or third party payor.

Opioid Overdose Reversal Agent Training

To register for naloxone training in Alabama, visit the Jefferson County Health Department website.

Other training resources will be available soon.

Overdose Response Resource Cards

These cards were developed for first responders to give to those who would benefit from free opioid overdose reversal agents, including friends, family, or communities that may encounter overdoses. Resources for treatment, recovery and free opioid overdose reversals agents are listed on the card.

  • Online training with an instructional video and instructions for requesting a free opioid overdose reversal agent that will be mailed to their home.
  • Recovery Organization of Support Specialists (ROSS) Helpline number where help is available 24/7.
  • Recovery Resource Center (RRC) provides information and resources.

Overdose Response Resource Card




Frequently Asked Questions

Naloxone 4 mg nasal spray, including NARCAN® Nasal Spray, an approved over-the-counter treatment for opioid overdose, is available for purchase in retail stores and online and remains available to purchase under a prescription if required by your insurance. In addition, naloxone 8 mg nasal spray (Kloxxado®) is available by prescription, as is nalmefene (Opvee®) 2.7 mg nasal spray, a newly approved opioid overdose reversal agent.

The Standing Order serves as an opioid overdose reversal agent prescription and should be retained by the pharmacy and filed as any other prescription. The Client Form should be completed, signed by the recipient, and retained by the pharmacy or agency (see page 6 of the standing order).

By signing the Client Form, the recipient acknowledges that he/she has:

  • Received information on how to recognize and respond to a possible opioid overdose.
  • Received basic information on how to administer the opioid overdose reversal agent.
  • Been offered information/counseling on the risk factors for opioid overdose, overdose prevention measures, risk and recognition of addiction, and r
  • The pharmacist should provide all of the above.
  • Patients with a history of overdosing.
  • Patients with a history of opioid use disorder.
  • Patients whose daily opioid dose is greater than 50 morphine equivalents.
  • Patients taking an opioid and a benzodiazepine.

The opioid overdose reversal agent Standing Order allows the pharmacist to choose the medication that is best for the patient or caregiver. See page 2 of the Standing Order for a description of each medication.

Alabama Code Section 20-2-280 states that a physician or dentist who prescribes, a pharmacist who dispenses, and an individual who administers an opioid antagonist in good faith to an individual at risk of experiencing an opiate-related overdose or to a family member, friend, or other individual, including law enforcement, in a position to assist a individual at risk of experiencing an opiate-related overdose is immune from civil or criminal liability.

The Alabama Department of Mental Health provides a list of treatment and prevention providers. The Prescription Drug Monitoring Program also provides resources for the public.

State Pharmacy Director Nancy Bishop, RPh
Office: 1-877-703-9869

Page last updated: May 17, 2024