Sections- Naloxone Distribution Project (NDP) Overview
- Orders and Shipments
- Program Eligibility
- Program Rules
- Fentanyl Test Strips (FTS)
- Intramuscular (IM) Naloxone
- Training Resources
Naloxone Distribution Project (NDP) Overview
1. What is the NDP?
The NDP is administered by the Department of Health Care Services (DHCS) to combat opioid overdose-related deaths throughout California. The NDP aims to reduce opioid overdose deaths through the provision of free naloxone. Through the NDP, qualified entities can request free naloxone or fentanyl test strips from DHCS and have it directly shipped to their address.
The NDP's funding comes from various sources including state, federal, and opioid settlement funds. This project is subject to normal state legislative appropriation and budgetary processes and is subject to available funding for naloxone distribution.
2. What is naloxone?
Naloxone is a life-saving medication that reverses an opioid overdose while having little to no effect on an individual if opioids are not present in their system. Naloxone works by blocking the opioid receptor sites and reversing the toxic effects of the overdose. It has few known adverse effects and no potential for abuse.
Naloxone is administered when an individual is showing signs of opioid overdose. The medication can be given by intranasal spray, intramuscular (into the muscle), subcutaneous (under the skin), or by intravenous injection.
3. Can naloxone be used for overdoses of other substances (e.g., xylazine)?
Naloxone is administered when an individual is showing signs of opioid overdose. The medication can be given by intranasal spray, intramuscular (into the muscle), subcutaneous (under the skin), or by intravenous injection.
4. What naloxone nasal spray is offered by DHCS through the NDP?
As of April 2026, brand name Narcan nasal spray will not be available through the NDP, and applicants requesting naloxone nasal spray will receive generic naloxone nasal spray. Brand name Narcan and generic naloxone nasal spray both contain the same active ingredients, are administered the same way, and have the same effect. Both can be used if an individual is showing signs of an opioid overdose.
5. How should naloxone nasal spray be stored?
As of April 2026, brand name Narcan nasal spray will not be available through the NDP, and applicants requesting naloxone nasal spray will receive generic naloxone nasal spray. Brand name Narcan and generic naloxone nasal spray both contain the same active ingredients, are administered the same way, and have the same effect. Both can be used if an individual is showing signs of an opioid overdose.
6. What is the purpose of the naloxone standing order?
The purpose of the standing order is to allow non-medical organizations to distribute naloxone to those at risk of an opioid-related overdose and for lay people to administer naloxone to an individual suspected of experiencing an overdose. The issuance of the naloxone standing order is authorized through the California Civil Code §1714.22.
Please note, a standing order is no longer required to receive 4mg naloxone nasal spray from the NDP. However, it remains a requirement for NDP applications requesting 0.4mg/mL intramuscular naloxone, as that product is available by prescription only.
For more information about naloxone standing orders, please see the California Department of Public Health (CDPH)
FAQs document and
resources page. To obtain a standing order please apply through the
CDPH online application form.
7. Are there protections against liabilities for administering naloxone in an emergency situation?
California's Good Samaritan law protects those giving emergency medical care at the scene of a medical emergency, including administering naloxone. Under this law, a person cannot be liable for any civil damages that result from his or her providing of emergency care, such as giving naloxone, if: 1) The person acted in good faith, and not for compensation; 2) The person provided either emergency medical care or nonmedical care; and 3) The care was provided at the scene of an emergency. For additional legal guidance, consult with your organization's legal counsel.
8. How can organizations apply to the NDP for naloxone nasal spray?
Complete the
online NDP application located on the
DHCS website. The application includes instructions, as well as the
terms and conditions of participating in the NDP. In addition to filling out the application form and agreeing to the terms and conditions, organizations must also provide:
- A copy of a valid and active business, 9-digit FEIN, or tax-exempt letter.
- If the naloxone request is for
240 units or less, your
organization must provide a brief (2-3 sentence) description of the intended plan for naloxone distribution and/or utilization.
-
If the naloxone request is for
more than 240 units, your organization must provide
a comprehensive justification and a policies and procedures document that outlines the: 1) storage; 2) inventory tracking; and 3) distribution plan for naloxone received through the program.
A list of additional supplemental documents required for your entity type can be found in the Required Materials section on the
NDP landing page.. Applications that fail to submit all required documentation may be deemed incomplete and result in application denial.
Orders and Shipments
1. How much does it cost to obtain naloxone or fentanyl strips (FTS) through the NDP?
The products are free and shipped directly to approved applicants. Please note, some applicants may see language regarding “invoices" for their order. This can be disregarded; approved applicants will not be charged for any products received through the program.
2. How much naloxone can I request through the NDP?
Requests for naloxone nasal spray must be made in increments of 24, which is the minimum. The maximum per application is 2,400 naloxone nasal spray units (two 4mg devices per unit).
3. Can I split the two 4mg devices per unit?
One unit of naloxone nasal spray includes two 4mg spray devices. DHCS does not recommend splitting or separating the 4mg devices.
4. Can organizations apply for more supplies?
Yes. You may request more by submitting a new application to DHCS via the
online NDP application. There is no limit to the number of times or frequency that an organization can reapply for additional supplies. Prior approval does not guarantee approval of additional requests.
5. Can I change my address after I place an order?
Review the information submitted under your application order upon receiving the application submission confirmation. If you need to make any changes to your contact information, delivery address, or request contact
naloxone@dhcs.ca.gov within 24 hours of submitting your application with the requested changes.
6. Is it acceptable to include a P.O. box as the mailing address?
No. NDP products cannot be delivered to a P.O. box, please provide a valid street address.
7. Once an application is approved, how long does the applicant have to wait to receive the shipment?
DHCS will contact the applicant via email within 1-2 weeks of the date of application submission and confirm if the request has been approved or denied. The shipment
will be mailed within 1-2 weeks of the date of approval of the application.
8. What should I do if there are issues with my shipment?
Please refer to your approval letter for contact information regarding any product or shipment questions.
Program Eligibility
1. Can individuals apply to the NDP?
No. The NDP is not intended to distribute directly to individuals. Many community organizations distribute free naloxone to individuals, including California's syringe service programs.
Individuals in California can also purchase CalRx® 4 mg nasal spray naloxone for $19 per two-pack plus taxes and shipping through the
CalRx Naloxone Access Initiative direct-to-consumer option online.
2. Can federal agencies apply to the NDP?
No. Only state, local, and tribal agencies in the state of California are eligible to apply for the NDP.
3. Can county public health and behavioral health agencies apply to the NDP?
Yes, county public health and behavioral health agencies may apply to the NDP to receive naloxone or fentanyl text strips (FTS).
County agency applications that include distribution to NDP eligible entities (e.g. law enforcement, homeless shelters, or community clinics) are typically not approved. DHCS recommends that eligible entities directly apply to the NDP for their naloxone or FTS needs. This is so that DHCS can collect accurate data regarding naloxone distribution and overdose reversals.
If your agency has a need to apply to the NDP with sub-recipients, please include a detailed distribution plan that includes allotments to each entity and, for naloxone only, an overdose reversal tracking policy with your application to the NDP.
4. Can hospital emergency departments apply for the program?
Yes. Hospital emergency departments are eligible entities for the NDP and may provide take-home doses of naloxone and FTS to patients and visitors.
Emergency departments must provide the following supplemental documentation with their application for naloxone:
- Policies and procedures for naloxone received through the program from other medications that may be billed to the patient insurance.
- Seperate storage of naloxone received through the program from other medications that may be billed to patient insurance.
-
A log to track the distribution of the naloxone doses distributed through the program.
The hospital emergency department is required to have policies and procedures, which will dictate how the hospital emergency department will distribute the naloxone, including storage locations and whether the naloxone will be labeled or not labeled. The Board of Pharmacy has clarified that naloxone obtained through the NDP and stored separately from the hospital's pharmacy inventory for distribution under a standing order pursuant to
Civil Code §1714.22 is not a pharmaceutical that will be used in the healthcare setting and is exempt from
California Code of Regulations, Business and Professions Code §4068, Title 22 §70265,
Business and Professions Code §4068, and
Business and Professions Code §4076. As the inventory is considered separate from the pharmacy inventory, it does not need to be maintained, stored, or labeled in compliance with Business and Professions Code §4068.
Hospitals and emergency departments looking to participate in Physician Lead Syringe Exchange should reach out to the California Department of Public Health at
SSPinfo@cdph.ca.gov. The Harm Reduction Supply Clearinghouse provides materials to SSPs, including fentanyl test strips, needles and syringes, containers for mixing injectable drugs (cookers), glass pipes, tourniquets, and condoms. A list of local Syringe Services Programs can be found on the
California Department of Public Health website. For more information on supplies currently offered by the Clearinghouse, contact SSPinfo@cdph.ca.gov.
5. Can schools apply for the NDP?
Yes, schools are eligible to apply to the NDP. If a school district or office of education plans to distribute
naloxone to multiple schools/sites, they must provide the following supplemental information with their application:
- A list of each school receiving naloxone, using the school's full name (e.g., T.W. Brooks High vs. Brooks High).
- The total number of naloxone kits each school will receive.
Please note that this an exception to the terms and conditions of the NDP that requires any subrecipients to directly apply to NDP.
2. Can substance use disorder recovery facilities apply for the NDP?
Yes. Inpatient, outpatient, and residential facilities are eligible entities for the NDP and may have naloxone onsite in case of overdoses or provide take-home naloxone to clients leaving the facility. Facilities must provide the following supplemental documentation with the application:
- Copy of the program's DHCS license (if applicable).
- Policies and procedures for naloxone distribution, including:
- Separate storage of
naloxone received through the program from other medications that may be billed to patient insurance.
- Storage of
FTS received through the program.
- Inventory tracking of naloxone received through the program.
- Distribution plan for naloxone received through the program.
3. Where can I get naloxone if my organization is not eligible for NDP?
All individuals and organizations can obtain naloxone through:
- The
CalRx Naloxone Access Initiative direct-to-consumer option makes available 4mg naloxone nasal spray for purchase online for $19 per two-pack plus taxes and shipping.
- Community organizations in your area that may have received naloxone through the NDP and distribute locally at no cost. Visit
NEXT Distro to learn more about naloxone availability in your area or obtain naloxone through their mailing service.
Program Rules
1. Where can I find the terms and conditions for the NDP?
The
terms and conditions can be found on the
DHCS website. When applicants sign the terms and conditions document, they are certifying they will abide by all requirements outlined. Should an organization violate any of these requirements, they may be ineligible to apply in the future.
2. Can recipients of NDP products ship the product out of state?
No. As stated in the
terms and conditions, products received through the NDP must be distributed to individuals within the state of California.
3. Are organizations that receive products through the NDP permitted to sell?
No. As stated in the
terms and conditions, products may only be used by the applicant and may not be sold or submitted for reimbursement of any type, including but not limited to, private pay, commercial, government authority or agency.
The NDP was established to allow community organizations and other entities that are in possession of naloxone to distribute it, and to allow individuals that receive naloxone to administer it.
4. Can my organization distribute products provided by the NDP to third-party organizations?
No. As stated in the NDP
terms and conditions, organizations cannot distribute products received through the program to any third-party organizations that are eligible to apply. All eligible organizations must apply directly to the NDP.
5. Can I return the product?
No. The product is not returnable. If your shipment is undeliverable or arrives damaged, please contact the manufacturer at the email address provided in your approval letter and tracking information.
6. What are data reporting requirements for organizations receiving naloxone through the NDP?
Organizations participating in the program agree to maintain and report information regarding the number of reversals that occurred using the naloxone provided by the NDP. Reversals can be reported individually to
naloxone@dhcs.ca.gov. Organizations that are re-applying are required to submit information about overdose reversals using naloxone received through the NDP.
To access data on NDP outcomes, please visit the
Department of Health Care Services Opioid Response website.
Fentanyl Test Strips (FTS)
1. What is fentanyl?
Fentanyl is a synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine. Fentanyl is a major contributor to fatal and nonfatal overdoses in California and the United States.
There are two types of fentanyl: 1) pharmaceutical fentanyl and 2) illicitly manufactured fentanyl (IMF or illicit fentanyl). Doctors prescribe pharmaceutical fentanyl to treat severe pain, such as while in the hospital for and after surgery or for advanced-stage cancer. Illicit fentanyl is unregulated and distributed through illegal drug markets for its heroin-like effect.
2. Why is fentanyl dangerous?
Fentanyl is extremely potent and can cause an individual's breathing to slow or stop more quickly compared to other opioids. Illicit fentanyl can be added to other drugs to make them cheaper, more powerful, and more addictive. People who use drugs may be unaware if their drugs contain fentanyl. Small amounts of fentanyl can be deadly and the amount of fentanyl in substances varies dramatically. This can lead to a life-threatening or fatal overdose event.
3. What are FTS?
FTS are small strips of paper that can detect the presence of fentanyl in different drugs (such as cocaine, methamphetamine, and heroin) and drug forms (pills, powder, and injectables).
4. How reliable are FTS?
A
study from 2018 found that FTS were accurate at detecting fentanyl when it was present in samples of street drugs obtained by law enforcement. This same study found that fentanyl test strips are unlikely to produce false negative results.
5. How can organizations apply to the NDP for FTS?
To request free FTS, organizations will complete the
online application located on the
DHCS website. This is the same application form used for requesting naloxone through the NDP. The application includes instructions, as well as the
terms and conditions of receiving FTS from DHCS. In addition to filling out the application form and agreeing to the terms and conditions, organizations must also provide:
- A copy of a valid and active business license, 9-digit FEIN, or tax-exempt letter.
- If the FTS request is for
4,000 units or less, your organization must provide a brief (2-3 sentence) description of the intended plan for FTS distribution and/or utilization.
- If the FTS request is for
more than 4,000 units, your organization must provide a comprehensive justification and a policies and procedures document that outlines the 1) storage; 2) inventory tracking; and 3) distribution plan for FTS received from DHCS.
Please note that entities may only use FTS received from DHCS for distribution purposes and may not use FTS for drug testing in criminal justice settings.
6. How should FTS be stored?
Keep FTS out of light and do not store them in extreme temperatures. Fentanyl test strips can be stored for up to two years before expiring. For the exact date of expiration, please refer to the product packaging.
7. How many FTS am I able to request through the NDP?
Requests for FTS must be made in increments of 500, which is the minimum. The maximum per application is 25,000 units. The maximum request is subject to change based on DHCS' ability to meet projected demand with available funding.
8. What are data reporting requirements for organizations receiving FTS from the NDP?
Organizations receiving FTS through the program agree to maintain and report information regarding the number of FTS distributed. Total number of FTS distributed from your previous shipment can be submitted in subsequent applications to DHCS via the
online application form, Entities that are re-applying to receive FTS from DHCS are required to submit this information.
Intramuscular (IM) Naloxone
1. How can organizations apply to the NDP for intramuscular (injectable) naloxone?
The NDP offers free intramuscular (injectable) naloxone in addition to 4mg naloxone nasal spray. Please submit separate applications for intramuscular naloxone and naloxone nasal spray.
Apply by submitting the
online application form located on the
DHCS website. The application includes instructions, as well as the
terms and conditions of participating in the NDP. In addition to filling out the application form and agreeing to the terms and conditions, organizations must also provide:
- The CDPH standing order or physician's prescription for intramuscular (injectable) naloxone
- Comprehensive summary justifying your need; and
- A policies and procedures document that outlines the: 1) storage; 2) inventory tracking; and 3) distribution plan for the naloxone received through the program.
- The policy and procedures document must include how your organization plans to store, track, and report reversal information
separately from all other naloxone, including naloxone nasal spray received through NDP.
A list of additional supplemental documents required for your entity type can be found in the Required Materials section on the
NDP landing page. Applications that fail to submit all required documentation may be deemed incomplete and result in application denial.
2. How much IM naloxone can I apply for through the NDP?
Requests for intramuscular (injectable) naloxone must be made in increments of 500, which is the minimum that can be requested. There is no maximum number of units for intramuscular naloxone.
Training Resources
1. Where can I find training videos and resources?
For naloxone: As part of the NDP application, organizations must certify that they have received training on overdose prevention and treatment to respond effectively in an opioid emergency, and that they will provide overdose prevention and treatment training to all individuals receiving naloxone from the organization.
Online training resources can be found at:
For fentanyl test strips (FTS): Please visit the manufacturer's website for instructions on how to use FTS from DHCS:
FTS kit guide.
2. Does the NDP offer naloxone training kits?
To request naloxone training kits, complete the online NDP application located on the
DHCS website. Each naloxone training kit includes one training device and an instruction card. Naloxone training kits are available to
add to your nasal naloxone application and cannot be ordered independently.
Requests must be made in increments of two and are based on a sliding scale capped at 12. Your approval letter will include shipping instructions.
Naloxone Kits Ordered
|
Training Kit Request Maximum
|
24-384
| 2
|
408-792
| 4
|
816-1200
| 6
|
1224-1608
| 8
|
1632-2016
| 10
|
NDP Frequently Asked Questions
Sections
- Naloxone Distribution Project (NDP) Overview
- Orders and Shipments
- Program Eligibility
- Program Rules
- Fentanyl Test Strips (FTS)
- Intramuscular (IM) Naloxone
- Training Resources
Naloxone Distribution Project (NDP) Overview
1. What is the NDP?
The NDP is administered by the Department of Health Care Services (DHCS) to combat opioid overdose-related deaths throughout California. The NDP aims to reduce opioid overdose deaths through the provision of free naloxone. Through the NDP, qualified entities can request free naloxone or fentanyl test strips from DHCS and have it directly shipped to their address.
The NDP's funding comes from various sources including state, federal, and opioid settlement funds. This project is subject to normal state legislative appropriation and budgetary processes and is subject to available funding for naloxone distribution.
2. What is naloxone?
Naloxone is a life-saving medication that reverses an opioid overdose while having little to no effect on an individual if opioids are not present in their system. Naloxone works by blocking the opioid receptor sites and reversing the toxic effects of the overdose. It has few known adverse effects and no potential for abuse.
Naloxone is administered when an individual is showing signs of opioid overdose. The medication can be given by intranasal spray, intramuscular (into the muscle), subcutaneous (under the skin), or by intravenous injection.
3. Can naloxone be used for overdoses of other substances (e.g., xylazine)?
Naloxone is administered when an individual is showing signs of opioid overdose. The medication can be given by intranasal spray, intramuscular (into the muscle), subcutaneous (under the skin), or by intravenous injection.
4. What naloxone nasal spray is offered by DHCS through the NDP?
As of April 2026, brand name Narcan nasal spray will not be available through the NDP, and applicants requesting naloxone nasal spray will receive generic naloxone nasal spray. Brand name Narcan and generic naloxone nasal spray both contain the same active ingredients, are administered the same way, and have the same effect. Both can be used if an individual is showing signs of an opioid overdose.
5. How should naloxone nasal spray be stored?
As of April 2026, brand name Narcan nasal spray will not be available through the NDP, and applicants requesting naloxone nasal spray will receive generic naloxone nasal spray. Brand name Narcan and generic naloxone nasal spray both contain the same active ingredients, are administered the same way, and have the same effect. Both can be used if an individual is showing signs of an opioid overdose.
6. What is the purpose of the naloxone standing order?
The purpose of the standing order is to allow non-medical organizations to distribute naloxone to those at risk of an opioid-related overdose and for lay people to administer naloxone to an individual suspected of experiencing an overdose. The issuance of the naloxone standing order is authorized through the California Civil Code §1714.22.
Please note, a standing order is no longer required to receive 4mg naloxone nasal spray from the NDP. However, it remains a requirement for NDP applications requesting 0.4mg/mL intramuscular naloxone, as that product is available by prescription only.
For more information about naloxone standing orders, please see the California Department of Public Health (CDPH)
FAQs document and
resources page. To obtain a standing order please apply through the
CDPH online application form.
7. Are there protections against liabilities for administering naloxone in an emergency situation?
California's Good Samaritan law protects those giving emergency medical care at the scene of a medical emergency, including administering naloxone. Under this law, a person cannot be liable for any civil damages that result from his or her providing of emergency care, such as giving naloxone, if: 1) The person acted in good faith, and not for compensation; 2) The person provided either emergency medical care or nonmedical care; and 3) The care was provided at the scene of an emergency. For additional legal guidance, consult with your organization's legal counsel.
8. How can organizations apply to the NDP for naloxone nasal spray?
Complete the
online NDP application located on the
DHCS website. The application includes instructions, as well as the
terms and conditions of participating in the NDP. In addition to filling out the application form and agreeing to the terms and conditions, organizations must also provide:
- A copy of a valid and active business, 9-digit FEIN, or tax-exempt letter.
- If the naloxone request is for
240 units or less, your
organization must provide a brief (2-3 sentence) description of the intended plan for naloxone distribution and/or utilization.
-
If the naloxone request is for
more than 240 units, your organization must provide
a comprehensive justification and a policies and procedures document that outlines the: 1) storage; 2) inventory tracking; and 3) distribution plan for naloxone received through the program.
A list of additional supplemental documents required for your entity type can be found in the Required Materials section on the
NDP landing page.. Applications that fail to submit all required documentation may be deemed incomplete and result in application denial.
Orders and Shipments
1. How much does it cost to obtain naloxone or fentanyl strips (FTS) through the NDP?
The products are free and shipped directly to approved applicants. Please note, some applicants may see language regarding “invoices" for their order. This can be disregarded; approved applicants will not be charged for any products received through the program.
2. How much naloxone can I request through the NDP?
Requests for naloxone nasal spray must be made in increments of 24, which is the minimum. The maximum per application is 2,400 naloxone nasal spray units (two 4mg devices per unit).
3. Can I split the two 4mg devices per unit?
One unit of naloxone nasal spray includes two 4mg spray devices. DHCS does not recommend splitting or separating the 4mg devices.
4. Can organizations apply for more supplies?
Yes. You may request more by submitting a new application to DHCS via the
online NDP application. There is no limit to the number of times or frequency that an organization can reapply for additional supplies. Prior approval does not guarantee approval of additional requests.
5. Can I change my address after I place an order?
Review the information submitted under your application order upon receiving the application submission confirmation. If you need to make any changes to your contact information, delivery address, or request contact
naloxone@dhcs.ca.gov within 24 hours of submitting your application with the requested changes.
6. Is it acceptable to include a P.O. box as the mailing address?
No. NDP products cannot be delivered to a P.O. box, please provide a valid street address.
7. Once an application is approved, how long does the applicant have to wait to receive the shipment?
DHCS will contact the applicant via email within 1-2 weeks of the date of application submission and confirm if the request has been approved or denied. The shipment
will be mailed within 1-2 weeks of the date of approval of the application.
8. What should I do if there are issues with my shipment?
Please refer to your approval letter for contact information regarding any product or shipment questions.
Program Eligibility
1. Can individuals apply to the NDP?
No. The NDP is not intended to distribute directly to individuals. Many community organizations distribute free naloxone to individuals, including California's syringe service programs.
Individuals in California can also purchase CalRx® 4 mg nasal spray naloxone for $19 per two-pack plus taxes and shipping through the
CalRx Naloxone Access Initiative direct-to-consumer option online.
2. Can federal agencies apply to the NDP?
No. Only state, local, and tribal agencies in the state of California are eligible to apply for the NDP.
3. Can county public health and behavioral health agencies apply to the NDP?
Yes, county public health and behavioral health agencies may apply to the NDP to receive naloxone or fentanyl text strips (FTS).
County agency applications that include distribution to NDP eligible entities (e.g. law enforcement, homeless shelters, or community clinics) are typically not approved. DHCS recommends that eligible entities directly apply to the NDP for their naloxone or FTS needs. This is so that DHCS can collect accurate data regarding naloxone distribution and overdose reversals.
If your agency has a need to apply to the NDP with sub-recipients, please include a detailed distribution plan that includes allotments to each entity and, for naloxone only, an overdose reversal tracking policy with your application to the NDP.
4. Can hospital emergency departments apply for the program?
Yes. Hospital emergency departments are eligible entities for the NDP and may provide take-home doses of naloxone and FTS to patients and visitors.
Emergency departments must provide the following supplemental documentation with their application for naloxone:
- Policies and procedures for naloxone received through the program from other medications that may be billed to the patient insurance.
- Seperate storage of naloxone received through the program from other medications that may be billed to patient insurance.
-
A log to track the distribution of the naloxone doses distributed through the program.
The hospital emergency department is required to have policies and procedures, which will dictate how the hospital emergency department will distribute the naloxone, including storage locations and whether the naloxone will be labeled or not labeled. The Board of Pharmacy has clarified that naloxone obtained through the NDP and stored separately from the hospital's pharmacy inventory for distribution under a standing order pursuant to
Civil Code §1714.22 is not a pharmaceutical that will be used in the healthcare setting and is exempt from
California Code of Regulations, Business and Professions Code §4068, Title 22 §70265,
Business and Professions Code §4068, and
Business and Professions Code §4076. As the inventory is considered separate from the pharmacy inventory, it does not need to be maintained, stored, or labeled in compliance with Business and Professions Code §4068.
Hospitals and emergency departments looking to participate in Physician Lead Syringe Exchange should reach out to the California Department of Public Health at
SSPinfo@cdph.ca.gov. The Harm Reduction Supply Clearinghouse provides materials to SSPs, including fentanyl test strips, needles and syringes, containers for mixing injectable drugs (cookers), glass pipes, tourniquets, and condoms. A list of local Syringe Services Programs can be found on the
California Department of Public Health website. For more information on supplies currently offered by the Clearinghouse, contact SSPinfo@cdph.ca.gov.
5. Can schools apply for the NDP?
Yes, schools are eligible to apply to the NDP. If a school district or office of education plans to distribute
naloxone to multiple schools/sites, they must provide the following supplemental information with their application:
- A list of each school receiving naloxone, using the school's full name (e.g., T.W. Brooks High vs. Brooks High).
- The total number of naloxone kits each school will receive.
Please note that this an exception to the terms and conditions of the NDP that requires any subrecipients to directly apply to NDP.
2. Can substance use disorder recovery facilities apply for the NDP?
Yes. Inpatient, outpatient, and residential facilities are eligible entities for the NDP and may have naloxone onsite in case of overdoses or provide take-home naloxone to clients leaving the facility. Facilities must provide the following supplemental documentation with the application:
- Copy of the program's DHCS license (if applicable).
- Policies and procedures for naloxone distribution, including:
- Separate storage of
naloxone received through the program from other medications that may be billed to patient insurance.
- Storage of
FTS received through the program.
- Inventory tracking of naloxone received through the program.
- Distribution plan for naloxone received through the program.
3. Where can I get naloxone if my organization is not eligible for NDP?
All individuals and organizations can obtain naloxone through:
- The
CalRx Naloxone Access Initiative direct-to-consumer option makes available 4mg naloxone nasal spray for purchase online for $19 per two-pack plus taxes and shipping.
- Community organizations in your area that may have received naloxone through the NDP and distribute locally at no cost. Visit
NEXT Distro to learn more about naloxone availability in your area or obtain naloxone through their mailing service.
Program Rules
1. Where can I find the terms and conditions for the NDP?
The
terms and conditions can be found on the
DHCS website. When applicants sign the terms and conditions document, they are certifying they will abide by all requirements outlined. Should an organization violate any of these requirements, they may be ineligible to apply in the future.
2. Can recipients of NDP products ship the product out of state?
No. As stated in the
terms and conditions, products received through the NDP must be distributed to individuals within the state of California.
3. Are organizations that receive products through the NDP permitted to sell?
No. As stated in the
terms and conditions, products may only be used by the applicant and may not be sold or submitted for reimbursement of any type, including but not limited to, private pay, commercial, government authority or agency.
The NDP was established to allow community organizations and other entities that are in possession of naloxone to distribute it, and to allow individuals that receive naloxone to administer it.
4. Can my organization distribute products provided by the NDP to third-party organizations?
No. As stated in the NDP
terms and conditions, organizations cannot distribute products received through the program to any third-party organizations that are eligible to apply. All eligible organizations must apply directly to the NDP.
5. Can I return the product?
No. The product is not returnable. If your shipment is undeliverable or arrives damaged, please contact the manufacturer at the email address provided in your approval letter and tracking information.
6. What are data reporting requirements for organizations receiving naloxone through the NDP?
Organizations participating in the program agree to maintain and report information regarding the number of reversals that occurred using the naloxone provided by the NDP. Reversals can be reported individually to
naloxone@dhcs.ca.gov. Organizations that are re-applying are required to submit information about overdose reversals using naloxone received through the NDP.
To access data on NDP outcomes, please visit the
Department of Health Care Services Opioid Response website.
Fentanyl Test Strips (FTS)
1. What is fentanyl?
Fentanyl is a synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine. Fentanyl is a major contributor to fatal and nonfatal overdoses in California and the United States.
There are two types of fentanyl: 1) pharmaceutical fentanyl and 2) illicitly manufactured fentanyl (IMF or illicit fentanyl). Doctors prescribe pharmaceutical fentanyl to treat severe pain, such as while in the hospital for and after surgery or for advanced-stage cancer. Illicit fentanyl is unregulated and distributed through illegal drug markets for its heroin-like effect.
2. Why is fentanyl dangerous?
Fentanyl is extremely potent and can cause an individual's breathing to slow or stop more quickly compared to other opioids. Illicit fentanyl can be added to other drugs to make them cheaper, more powerful, and more addictive. People who use drugs may be unaware if their drugs contain fentanyl. Small amounts of fentanyl can be deadly and the amount of fentanyl in substances varies dramatically. This can lead to a life-threatening or fatal overdose event.
3. What are FTS?
FTS are small strips of paper that can detect the presence of fentanyl in different drugs (such as cocaine, methamphetamine, and heroin) and drug forms (pills, powder, and injectables).
4. How reliable are FTS?
A
study from 2018 found that FTS were accurate at detecting fentanyl when it was present in samples of street drugs obtained by law enforcement. This same study found that fentanyl test strips are unlikely to produce false negative results.
5. How can organizations apply to the NDP for FTS?
To request free FTS, organizations will complete the
online application located on the
DHCS website. This is the same application form used for requesting naloxone through the NDP. The application includes instructions, as well as the
terms and conditions of receiving FTS from DHCS. In addition to filling out the application form and agreeing to the terms and conditions, organizations must also provide:
- A copy of a valid and active business license, 9-digit FEIN, or tax-exempt letter.
- If the FTS request is for
4,000 units or less, your organization must provide a brief (2-3 sentence) description of the intended plan for FTS distribution and/or utilization.
- If the FTS request is for
more than 4,000 units, your organization must provide a comprehensive justification and a policies and procedures document that outlines the 1) storage; 2) inventory tracking; and 3) distribution plan for FTS received from DHCS.
Please note that entities may only use FTS received from DHCS for distribution purposes and may not use FTS for drug testing in criminal justice settings.
6. How should FTS be stored?
Keep FTS out of light and do not store them in extreme temperatures. Fentanyl test strips can be stored for up to two years before expiring. For the exact date of expiration, please refer to the product packaging.
7. How many FTS am I able to request through the NDP?
Requests for FTS must be made in increments of 500, which is the minimum. The maximum per application is 25,000 units. The maximum request is subject to change based on DHCS' ability to meet projected demand with available funding.
8. What are data reporting requirements for organizations receiving FTS from the NDP?
Organizations receiving FTS through the program agree to maintain and report information regarding the number of FTS distributed. Total number of FTS distributed from your previous shipment can be submitted in subsequent applications to DHCS via the
online application form, Entities that are re-applying to receive FTS from DHCS are required to submit this information.
Intramuscular (IM) Naloxone
1. How can organizations apply to the NDP for intramuscular (injectable) naloxone?
The NDP offers free intramuscular (injectable) naloxone in addition to 4mg naloxone nasal spray. Please submit separate applications for intramuscular naloxone and naloxone nasal spray.
Apply by submitting the
online application form located on the
DHCS website. The application includes instructions, as well as the
terms and conditions of participating in the NDP. In addition to filling out the application form and agreeing to the terms and conditions, organizations must also provide:
- The CDPH standing order or physician's prescription for intramuscular (injectable) naloxone
- Comprehensive summary justifying your need; and
- A policies and procedures document that outlines the: 1) storage; 2) inventory tracking; and 3) distribution plan for the naloxone received through the program.
- The policy and procedures document must include how your organization plans to store, track, and report reversal information
separately from all other naloxone, including naloxone nasal spray received through NDP.
A list of additional supplemental documents required for your entity type can be found in the Required Materials section on the
NDP landing page. Applications that fail to submit all required documentation may be deemed incomplete and result in application denial.
2. How much IM naloxone can I apply for through the NDP?
Requests for intramuscular (injectable) naloxone must be made in increments of 500, which is the minimum that can be requested. There is no maximum number of units for intramuscular naloxone.
Training Resources
1. Where can I find training videos and resources?
For naloxone: As part of the NDP application, organizations must certify that they have received training on overdose prevention and treatment to respond effectively in an opioid emergency, and that they will provide overdose prevention and treatment training to all individuals receiving naloxone from the organization.
Online training resources can be found at:
For fentanyl test strips (FTS): Please visit the manufacturer's website for instructions on how to use FTS from DHCS:
FTS kit guide.
2. Does the NDP offer naloxone training kits?
To request naloxone training kits, complete the online NDP application located on the
DHCS website. Each naloxone training kit includes one training device and an instruction card. Naloxone training kits are available to
add to your nasal naloxone application and cannot be ordered independently.
Requests must be made in increments of two and are based on a sliding scale capped at 12. Your approval letter will include shipping instructions.
Naloxone Kits Ordered
|
Training Kit Request Maximum
|
24-384
| 2
|
408-792
| 4
|
816-1200
| 6
|
1224-1608
| 8
|
1632-2016
| 10
|
