Statewide Standing Order for Naloxone
Please review the information below before applying for a standing order
The purpose of this standing order is to help reduce morbidity and mortality associated with opioid overdose by facilitating the distribution and administration of Naloxone Hydrochloride (Naloxone). Naloxone is an opioid antagonist indicated for the complete or partial reversal of opioid overdose, including respiratory depression, induced by natural and synthetic opioids. It may be delivered intramuscularly with a needle or intranasally. Naloxone is indicated for emergency treatment of a known or suspected opioid overdose. It is not a substitute for emergency medical care.
This standing order is issued pursuant to paragraphs (1) and (2) of subdivision (c) of Section 1714.22 of the California Civil Code, which allows a licensed health care provider authorized to prescribe an opioid antagonist to issue a standing order for the distribution and administration of naloxone.
(California pharmacists do not need to use the standing order. Pharmacists can dispense naloxone without a prescription from a health care provider as authorized and in compliance with Business and Profession Code Section 4052.01.)
This standing order authorizes:
A. Non-prescribing entities to distribute naloxone to individuals at risk of opioid overdose, their family members and friends, or other persons in a position to assist during an opioid-related overdose, who have completed an opioid overdose prevention and treatment training program.
B. The administration of naloxone received from the entity using this standing order to assist a person experiencing or reasonably suspected of experiencing an opioid overdose, by a family member, friend, or other person who has received opioid overdose prevention and treatment training from an opioid overdose prevention and treatment training program.
C. “Non-prescribing entities” means organizations that do not employ or contract with a medical provider that has a license to prescribe and can issue a standing order and provide oversight for the distribution and administration of naloxone.
1. A non-prescribing entity must apply for this standing order with the California Department of Public Health and agree to the terms and conditions specified.
D. “Opioid overdose prevention and treatment training program” means any program operated by a local health jurisdiction or that is registered by a local health jurisdiction to train individuals to prevent, recognize, and respond to an opiate overdose, and that provides, at a minimum, training in all of the following:
1. The causes of an opiate overdose.
2. Mouth to mouth resuscitation.
3. How to contact appropriate emergency medical services.
4. How to administer an opioid antagonist.
Additionally, the training program should include how to recognize an opioid overdose.
An example of an “overdose prevention and treatment training program” that is registered with or operated by a state or local health jurisdiction includes, but is not limited to:
All non-prescribing entities that intend to use the standing order must complete the on-line application process and agree to the terms and conditions specified.
A standing order is no longer required for Narcan® naloxone nasal spray due to the over-the-counter status. All other formulations and dosages of naloxone, including intramuscular naloxone, will remain available by prescription only and require a standing order to distribute and administer.