By Robb Layne
Capitol Weekly
When a person is facing a life-threatening situation, particularly for an overdose, do you know how to help? Calling 9-1-1, checking if they are conscious, performing CPR, administering naloxone — the emergency checklist that runs through our minds in these moments is critical, especially when every second can mean the difference between life and death.
While first responders, EMTs, nurses, police officers, firefighters and teachers are legally obligated to hold a valid CPR certificate, the requirements surrounding overdose reversals isn’t as concrete. Helping people survive these moments means investing in proactive approaches without the stigma surrounding them.
Emergency preparation begins with education, which is made all the more apparent when 38% and 45% of emergency department nurses report feeling “a little” or “somewhat” comfortable with the provided amount of opioid use disorder training
Training to be a person of action during life-or-death circumstances needs to incorporate all forms of preparation, including CPR and naloxone administration. The future of public health is dependent on emergency responders who are prepared for all situations.
So, what is the difference between performing CPR on someone facing a health complication and administering naloxone to someone experiencing an overdose? Stigma.
Public awareness around CPR certification is grounded in emergency preparedness and a shared responsibility to help others. Yet this isn’t carried over when discussing overdoses and substance use disorder. Professionals either don’t know how to help or have an internal stigma toward those facing a life-or-death situation.
With the root of stigma being a lack of education, we need to shift perception. An overdose is a medical emergency that deserves the same public action as someone choking and receiving the Heimlich maneuver or someone providing CPR.
The most effective way we can continue to break down stigma is through education and compassion. Interactions between emergency service providers and those experiencing an overdose have the potential to reduce harm or perpetuate it. Dispelling first responders’, primarily law enforcement’s, internal biases — whether known or not — is imperative for the greater good of public health.
Since January, 53 people in San Francisco have died from accidental overdoses. The dangers of fentanyl overdoses are receiving national attention, with deadly doses hidden in substances that affect students, police officers in the line of duty, and individuals on the street. The crisis does not discriminate.
In San Francisco, public health officials have expanded access to treatment programs for drug use since 2022, with admissions to substance use disorder treatment reaching record levels in 2024. Local policy changes have also boosted the availability of medication-assisted treatment and naloxone. These steps show progress in California, but prevention and immediate response are critical to continue saving lives.
A USF study emphasized that naloxone administration training programs can enhance health practitioners’ knowledge and confidence in administering naloxone, helping address this preventable public health crisis.
Providing emergency responders with this education gives them the power to act decisively, compassionately and save lives when it matters most.
Integrating naloxone training alongside existing CPR frameworks would create a standardized approach that raises awareness while maintaining practical, cost-effective implementation. By leveraging existing state guidance and training infrastructure, the state can expand lifesaving capacity without redesigning CPR curricula from the ground up.
Expanding the scope of lifesaving training also means confronting stigma and clearing misconceptions about substance use disorders and access to care. When we treat overdose response as essential emergency preparedness rather than casting judgment, we can empower Californians to act.
Awareness leads to action, and action saves lives.
Robb Layne is the Executive Director of the California’s Association of Alcohol and Drug Program Executives (CAADPE), the only state-wide association representing all types of substance use disorder services.