FDA’s approval of over-the-counter naloxone will save lives

CHICAGO – The American Society of Anesthesiologists (ASA) urges the public to help fight the opioid epidemic by learning to recognize and respond to an overdose. This includes understanding how to use naloxone, a life-saving medication approved today for sale over the counter by the U.S. Food and Drug Administration.

“While naloxone doesn’t treat the underlying epidemic, it can prevent the most tragic consequences. Expanding its availability throughout our communities will help ensure equitable access to this vital treatment,” said ASA President Michael W. Champeau, M.D., FAAP, FASA. “It’s important to understand that overdoses don’t only impact those with a prescription for opioids or those who live with someone with substance use disorder. Anyone can encounter a person experiencing an overdose at any time, anywhere – in restrooms, parking garages, on public transportation. And anyone could save a life by knowing how to administer CPR and naloxone.”

Naloxone – commonly sold as a nasal spray – is safe, easy to use and quickly reverses an opioid overdose by blocking the effects of the drug, restoring breathing and consciousness. It was previously available with or without a prescription, but sold behind the pharmacy counter. With the significant stigma associated with opioid use, many people may be afraid to ask the pharmacist for it.

“No one should have to suffer the loss of a loved one to overdose nor the deeply unsettling experience of having to revive someone they know. Yet this epidemic makes it likely we will encounter someone experiencing an overdose at some point,” said Bonnie Milas, M.D., clinical professor of anesthesiology and critical care medicine at the University of Pennsylvania in Philadelphia and a member of the ASA Committee on Trauma and Emergency Preparedness. Dr. Milas lost both of her sons to accidental overdoses. “While I have no remaining children, naloxone gave me more time with my sons and gave my sons more opportunities to find success. You never know when one more chance will turn into lifelong healing, which is why I am deeply committed to reducing the stigma associated with opioid use disorder and saving lives from opioid overdoses.”

Dr. Milas notes physician anesthesiologists are pain medicine experts who have a specialized understanding of opioids and their potentially life-threatening effects. ASA and its members are uniquely qualified to play a leading role in this critical public health issue.

The Society encourages the public to take the first step to becoming immediate responders by knowing the common signs of an overdose, including:

  • Shallow, slow or irregular breathing (fewer than eight breaths a minute or a gap of more than 10 seconds between breaths)
  • Small pupils
  • Extreme sleepiness or unconsciousness (e.g., “passed out”)
  • Inability to talk
  • Blue or gray skin color, with dark lips and fingernails
  • Snoring or gurgling sounds
  • Confusion
  • Vomiting
  • Seizures

ASA also recommends the creation of a voucher system – supported by settlement funds provided by opioid manufacturers and distributors – for patients to receive access to the life-saving medication, as well as a nationwide education and training program on its safe use. A mail-to-home option for naloxone – similar to the U.S. government’s free COVID-19 test mailing program – could provide even wider access.

To learn more about naloxone, as well as how to recognize an opioid overdose, react and revive, visit www.REVIVEme.com.


Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research and scientific society with more than 56,000 members organized to raise and maintain the standards of the medical practice of anesthesiology. ASA is committed to ensuring physician anesthesiologists evaluate and supervise the medical care of patients before, during and after surgery to provide the highest quality and safest care every patient deserves.

For more information on the field of anesthesiology, visit the American Society of Anesthesiologists online at asahq.org. To learn more about the role physician anesthesiologists play in ensuring patient safety, visit asahq.org/MadeforThisMoment. Like ASA on Facebook, follow ASALifeline on Twitter.


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