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​EMS ​Naloxone Leave-Behind​

Jump to​: Resources for ​​EMS Clinicians​​, Studies and Best Practices​​​​


​What is EMS Naloxone
Leave-​​Behi​nd?

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.

​ Respond: EMS personnel respond to a nonfatal overdose. Assess: EMS identifies patient(s) and/or their support network. Leave behind: EMS provides naloxone and referrals to patient(s) and/or bystanders.

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 agencies 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 give naloxone to the people who need it the most. By providing these kits, EMS can save lives beyond the patient care given in the moment after an overdose.

Benefits of Lea​​​ve-Behind

Benefits of leave-behind as strategic community overdose prevention include: naloxone is safe and effective; non-stigmatizing and non-coercive; community-based intervention; public health / public safety collaboration; connect survivors to services.

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 300+​ organizations​ that can dispense naloxone refills in every Maryland county.

Leave-Behind in Maryland​

EMS naloxone leave-behind map of Maryland counties. All have implemented EMS NLB except Queen Anne's, which has a law enforcement leave-behind program, and Somerset, which has neither an EMS nor a law enforcement leave-behind program.​​

Maryland’s leave-behind program is here to stay. Since July 2025, Maryland's EMS medical protocols have allowed all Maryland EMS agencies to participate by default. Between 2018 a​nd June 2025, the program was opt-in by county.

Since 2018, EMS leave-behind programs have distributed over 62,000 dose​​s of naloxone to over 27,000 Marylanders. For the most up-to-date Maryland EMS naloxone leave-behind data, visit the MDH Overdose Dashboard.​

Leave-behind programs have proven successful across multiple states.​

Resources for ​E​MS Cli​​​nic​​ians

Video: ​​Jason Patton ​on Post-Ove​rdose 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.



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MIEMSS Training: EM​​S Naloxone Leave-Behind

MIEMSS offers EMS clinicians a 0.25-credit training about Maryland's naloxone leave-behind program. To complete the training, visit EMS Online Training​.

MIEMSS Training: Naloxo​​ne Administration

MIEMSS offers EMS clinicians a 0.5-credit training about how to administer naloxone for suspected opioid overdose. To complete the training, visit EMS Online Training​.

Video: ​Trauma-Inform​​ed 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. To view the video, visit YouTube​​​.​

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

A 1.5-hour BCoFD EMS Academy overview of the treatment of opioid use disorder, community-based overdose prevention strategies, and the role of adverse childhood events (ACES) in the development of substance use disorders. To view the video, visit ​​​YouT​ube​​.​​

​Studies and ​​​Best ​​​Practic​es

Connecting Communities to S​ubstance Use Services: Practical Approaches for First Responders​​​

This 2023 SAMHSA guide provides practical, evidenced-based information that first responder agencies, their partners, and communities can use to implement or expand practices and approaches for linking people to substance use services. ​To view the report, visit National Drugs Library​.​

Engaging Emer​​​gency Medic​​al 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. To download the brief, visit PTTC Network.

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. To read the study, visit Best Practices for a Novel EMS-Based Naloxone Leave behind Program.

Preliminary Analysis of Ver​​mont'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. To view the analysis, visit University of Vermont​.​​

​Page content last updated 3/23/26.​​ Page contact: [email protected]​
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