Public Health Advisory - Suspected Opioid Overdoses (7/21/2026)

Summary
 

Marin County Public Health is seeing an increase in suspected opioid overdoses within the community. Rapid recognition and response are critical to preventing overdose deaths. 

Naloxone (Narcan®) is a safe, lifesaving medication that can rapidly reverse the effects of an opioid overdose. Healthcare organizations should ensure staff are trained to recognize opioid overdose, know where naloxone is located, and are prepared to administer it immediately while activating emergency medical services (911). Prompt action can save a life.

Actions Requested of Clinicians and Healthcare Organizations

1. Ensure naloxone is readily available in clinical and community-facing settings and that staff know where it is stored.
2. Review staff training on recognizing opioid overdose, administering naloxone, activating EMS (911), and providing rescue breathing when appropriate. Free Naloxone trainings are available.
3. Administer naloxone immediately when opioid overdose is suspected. Do not delay treatment while awaiting emergency responders.
4. Call 911 immediately after administering naloxone. Patients may require additional naloxone, airway support, or ongoing medical evaluation.
5. Educate patients, families, and caregivers on overdose recognition, naloxone use, and the importance of calling 911 after naloxone administration.

Key Clinical Points

• Suspect opioid overdose in individuals with unresponsiveness, slow or absent breathing, and pinpoint pupils.
• Naloxone is safe and effective. If opioid overdose is suspected, administer naloxone immediately. It will not harm someone who is not experiencing an opioid overdose.
• Do not wait for confirmation before administering naloxone.
• If there is no response within 2–3 minutes, administer an additional dose if available.
• Continue rescue breathing and monitor the individual until EMS arrives.

Clinical Guidance

Recognizing Opioid Overdose
 

Common signs include:

• Unresponsiveness or inability to awaken
• Slow, shallow, or absent breathing
• Pinpoint pupils
• Blue or gray lips or fingernails (cyanosis)
• Gurgling, choking, or snoring respirations
• Limp body or loss of muscle tone

Naloxone Administration

Naloxone rapidly reverses opioid-induced respiratory depression and can be safely administered by healthcare personnel and trained community members.

When opioid overdose is suspected:

• Administer naloxone immediately.
• Call 911 immediately after naloxone administration.
• Provide rescue breathing if the individual is not breathing normally.
• Repeat naloxone after 2–3 minutes if there is no response.
• Remain with the individual until EMS arrives, as the effects of naloxone may wear off before the opioid has cleared.

Patient and Community Education
 

Encourage patients, families, and caregivers to:

• Carry naloxone if at increased risk for opioid overdose.
• Learn to recognize the signs of opioid overdose.
• Administer naloxone immediately if an overdose is suspected.
• Call 911 immediately after giving naloxone.
• Stay with the individual until emergency responders arrive.

Community Preparedness

Healthcare organizations play a critical role in reducing overdose deaths.

Marin County Public Health encourages organizations to:

• Ensure naloxone is stocked and readily accessible in patient care and public-facing areas.
• Review overdose response procedures with all staff.
• Provide refresher training on naloxone administration and overdose recognition.
• Confirm staff know where naloxone is stored and how to access it quickly.
• Encourage patients and families at increased risk to obtain and carry naloxone.
• Reinforce that prompt naloxone administration saves lives and that staff should not hesitate to administer naloxone when opioid overdose is suspected.

Resources

• CDC – Responding to an Opioid Overdose
• California Department of Public Health – Naloxone Distribution Project
• California Overdose Surveillance Dashboard
• Marin County Naloxone Resources