Information for Prescribers and Pharmacists


Role of Medical Providers in Overdose Prevention


" Medical Providers may have the opportunity to maximize patient quality of life by providing prescription opioids, yet those same medicines have contributed to the fact that drug overdose has overtaken motor vehicle crashes as the #1 cause of injury death in the United States." (


Providers can consider taking the stance of "risky medicines," instead of "risky patients" and engage in proactive dialogue with patients to minimize poisoning, oversedation, and overdose risk with patients who need opioid medications to improve their quality of life. Discussing an emergency overdose/poisoning/oversedation plan and naloxone prescribing is an essential component of keeping patients alive. (


It is also essential to consider the potential impact that these medications may have on others in the home including children. Children are at risk of accidental exposure to these potentially lethal medications any time they are in the homes where they live. Think of the "one pill can kill" substances, opioids are in that class of substances.  


Assessing Overdose Risk and Patient History:

  • Review medications
  • Ask about children in the home
  • Take a substance abuse history
  • Check the prescription monitoring program
  • Take an overdose history - Ask your patient whether they have:
    • ​Overdosed or had a bad reaction to taking opioid medications?
    • Witnessed an overdose?
    • Received training to prevent, recognize, or respond to an overdose or medication-related oversedation?


Prescribing naloxone is legal in the state of Utah. Consider prescribing it to your patients and their families.  There is no Physician-Patient Relationship required.  

In the state of Utah, physicians, nurse practitioners, and physician assistants who have prescribing authority may prescribe and distribute naloxone rescue kits to anyone at risk of experiencing an opioid overdose or at risk of witnessing an opioid overdose according to UT code § 26-55-101




Utah Naloxone Access Law.
This is a link to the Utah Naloxone Access Law for Reference
Link to Utah Naloxone Access Law.pdf
Adobe Acrobat document [119.0 KB]


Description and Analysis of the Utah Overdose Prevention Legislation with updates through 2016
Here is an analysis and description of the laws in Utah enacted to prevent opioid overdose death done by the Network for Public Health Law.
Utah overdose prevention 2016 update R2 [...]
Adobe Acrobat document [1.2 MB]



The American Medical Association (AMA) and American College of Emergency Physicians (ACEP) have issued Policy Statements in support of access to naloxone rescue kits, as have many other professional societies

  • From the AMA: "Opioid addiction and drug abuse place a great burden on patients and society, and the number of fatal poisonings involving opioid analgesics more than tripled between 1999-2006. Naloxone is a drug that can be used to reverse the effecgs of opioid overdose. The AMA has adopted a policy to support further implementation of community-based programs that offer naloxone and other opioid overdose prevention services. The policy also encourages education of health care workers and opioid users about the use of naloxone in preventing opioid overdose fatalities."





Below are Prescription forms and information you can print out for prescribing to your patients.  There is also a comparison chart for the various available naloxone products.



Printable Intramuscular (IM) Naloxone Kit Prescription
This Rx with patient instructions can be printed and used to prescribe to your patients. Source:
IM Rx.pdf
Adobe Acrobat document [2.2 MB]
Printable Intranasal (IN) Naloxone Kit Prescription
This Rx with patient instructions can be printed and used to prescribe to your patients. Source:
IN Rx.pdf
Adobe Acrobat document [1.1 MB]
Example of Narcan Nasal Spray Device Prescription
This example will show you how to write a prescription for the Adapt Brand Narcan Nasal Spray Devices. Source:
Adapt Narcan Nasal Rx.pdf
Adobe Acrobat document [55.5 KB]
Instructions for Prescribing an Auto-Injector
This will describe how you can write a prescription for the kaleo brand auto-injector product Evzio. Source:
Adobe Acrobat document [1.1 MB]




Comparison Chart of Various Available Forms of Naloxone. Source:
This chart describes product comparison, prescribing variation and ordering information. Thank you to the team at for compiling this very helpful chart.
Comparison Naloxone-product-chart.pdf
Adobe Acrobat document [154.5 KB]




Printable Handout to give to patients and families on "Opioid Safety and How to Use Naloxone"
Courtesy of San Francisco Department of Public Health. Clear, concise 2 page handout. Source:
Naloxone Patient Flyer_SFDPH_2016.pdf
Adobe Acrobat document [495.8 KB]

For Questions or to Obtain a Naloxone Rescue Kit: 

Utah Naloxone


525 E 100 So #4400

Salt Lake City, Utah 84102 

(385) 495-9050


Email: UtahNaloxone





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