With increasing age, older adults are more likely to encounter health conditions and injuries that may require opioid therapy for pain relief. This reality means that opioid overdoses are a concern for older adults as well as for their family members and other caregivers.
This decision aid serves as a guide to questions about pain management and opioid reversal that older adults and their caregivers can ask themselves and the older adult’s health care team. Caregivers should take the steps described in this guide if someone has signs and symptoms that indicate an apparent overdose.
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Decision Tree: How to Use Naloxone for Management of Potential Opioid Overdose
LAY the person down in a safe position.
SPRAY the Naloxone into either nostril.
STAY with the person until help arrives.
• No need for naloxone.
• Observe for any changes
Step 1 Is the person responsive?
Step 3
Administer first dose of naloxone according to instructions.
Step 2 Are signs of opioid overdose present?
Step 4 Call EMS now!
• No need for naloxone.
• Observe for any changes
Signs
of Overdose
• Unresponsiveness.
• No or shallow breathing.
• Blue lips or nails.
• Pinpoint pupils.
• Unusual drowsiness or inability to stay awake.
Step 5
• Monitor the person.
• Does the person regain consciousness or start breathing again?
NO
Step 6
Continue giving naloxone every 2 to 3 minutes until the person wakes up or EMS arrives.
Call MedicalEmergencyServices (EMS) NOW
Even if you have naloxone, you need to have EMS assess the person and likely transport them to a medical facility.
Naloxone can be administered by spraying an intranasal product into the person’s nose or using an injectable product as instructed (into the person’s thigh or upper arm)
Continue monitoring the person until EMS arrives.
2025 Gerontological Society of America • geron.org