​EMS ​Naloxone Leave-Behind​

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​What is EMS Naloxone

Naloxone leave-behind is a collaboration between public health and public safety that allows EMS clinicians to leave naloxone on-scene with patients and their support system.

Research shows overdose survivors face a significantly increased risk of fatally overdosing in the future. EMS personnel can help reduce the risk of fatal overdose by giving naloxone kits directly to at-risk patients and their family, friends, and roommates.


Why do Naloxone​ Leave-Behind?

Naloxone Leave-Behind programs improve linkages to care in the community, which can reduce future overdoses and the strain on the EMS workforce.

Naloxone is provided at no cost to EMS companies by the state of Maryland. While naloxone is not the sole answer to the overdose crisis, it can help patients live another day, improve community health, and prevent overburdening healthcare systems.​

Naloxone leave-behind allows EMS p​rofessionals to directly give naloxone to exactly the people who need it the most. By providing these kits, EMS can save lives beyond the patient care given in the moment of an overdose.

Benefits of Lea​​​ve-Behind


Leave-behind allows clinicians to provide life-saving resources whether a patient accepts transport or not. In the long term, connecting patients to resources can make your job as an EMS clinician easier.

First responders are uniquely positioned to interrupt the cycle of nonfatal-to-fatal opioid overdose by increasing distribution of overdose prevention resources to patients in real time.

Leave-behind kits can also connect patients to 200+​ organizations​ that can dispense naloxone refills in every Maryland county.

Leave-Behind in Maryland​


Maryland’s leave-behind program, active since 2018, is here to stay. The program is opt-in by county.

Between 2018 and 2021, thirteen jurisdictions operating EMS leave-behind programs successfully distributed 7,844 doses of naloxone to approximately 2,899 Marylanders.*

Although data is still developing on recently implemented programs in Maryland, leave-behind programs have proven successful across multiple states.

*Data as of 2/8/2022 as reported to the Maryland Department of Health Center f​​​or Harm Reduction Services through the Overdose Response Program Training Report Form.


​E​MS Clinic​​ians

Video: ​​Jason Patton on Post-Overdose Outreach​

This 3-minute video e​​xplains t​​​​he unique ability first responders have to intervene post-overdose, and why hope is never out of reach. ​Learn more at ​Post-Overdose Outreach.

MIEMSS Training: EMS Naloxone Leave-Behind

Learn about Maryland's naloxone leave-behind program through a 0.25-credit training here​.

MIEMSS Training: Naloxone Administration

Learn how to administer naloxone for suspected opioid overdose through a 0.5-credi​​t training here​.

Video: ​Trauma-Informed Ca​​re​​

In this one-hour BCoFD EMS Academy training, Stephanne Thornton discusses how vicarious trauma, compassio​​​n fatigue, and burnout impact professionals working with a traumatized population. ​Watch on YouTube​​.

Video: ​Working with Individuals Who Misuse Opioids in a More Compassionate Way​

A ​1.5-hour BCoFD EMS Academy overview of the treatment of opioid use disorder, including harm reduction approaches, and the role of adverse childhood events (ACES) in the development of addiction.​ Watch on YouT​ube​​.​​

​Studies and Best

Engaging Emer​​​gency Medical Services in Naloxone Distribution

This report provides an overview of the naloxone leave-behind program and examples of the program in action in three states. View the webinar or download the brief.

Howard County, Maryland EMS Leave-Be​​hind Study

This study highlights the importance of engaging an individual’s family and social network when offering connections to treatment and recovery resources. Read here.

Preliminary Analysis of Vermont's EMS Naloxone Leave-Behind Program

Vermont initiated an EMS protocol allowing all levels of providers to provide naloxone leave-behind kits to patients and/or their family or friends when a patient is identified as high-risk for opiate overdose and is not transported to a hospital by the responding EMS agency. Read here​.

Contra Costa County, Californ​​ia EMS Leave-Be​hind Innovation

​When an emergency physician in Contra Costa County, California, noticed opioid overdoses increasing to epidemic proportions and EMS providers often reviving the same patient repeatedly, he set out to break down silos across agencies to improve the local response. Read here.​

​Contact the Center ​for Harm Reduction Services

​Please reach out to us at mdh.naloxone@maryland.gov​ with any ​questions.​​