How to Create a Family Overdose Emergency Plan for Medications

Every year, more than 100,000 people in the U.S. die from drug overdoses. Most of those deaths involve opioids - especially synthetic ones like fentanyl - and many happen at home. The truth is, if someone in your household takes prescription pain medication, an overdose emergency plan isn’t optional. It’s as essential as a fire extinguisher. You hope you never need it. But if you do, those first few minutes could save a life.

Why This Plan Matters More Than You Think

Most people don’t realize how fast an overdose can turn deadly. With fentanyl, a person can stop breathing in under three minutes. By the time someone calls 911, finds their phone, or tries to wake them up, it’s often too late. The window to reverse an opioid overdose? Four to six minutes. After that, brain damage or death becomes likely.

But here’s the good news: naloxone - the medication that reverses opioid overdoses - works 93% of the time when given quickly. And it doesn’t need to be given by a doctor. A teenager, a grandparent, or a neighbor can use it. The problem? Most families don’t have it on hand. Only 12.3% of U.S. households with prescription opioids have a plan in place.

This isn’t about fear. It’s about preparation.

Step 1: Know Who’s at Risk

Not everyone in the house needs a plan - but some do. You need one if someone takes:

• Opioid painkillers like oxycodone, hydrocodone, morphine, or fentanyl patches
• Any medication prescribed for chronic pain, especially at doses above 50 morphine milligram equivalents (MME) per day
• Medications combined with benzodiazepines (like Xanax or Valium) or alcohol - this increases overdose risk
• Medications after a recent hospital discharge, surgery, or dose increase

If someone has a history of substance use disorder, even if they’re currently stable, that’s another red flag. And don’t forget: teens and young adults are at rising risk. One in three high school students knows someone who’s overdosed.

Step 2: Get Naloxone - and Keep It Accessible

Naloxone comes in two forms: nasal spray (like Narcan) and injectable. For families, the nasal spray is easiest. No needles. No training needed beyond reading the box.

Where to get it:

• Pharmacies in 46 states: You can buy it without a prescription at CVS, Walgreens, and many local pharmacies. Many offer it for $25 or less with insurance.
• Free kits: Health departments in cities like New York, Seattle, and Chicago give out free naloxone. Check your local health website.
• Community programs: Some nonprofits and tribal organizations distribute kits for free - especially in rural areas where access is limited.

How many doses to keep: Get at least two. Fentanyl is so strong that one dose of naloxone might not be enough. Some people need three.

Where to store it: Keep it where everyone can find it - not locked in a cabinet, not in the glove compartment. A drawer in the kitchen or bathroom works. Keep it away from direct sunlight and extreme heat. Room temperature (68-77°F) is fine. Check the expiration date every 18 months. Naloxone doesn’t suddenly stop working, but it loses strength over time.

Step 3: Learn the Signs of Overdose

An overdose doesn’t always look like what you see on TV. The person won’t necessarily be shaking or screaming. Often, they’re silent. Look for these three signs:

• Unresponsive: Shake their shoulder hard. Yell their name. If they don’t wake up, it’s an emergency.
• Abnormal breathing: Are they breathing less than 12 times a minute? Or are they making slow, gurgling, snoring sounds? That’s not sleep - that’s drowning on their own breath.
• Pinpoint pupils: Shine a light in their eye. If the black part of the eye is tiny like a pinhead, that’s a classic sign.

If you see even one of these - act. Don’t wait. Don’t assume they’re just passed out. Don’t try to wake them with cold water or shaking harder. Time is everything.

Step 4: Practice the Response - Every Family Member

This isn’t a one-time thing. Everyone in the house - including kids over 12 - needs to know what to do. Here’s the simple sequence:

1. Assess: Check for the three signs above.
2. Naloxone: Remove the device from the package. Insert the nozzle into one nostril. Press the plunger firmly. That’s it. No need to tilt the head or blow.
3. Call 911: Do this immediately after giving naloxone. Even if they wake up, they need medical care. Overdose symptoms can return after 30-90 minutes.
4. Have more ready: If they don’t wake up in 3-5 minutes, give a second dose in the other nostril.
5. Observe: Stay with them. Keep them on their side. Watch their breathing. Don’t leave them alone.
6. Review: After the emergency, talk about what happened. Did the plan work? What would you change?

This is called the A.N.C.H.O.R. protocol - Assess, Naloxone, Call 911, Have additional naloxone ready, Observe, Review. It’s taught by health departments across the country. Print it out. Tape it to the fridge.

Step 5: Make a Quick-Reference Card

Create a laminated card that fits in a wallet or purse. Include:

• Names and phone numbers of emergency contacts
• Medications the person takes (including doses and doctor’s name)
• Location of naloxone kits
• Step-by-step instructions in plain language
• Any allergies or medical conditions

In a real emergency, stress slows thinking. A card cuts through the panic. Ohio’s emergency responders found that families with these cards reduced response time by nearly 50 seconds - enough to make a difference.

What About Non-Opioid Overdoses?

Naloxone only works on opioids. It won’t help with overdoses from alcohol, benzodiazepines, or antidepressants. But here’s the thing: most fatal overdoses in homes today involve opioids - even if other drugs are mixed in. So having naloxone still gives you the best shot.

If someone takes multiple medications, keep a list of what they’re on. If you’re unsure whether an overdose is opioid-related, give naloxone anyway. It’s safe. It won’t hurt someone who didn’t take opioids.

Common Mistakes and How to Avoid Them

• Expired naloxone: 31% of failed attempts involved old kits. Set a calendar reminder every 18 months.
• Wrong administration: 24% of people didn’t inject it properly. Practice on a training device (some pharmacies give them out for free).
• Delaying 911: 63% of preventable deaths involved waiting too long to call. Call as soon as you give naloxone - not after.
• Not training everyone: If only one person knows what to do, and they’re not home? The plan fails. Include teens, roommates, caregivers.

What Happens After the Emergency?

Surviving an overdose doesn’t mean the crisis is over. The person needs medical care. They may need treatment for addiction. But here’s the hopeful part: 89% of people who survive with naloxone go on to seek help. That’s not a coincidence. Having a plan gives families the courage to act - and that moment of intervention often becomes the turning point.

Don’t wait for a tragedy to start this conversation. Talk to your family. Practice the steps. Keep naloxone in the drawer next to the first aid kit. Treat it like smoke alarms - not because you expect fire, but because you care enough to be ready.

Resources You Can Use Today

• Free training: The American Red Cross offers a free 15-minute online course on overdose response.
• Free naloxone: Visit your local health department or search ‘free naloxone near me’.
• Insurance coverage: Since 2024, Medicare Part D covers naloxone with $0 copay. Most private insurers do too - call your plan to confirm.
• Apps: The ‘Overdose Guardian’ app (released Jan 2024) gives real-time alerts if overdoses are reported near your home.

You don’t need to be a medical expert. You just need to be ready. And right now, that’s more than most people are.