Naloxone is a short-acting opioid antagonist medicine that reverses the effects of opioid overdose.
The NSW Health Opioid Overdose Response and Take Home Naloxone (ORTHN) intervention aims to reduce the mortality and morbidity for people who use opioid drugs or medicines.
Trained health workers at needle and syringe programs and alcohol and other drugs services in NSW can supply naloxone at no cost to the consumer, carer or family member, and provide a brief intervention about how to use the medicine.
Two formulations of naloxone are provided in this intervention – a pre-filled syringe for injection and an intranasal spray.
A research study developed and tested the naloxone intervention in six local health districts and networks and the Medically Supervised Injecting Centre. Based on the success of this trial, the intervention is now being introduced to other health services across NSW.
On this page
- Information for the community
- Information for NSW public health services and the Medically Supervised Injecting Centre
- Information for non-government organisations and private service providers (including sole traders)
- Australian Government Department of Health - take home naloxone pilot
Information for the community
What is naloxone?
Naloxone is a short-acting medicine that can temporarily reverse an overdose caused by opioid drugs (like heroin, or strong painkillers that contain morphine or oxycodone). A dose of naloxone can help a person to breathe properly and regain consciousness after they’ve had too much of an opioid drug. Even if naloxone is used, an ambulance should still be called by phoning triple zero (000).
Naloxone comes in a few different formulations. NSW Health is providing naloxone nasal spray and naloxone in pre-filled syringes ready for injection.
Who is take home naloxone for?
Anyone who is at risk of overdosing on opioid drugs, or witnessing an opioid overdose, should consider having naloxone at home, to start to reverse and overdose quickly, even before an ambulance arrives.
Who is at risk of an opioid overdose?
- People on high doses of opioid pain medicines can be at risk of overdose.
- People who use opioid drugs, have recently quit using, or have recently been released from prison are often at high risk of overdose.
- People who use opioids in combination with other drugs or medicines are at risk of overdose.
Health services are also providing naloxone to people who live with or spend time with someone who uses opioid drugs. Remember that naloxone can only help if there’s another person nearby who knows how to use it.
Visit Your Room for more information about naloxone.
Visit NUAA for ways to stay safe when using opioid drugs.
Information for NSW public health services and the Medically Supervised Injecting Centre (MSIC)
The Opioid Overdose Response & Take Home Naloxone Policy Directive and Procedures apply to NSW public health services and the MSIC for the management of clients at risk of experiencing or witnessing an opioid overdose.
A legal instrument accompanying the policy directive and procedures enables specific kinds of workers to supply naloxone as part of the ORTHN intervention.
Eligible health workers at public health services and the MSIC must complete ORTHN training and credentialing requirements set out in the ORTHN Procedures before they are legally able to supply naloxone using the ORTHN intervention.
The training is being delivered to all local health districts, the Justice Health & Forensic Mental Health Network and MSIC in 2019 and 2020.
A key contact has been nominated from each district, network or service to schedule training and oversee local preparations. To find out who your contact is, email us at firstname.lastname@example.org
ORTHN implementation documents
When delivering ORTHN interventions, health workers in public health services and the MSIC need to use specific forms and documents. The ORTHN policy directive and procedures provide instruction about the use of these documents.
The ORTHN checklist and record of supply is a state form which needs to be ordered from Stream Solutions. Contact email@example.com for information about how to order the form from Stream Solutions.
Consumer Information Sheets can be ordered for free using the naloxone factsheet order form.
All enquiries should be directed to firstname.lastname@example.org
Information for non-government and private service providers (including sole traders)
Non-government and private services can play a key role in increasing community access to take home naloxone across NSW.
The Opioid Overdose Response & Take Home Naloxone (ORTHN) Procedures provide instructions for supplying take home naloxone in non-government and private services that are not otherwise authorised to supply this medication. Participating services will be able to obtain naloxone at no cost and supply it to people at risk of experiencing or witnessing an opioid overdose for free and without a prescription.
Agencies will need to enter into a Letter of Agreement with the NSW Ministry of Health to participate in the Opioid Overdose Response & Take Home Naloxone program. The agreement requires participating services to comply with the procedures for supplying take home naloxone.
A Legal authority will enable certain types of workers to supply naloxone, provided they successfully complete worker training and credentialing, and supply naloxone in compliance with the Procedures.
In order to be credentialed, non-government and private workers need to attend the worker training and complete assessments to demonstrate satisfactory knowledge and skills to deliver a take home naloxone brief intervention in accordance with the Procedures.
Take home naloxone worker training is funded by the NSW Ministry of Health and will be delivered remotely by a Registered Training Organisation.
Training will be available for free for up to eight workers in each participating service, in metropolitan and regional locations across NSW. The NSW Ministry of Health is unable to fund travel expenses or staff relief costs associated with the training.
Expressions of interest for non-government and private services
Non-government and private services are invited to submit an Expression of Interest (EOI) to supply take home naloxone through this program.
The FAQs summarise the program and may be useful when seeking senior management support to participate in the Opioid Overdose Response & Take Home Naloxone program.
1. Review the EOI document including the Procedures, Letter of Agreement template and Legal Authority and check the eligibility criteria of your service and workforce.
The NSW Ministry of Health will review EOI forms and respond to eligible organisations with a Letter of Agreement to sign.
Worker training will be available from May 2020. The training provider will contact participating services to schedule a remote training session.
A list of non-government and private services participating in the take home naloxone program will be published on the NSW Health website.
All enquiries should be directed to email@example.com
Australian Government Department of Health - take home naloxone pilot
The Australian Government Department of Health take home naloxone pilotwill fund the cost of naloxone medicines in NSW, SA and WA. The pilot will complement the NSW Health program to supply naloxone in alcohol and other drug services and needle and syringe programs in NSW and will naloxone available in even more places including community pharmacies. The pilot will be implemented in stages from December 2019 and will run until February 2021.
New take home naloxone promotional resources are available to display and distribute in services participating in the pilot. They can be ordered for free using the take home naloxone pilot resource order form.
Australian Government naloxone pilot commences in NSW Health services
NSW is participating from 1 March 2020. NSW Health services supplying take home naloxone for ORTHN interventions can access naloxone through the PBS pilot for free. A PBS prescription is not required.
Reporting requirements and Portal registration for sites participating in the pilot
Under the Special Arrangement the Australian Government requires that each ORTHN site provides data every month about the naloxone it supplies which has been obtained through the PBS pilot., the Australian Government requires that each ORTHN site provides data every month about the naloxone it supplies which has been obtained through the PBS pilot.
An online PPA portal has been established by the Australian Government. ORTHN sites must use the PPA portal to report data about the naloxone they supply during the PBS pilot.
In the first week of March 2020, the PPA portal administrators will send an email to the contact person at the ORTHN site (NSW Health services nominated a contact person for each of their ORTHN supply sites to NSW Ministry of Health in early December 2019.) The email link will be sent to the contact person nominated, asking the ORTHN site to register with the PPA portal as an ‘Authorised Alternative Site’ and start entering data. A user guide for the PPA portal will also be provided by the PPA Administrators.
For each ORTHN intervention provided, de-identified information about the naloxone products supplied and the client intervention must be entered into the PPA portal.
Amended ORTHN state form
The Opioid Overdose Response & Take Home Naloxone checklist and record of supply state form was amended in February 2020 to include all data collection fields required for the PBS pilot.
All ORTHN sites must use the amended form for the duration of the PBS pilot. The amended form replaces the form at PD2019_036: Procedures, Appendix A.
The amended form contains a new section, ‘Supply Information’. Workers providing ORTHN interventions are requested to record whether the client reports receiving naloxone previously, reason for re-supply, and source of opioids (if disclosed).
The amended form can be ordered by any ‘Stream Solutions user’ in the LHD or network.
The PPA portal is administered under the authority of the Australian Government. Approval to release de-identified data from NSW Health to the Australian Government via the PPA portal has been obtained under the Health Administration Regulation 2015, Public Health Act 2010, Clause 17(2) – Disclosure of Information.
The Australian Government will provide NSW Ministry of Health with data reports from the PPA portal for program monitoring purposes.
NSW Ministry of Health is writing to Chief Executives of LHDs and specialty health networks advising that their services are required to report data as set out in this Information Bulletin and how Pharmacy Departments can gain reimbursement through the PBS–subsidised pilot as set out in this Information Bulletin.
In line with the NSW Health Data Governance Framework (GL2019_002), a Data Sponsor, Data Custodian and Data Steward have been appointed for this state wide data asset.
Evaluation of the pilot
An evaluation of the PBS pilot is planned. There will be some additional client consent and reporting requirements associated with the evaluation once ethics approval has been received.
The PPA portal includes a client consent tick box to register if clients consent, or otherwise, to having de-identified information used for evaluation purposes. This box should be checked 'No' for consent until ORTHN sites have been notified that all ethics approvals are in place.Where the box is checked ‘no’ to consent, only basic information about the supply of naloxone is collected by the PPA portal.
The Australian Government is seeking approval for data collected via the PPA portal to be released to University of Queensland, and once received this will be shared with the states. Until that time all data will be held by the PPA portal.
Pilot conditions established by the Special Arrangement end on 28 February 2021. Naloxone supplied under the Special Arrangement must be supplied to clients by 28 February 2021. ORTHN sites must manage stock levels carefully close to the pilot end date.
Information for community pharmacies
Health professionals participating in this pilot program may wish to provide information to consumers about how to use naloxone by referring to the consumer medicine information sheetprovided with each product or to the NSW Health Consumer Information Sheet: Nyxoid® or Consumer Information Sheet: Prenoxad®.
Information for general practitioners
For information on naloxone and how it can be used in general practice for overdose prevention and response, watch the RACGP webinar A guide to naloxone for general practitioners.