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Surgeon General’s Advisory on Naloxone and Opioid Overdose

https://www.surgeongeneral.gov/priorities/opioid-overdose-prevention/naloxone-advisory.html

View the May REVIVE! Newsletter HERE for training and naloxone updates.

For information on upcoming REVIVE! trainings, visit the Events tab at the bottom of the page.

REVIVE! is the Opioid Overdose and Naloxone Education (OONE) program for the Commonwealth of Virginia. REVIVE! provides training to professionals, stakeholders, and others on how to recognize and respond to an opioid overdose emergency with the administration of naloxone (Narcan ®). REVIVE! is a collaborative effort led by the Virginia Department of Behavioral Health and Developmental Services (DBHDS) working alongside the Virginia Department of Health, the Virginia Department of Health Professions, recovery community organizations such as the McShin Foundation, OneCare of Southwest Virginia, the Substance Abuse and Addiction Recovery Alliance of Virginia (SAARA), and other stakeholders.

REVIVE! offers two different types of trainings:

  • Lay Rescuer trainings are between 1-1.5 hours long. This training covers understanding opioids, how opioid overdoses happen, risk factors for opioid overdoses, and how to respond to an opioid overdose emergency with the administration of Naloxone.
  • Lay Rescuer Training of Trainers is approximately 3 hours long and covers everything in the lay rescuer training with additional focus and discussion of each specific training objective to ensure a thorough understanding of the materials trainers will be presenting on. This training teaches trainers how to conduct trainings and is appropriate for individuals who intend on leading trainings in the community.

For information on upcoming REVIVE! trainings, visit the Events tab at the bottom of the page. Law enforcement is required to go through a separate Law Enforcement Officer training offered directly through DBHDS. To request the Law Enforcement REVIVE! training for your agency, please contact revive@dbhds.virginia.gov

Virginia is currently under a public health emergency as a result of the opioid addiction crisis. Virginia has been severely impacted by opioid abuse, particularly the abuse of prescription drugs. In 1999, the first year for which such data is available, approximately 23 people died from abuse of fentanyl, hydrocodone, methadone, and oxycodone (the leading prescription opioids abused, commonly referred to as FHMO). By 2013, the most recent year for which complete data is available, 386 individuals died from the abuse of FHMO, an increase of 1,578%, with fentanyl being the primary substance fueling this increase. In 2013 alone, there was an increase of more than 100% in deaths attributed to fentanyl use. In 2013, as before in 2011, drug-related deaths happened at a higher per capita level (11.0 deaths per 100,000) than motor vehicle crashes (10.1 per 100,000).




This 2016 data provides evidence of other disturbing trends in Virginia, including a sharp rise in Opioid deaths.

Currently, the number of overdose deaths related to opioids continues to rise as seen in this chart on all opioid deaths in Virginia.

NEW Local Health Departments are now dispensing Narcan Nasal Spray at no charge.

In an attempt to make naloxone more accessible in our communities, the Virginia Department of Health will be dispensing Narcan Nasal Spray to those in need through the local health departments. There are two ways this is being accomplished:

1- In conjunction with REVIVE! trainings: This requires REVIVE! trainers to collaborate with their health departments on scheduling the training at a time when someone from the health department is available to dispense the medication at the event

2- On a walk-in basis: For this option, individuals should call the health department in advance to make sure a staff member who is able to dispense the medication is on-site when the individual at need plans on going in.

Please contact your local health department to coordinate efforts to make Narcan Nasal Spray available in your county. Click HERE for a list of Health District Directors who will serve as the main point of contact for their respective Health Department.

2017 Naloxone Dispensing at Trainings §54.1-3408

  • A person who is authorized by the Department of Behavioral Health and Developmental Services to train individuals on the administration of naloxone for use in opioid overdose reversal and who is acting on behalf of an organization that provides services to individuals at risk of experiencing an opioid overdose or training in the administration of naloxone for overdose reversal and that has obtained a controlled substances registration from the Board of Pharmacy pursuant to § 54.1-3423 may dispense naloxone to a person who has completed a training program on the administration of naloxone for opioid overdose reversal approved by the Department of Behavioral Health and Developmental Services, provided that such dispensing is
    • (i) pursuant to a standing order issued by a prescriber,
    • (ii) in accordance with protocols developed by the Board of Pharmacy in consultation with the Board of Medicine and the Department of Health, and
    • (iii) without charge or compensation. The dispensing may occur at a site other than that of the controlled substance registration provided the entity possessing the controlled substances registration maintains records in accordance with regulations of the Board of Pharmacy.
  • A person to whom naloxone has been dispensed pursuant to this subsection may possess naloxone and may administer naloxone to a person who is believed to be experiencing or about to experience a life-threatening opioid overdose.
  • Click HERE for a quick start guide
  • Contact the Board of Pharmacy to apply for Controlled Substance Registration: pharmbd@dhp.virginia.gov

Naloxone - Virginia Statewide Standing Order: A Standing order serves as a prescription for all Virginians who would like to obtain Naloxone. Virginia residents can now request Naloxone directly from the pharmacy without out having to visit their doctor or medical provider first.

Naloxone, a prescription medication, is an opioid antagonist drug that reverses the effects that opioids have in the brain. When a person overdoses on opioids, the opioid overwhelms specific receptors in the brain, slowly decreasing respiration and heart rate before finally stopping it altogether. Naloxone has a very high affinity for these receptors and effectively pushes the opioid off of the brain receptor. This action allows a person’s body to resume respiration. Naloxone has been used for years by emergency medical technicians and emergency room doctors to reverse opioid overdose emergencies. Outside of this singular purpose, naloxone has no effect on the body, and poses no danger to anyone who accidentally administers it to themselves or someone else.

Naloxone is a proven public health response to the epidemic of opioid overdose emergencies. The Centers for Disease Control and Prevention indicate that since 1996, when the first program to distribute naloxone to Lay Rescuers (REVIVE!’s terminology for community members who have been trained on naloxone administration) was implemented, 152,283 persons received training on administering naloxone. Those individuals have saved 26,463 lives by administering naloxone to individuals who were experiencing an opioid overdose emergency.

2016 RAM Video: SystemLEAD 2016 RAM Narcan Pilot Project

Please view the tabs below for more about REVIVE! If you need further information, you can send an email to revive@dbhds.virginia.gov.







  • GOVERNOR DECLARES OPIOID ADDICTION CRISIS A PUBLIC HEALTH EMERGENCY IN VIRGINIA. Click here for more information on what you can do.
  • Virginia AWARE - Here you will find information of where to find treatment if you or a loved one is struggling with addiction, access to resources in your part of Virginia, and the latest research and data on this crisis.


Current versions of all REVIVE! program documents are available for download. Click on the document you need and it will open in a new window.


These are the bills that are relevant to REVIVE! Click on the bill number for more information.

NEW 2017 Naloxone Dispensing at Trainings §54.1-3408

  • A person who is authorized by the Department of Behavioral Health and Developmental Services to train individuals on the administration of naloxone for use in opioid overdose reversal and who is acting on behalf of an organization that provides services to individuals at risk of experiencing an opioid overdose or training in the administration of naloxone for overdose reversal and that has obtained a controlled substances registration from the Board of Pharmacy pursuant to § 54.1-3423 may dispense naloxone to a person who has completed a training program on the administration of naloxone for opioid overdose reversal approved by the Department of Behavioral Health and Developmental Services, provided that such dispensing is
    • (i) pursuant to a standing order issued by a prescriber,
    • (ii) in accordance with protocols developed by the Board of Pharmacy in consultation with the Board of Medicine and the Department of Health, and
    • (iii) without charge or compensation. The dispensing may occur at a site other than that of the controlled substance registration provided the entity possessing the controlled substances registration maintains records in accordance with regulations of the Board of Pharmacy.
  • A person to whom naloxone has been dispensed pursuant to this subsection may possess naloxone and may administer naloxone to a person who is believed to be experiencing or about to experience a life-threatening opioid overdose.
  • Click HERE for a quick start guide
  • Contact the Board of Pharmacy to apply for Controlled Substance Registration: pharmbd@dhp.virginia.gov
  • HB 1427 - Death caused by controlled substance; penalty.
  • HB 1458 - Naloxone; administration in cases of opiate overdose.
  • HB 1500 - Safe reporting of overdoses.
  • HB 1833 - Law-enforcement officers; administration of naloxone.
  • SB 892 - Safe reporting of overdoses.
  • SB 1186 - Naloxone; administration in cases of opiate overdose.