If you think someone is overdosing, call 911 immediately. Learn more about the signs of overdose.


Virginia is working with community members and law enforcement to prevent fatal opioid overdoses. Friends, family members, residents, and law enforcement all have a role to play when someone is misusing drugs. The prescription medication naloxone (also known as Narcan and Evzio) and the state’s REVIVE! training program have empowered bystanders to intervene and save lives.

If you think someone is overdosing, call 911 immediately.

Signs of Opioid Overdose

An opioid overdose is a breathing emergency: Opioids slow down the central nervous system, and their overuse can lead to a sudden decrease in breathing and heart rate.

The key sign of an overdose is the lack of response someone shows, even to pinching, shaking, or loudly calling their name.

Other major signs are:

  • Breathing slowly or not at all; making gurgling noises
  • Turning very pale, including having blue fingernails and lips


Naloxone is the antidote for opioid overdoses. When given during an overdose, naloxone — which can be given nasally or injected — blocks the effects of opioids on the brain and will restore breathing.

Although naloxone is a prescription medicine, Virginia has passed a statewide law making it more easily available. The standing order, issued by Commissioner of Health Dr. M. Norman Oliver, authorizes pharmacists to dispense naloxone.

Virginians can also obtain naloxone from many local health departments, Community Services Boards, and other community-based organizations.


REVIVE! is Virginia’s opioid overdose and naloxone education program, training healthcare providers and community members to recognize an opioid overdose and respond with naloxone.

To the community, REVIVE! offers brief overviews lasting five to 10 minutes as well as one-hour classroom trainings.

REVIVE!’s First Responder Training, which also lasts one hour, is offered to law enforcement personnel, emergency medical services providers, and firefighters.

The trainings recognize the important role that the public and public safety officials have in responding to opioid overdoses.

Healthcare Providers

Healthcare providers have begun to monitor prescriptions more carefully to reduce the risks associated with long-term opioid therapy. In 2016, the Virginia Department of Criminal Justice Services published Report of the Health and Criminal Justice Data Committee, which provides a multidisciplinary perspective on issues that affect both the health and criminal justice spheres — including prescription drug and heroin misuse. In 2017, the Virginia Board of Medicine adopted regulations to govern the prescribing of opioids and buprenorphine for physicians statewide. Virginia’s nurses, dentists, optometrists, and veterinarians also have opioid guidelines. This guidance is designed to ensure that all of Virginia’s providers prescribe opioids in the safest way possible.

Law Enforcement

Law enforcement members play a critical role in a community’s ability to respond to the opioid epidemic. They are central to the use of naloxone to combat overdose; they are also key partners in their communities and with counterparts at the local, state, and federal levels. Learn how to start a naloxone program in your community with the Law Enforcement Naloxone Toolkit.