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Opioid overdose remains the leading cause of cardiac arrest due to poisoning in North America. For a patient with suspected opioid overdose who has a definite pulse but no normal breathing or only gasping (ie, a respiratory arrest), in addition to providing standard BLS and/or ALS care, it is reasonable for responders to administer naloxone.
Before BLS, or Basic Life Support, was able to administer Narcan, agencies would have to wait for a MICP unit to arrive on scene to administer the lifesaving medication. They had overdosed, and this was before the widespread use of Narcan. Although protocols differ from state to state, local and agency protocols may vary as well.
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