State Revive trainers review naloxone use, safety and how to respond to opioid overdose

Tianna Vasquez, Revive Education Specialist with the Virginia Department of Behavioral Health and Developmental Services, told the Abatement Academy that Revive training focuses on three objectives: teaching how to identify opioid overdose, how to administer naloxone, and reducing stigma around substance use disorders.

"Naloxone is a medication designed to rapidly reverse opioid overdoses," Vasquez said, and she explained the two FDA‑approved formulations: intramuscular injection and intranasal spray. The session emphasized the nasal spray as the most widely used lay rescuer option because it is easier to carry and does not require injection.

Vasquez outlined a standard sequence for responding: check responsiveness (sternum rub/tactile stimulation), call 911, place an unresponsive breathing person in the recovery position to protect the airway, provide rescue breaths if not breathing, and administer intranasal naloxone (one firm push into a nostril), then wait 1–3 minutes to assess effect before repeating a dose if needed. She advised that naloxone does not require the person to be breathing to be effective.

On safety and side effects, Vasquez said serious allergic reactions to naloxone are rare; the main expected effect in people dependent on opioids is acute opioid withdrawal (nausea, vomiting, sweating). She noted that naloxone’s duration of action is about 30 to 90 minutes—enough time to allow EMS to arrive—and that the same dose is used for adults and children for intranasal products distributed through Revive training.

Vasquez discussed dosing and availability: the standard intranasal dose given in Revive materials is 4 milligrams; 8‑milligram products are also available and sometimes used in higher‑risk settings, but the presenters said the 4‑mg product is the general distribution item and the one available over the counter. She described access options: no‑cost naloxone at community service boards and local health departments, harm‑reduction providers that distribute kits, and retail pharmacies where naloxone is now available without a prescription. She said cost has dropped from prior prices (previously about $140 for a two‑dose pack) to roughly $40–$50 for two over‑the‑counter doses, and urged people to keep at least one kit at home or on site.

Vasquez repeatedly advised that if a person is responsive and declines naloxone, it generally should not be forced; but she also noted that administering naloxone to someone who turns out not to have an opioid overdose generally does not cause harm.

Ending

Vasquez encouraged attendees to take full Revive training for more detailed instruction and to carry or make naloxone available in workplaces, first‑aid kits and public venues.