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New York State Technical Working Group on Resuscitation Training in Naloxone Provision Programs

Posted 11/21/2019 (updated 3/28/2024)

Opioid overdose leads to respiratory depression and causes hypoxia culminating in cardiac arrest and death. Since April 2006, New York Public Health Law has allowed programs registered with the State Health Department to train potential witnesses to an opioid overdose in the processes of overdose recognition. These Trained Overdose Responders are also provided with naloxone to treat the victim and reverse the respiratory depressive effects of opioids and prevent death. The initial state-sanctioned training adopted the components of the other trainings in the United States that included the following steps: 

  • Recognition of a potential overdose;
  • Activation of Emergency Medical Services (EMS);
  • Rescue breathing;
  • Administration of naloxone  

Some opioid overdose prevention programs in other parts of the world differ in their guidelines, instead recommending chest compression only resuscitation or full Cardiopulmonary Resuscitation (CPR). 

The New York State Department of Health (NYSDOH) convened a Technical Working Group on Resuscitation Training in Naloxone Programs to ensure that overdose programs in New York State (NYS) and elsewhere are afforded the best possible resuscitation protocol guidance tailored to suspected opioid overdoses in diverse settings. The group discussed the relevant medical literature, current practices and available Health Department data and reached the following conclusions:

The basic curriculum for Trained Overdose Responders should include the following essential components:

  • Role of naloxone;
  • Recognition of a potential opioid overdose; 
  • Confirmation of unresponsiveness with the sternal rub;
  • Administration of naloxone and calling EMS;
  • Re-administration of naloxone if response is inadequate;
  • Ensuring that the revived person is monitored for several hours, preferably in a medical setting;
  • Legality of naloxone possession and administration in NYS;
  • Rescue position
  • The following elements should also be included when possible:
  • Hands-on practice with a demonstration kit;
  • Risk factors for overdose fatality;
  • New York State’s 911/Good Samaritan Law;
  • Resuscitation technique: As there is insufficient data to recommend one resuscitation method over another, clinical directors will need to determine whether rescue breathing, chest compressions, both or neither is most appropriate for inclusion in their training curricula.