Opioid Overdose Reversal Agents

Illinois is part of a group of states offering a statewide standing order with accompanying opioid overdose educational resources for obtaining, dispensing, and administering naloxone and nalmefene. This standing order, established in 2015 and updated in 2024, allows all pharmacists, schools, and opioid overdose education and naloxone distribution (OEND) programs to provide naloxone or nalmefene without a direct prescription to individuals at risk of an opioid overdose and to others who may assist an individual suffering an opioid-related overdose.

Solving the opioid crisis takes a comprehensive strategy that emphasizes prevention, treatment and recovery, and response, and involves multiple and interdisciplinary sectors.

Learn more about opioid overdose reversal agents and their role in addressing the opioid epidemic in this section and the Illinois Opioid Overdose Reversal Agent Standardized Procedure web page.

Naloxone and nalmefene are prescription medications that can block or reverse the effects of an opioid overdose. Anyone can easily use naloxone or nalmefene to save the life of someone overdosing on opioids, including heroin, fentanyl, or prescription medicines like OxyContin® or Percocet®.

The Opioid Overdose Reversal Agent Standing Order allows eligible entities, namely pharmacies, schools, and opioid overdose education and naloxone distribution (OEND) programs to provide naloxone or nalmefene to any requesting person with the intent to respond to a suspected opioid overdose without a direct prescription. With this standing order, insurers, such as Medicaid and Medicare, can be billed. Eligible entities must complete approved training and education on naloxone administration to access the order.

Pharmacies utilizing the order should report naloxone dispensing information to the Illinois Prescription Monitoring Program.

OEND programs utilizing the order must be enrolled with the Illinois Department of Human Services, Substance Use Prevention and Recovery Program.

Schools utilizing the order must be registered with the Illinois State Board of Education (ISBE) as required by Illinois School Code 105 ILCS 5/22-30(e-10), (f), (f-5), and (g).The medications can be administered by school nurses or other personnel who have met the educational requirements detailed in the Illinois Opioid Overdose Reversal Agent Standardized Procedure[KF1] [SJ2] [ER3] [SJ4]  on how to recognize an opioid overdose and how to administer treatment. ISBE reporting information is outlined at the following link: School Nursing (isbe.net).

Signs and Symptoms of Opioid Overdose include, but are not limited to, the following:

• Slowed, irregular, or no breathing
• Skin, nails turn blue
  
• Extreme sleepiness
  
• Unresponsive to sternal rub or when shaken
  
• Pinpoint pupils
  
• Generalized seizures in children not known to have epilepsy
  

If an individual is suspected of overdosing, an Opioid Overdose Reversal Agent must be administered as quickly as possible because an overdose may result in death.

• Prevention Training Utilizing the Illinois Naloxone Standing Order
• Illinois Naloxone Standardized Procedure and sample of the unsigned Illinois Naloxone Standing Order

• Illinois Naloxone Standing Order: Overview for Pharmacies Webinar
• Illinois State Opioid Antagonist Training
  

For information on how to report naloxone dispensing to the IL PMP contact:
Prescription Monitoring
401 North Fourth Street
Springfield, IL 62702
Fax: (217) 557-7975
Phone: (217) 524-1311

For Schools –  Nurses and school  staff personnel can visit School Nursing (isbe.net) to obtain the standing order

School Nursing

Placing the link for ISBE where nurses /staff can report the use to ISBE and find additional resources about this topic.

More information for Pharmacists

• Prescribe To Prevent FAQ

To register your OEND with the Illinois Department of Human Services, Substance Use Prevention and Recovery Drug Overdose Prevention Program contact:

• IDHS/SUPR Drug Overdose Prevention Program
• DHS.DOPP.coordinator@illinois.gov

• Prescribe to Prevent Patient Education Videos

• SAMHSA Opioid Prescribing Courses for Health Care Providers
• Prevent & Protect FAQ
• Prevent & Protect Resources