Frequently Asked Questions

What is naloxone?
Naloxone is a prescription drug that can reverse the effects of prescription opioid and
heroin overdose, and can be helpful in preventing overdose deaths if administered in

What is Narcan? How does it differ from naloxone?
Narcan® is a brand name form of the drug naloxone. Narcan® and naloxone are chemically identical.

How is naloxone administered? How does it work?
Naloxone can be administered nasally or by injection into a muscle or below the skin to a person suspected of an overdose. When administered during an overdose, naloxone blocks the effects of opioids on the brain and may restore breathing within two to eight minutes.

What are some of the signs/symptoms of an opioid overdose?
The primary symptoms of an opioid overdose are lack of response to stimuli such as
pinching, shaking or calling the person’s name loudly; pinpoint pupils; and lack of or very
shallowing, slow breathing.

What is REVIVE!?
REVIVE! is the Opioid Overdose and Naloxone Education (OONE) program for the
Commonwealth of Virginia. REVIVE! provides training to professionals, stakeholders and
others on how to recognize and respond to an opioid overdose emergency with the
administration of naloxone. REVIVE! is a collaborative effort led by the Virginia
Department of Behavioral Health and Developmental Services (DBHDS) working
alongside the Virginia Department of Health (VDH), the Virginia Department of Health Professions, community organizations, and other stakeholders. More information can be found here.

What does VDH’s statewide standing order for naloxone do?
The Virginia State Health Commissioner, Dr. Levine, issued a naloxone statewide standing order that authorizes pharmacists who maintain a current active pharmacist license to dispense naloxone in accordance with the Virginia Drug Control Act, §54.1-3408, and the current Board of Pharmacy-approved protocol. The standing order, protocol and Revive educational materials are located on the VDH Website. In essence, the standing order serves as a prescription written for the general public, rather than specifically for an individual.

Does the standing order mean that naloxone is free for patients?
No. The standing order does NOT remove the cost of the drug.

What is the cost?
The out of pocket cost for naloxone nasal spray ranges between $70 and $150 for a two
dose unit, depending on the formulation.

How is naloxone generally dispensed?
The standing order allows the pharmacist to dispense either two prefilled syringes in a kit
for nasal use; a twin pack that contains two intramuscular naloxone auto-injectors, or a
twin pack that contains two naloxone nasal sprays.

Do any health insurance plans help with the cost? If I don’t have a doctor’s order, will my insurance cover the cost of it?
Health insurance drugs plans can vary greatly and many do pay some portion of the
cost. Please consult with your health insurance to determine if they will cover naloxone.
Dr. Levine’s standing order is a doctor’s order.

What kind of counseling is required by the pharmacists?
The pharmacist is required to provide counseling which covers prevention, recognition,
response, and administration of naloxone. This counseling cannot be waived by the
recipient of the naloxone unless the recipient can provide proof of successful completion
of the REVIVE! training program.

Is there a waiting period between coming to get the naloxone and actually getting it?
No, however, it is possible that the pharmacy may need to order the drug if it is not in
stock which could create a minimal delay. It is advisable to contact the pharmacy prior
to visiting.

What kind of database am I entered into?
The information will be entered into the pharmacy’s prescription dispensing database.

Who has access to my information?
This information is classified as protected health information (PHI) and is protected by
federal laws that apply to PHI.

What accommodations are being made so my request is private to lessen the
stigma of purchasing naloxone?
You have the right to request to speak to the pharmacist directly in a private setting.

Where can I learn how to administer naloxone to someone suspected of an overdose?
One of the best ways for the public to learn about the use of naloxone is through the
Revive! training course on the Virginia Department of Behavioral Health and
Developmental Services website.