Pharmac to supply opioid overdose reversal medicine, naloxone, to needle exchange services

Medicines Decision

What we’re doing

We're supporting the New Zealand Needle Exchange Programme(external link) to access the opioid overdose reversal medicine, naloxone. Since 27 November 2023 the programme has had access to naloxone 400 mcg per ml, 1ml ampoules. This will allow needle exchange services to provide naloxone containing overdose kits where they are required in the community.


Naloxone is a medicine used in the treatment of opioid overdose, it acts as an opioid inhibitor and rapidly reverses the effects of opioid drugs including overdoses. Naloxone 400 mcg per ml, 1ml ampoules are currently funded and available in the community via prescription or PSO (practitioner supply order).

Naloxone ampoules were previously a prescription-only medicine which restricted the availability of naloxone for harm reduction programmes in the community, such as those operated by the New Zealand Needle Exchange Programme.

In 2023, the Medsafe Medicines Classification Council(external link) amended the restrictions around naloxone ampoules to allow distribution by groups such as needle exchange services. There are 21 needle exchanges across New Zealand, including 1 mobile exchange.

In September 2023, Pharmac was made aware of a number of reports of serious hospitalisations and overdoses from very potent synthetic opioids being sold illegally across New Zealand. In many cases illegal drugs are misrepresented as other substances. Drugs such as fentanyl and synthetic opioids are extremely potent to the level where even very small amounts are enough to cause serious opioid overdose. This is especially dangerous where people may believe they are taking another substance.

In response to this we have been working with Manatū Hauora (Ministry of Health), Te Whatu Ora (Health New Zealand) and the New Zealand Drug Foundation to ensure that naloxone will be available in the community where it is needed.

Who we think will be most interested

  • People who use illicit (or illegal) drugs, such as heroin, oxycodone, fentanyl, synthetic opioids or other opioids and their families and whānau.
  • People who may consider taking other illicit or illegal drugs.
  • Clinicians and healthcare workers.
  • People involved in opioid harm reduction programmes and community programmes.

Detail about this decision

There are no changes being made to the Pharmaceutical Schedule.

Pharmac has made arrangements so needle exchange services will be able to order supplies of funded naloxone which can be placed in emergency opioid overdose kits or supplied alongside needles/syringes with instructions for use. This is funded from the Combined Pharmaceutical Budget.

This will mean people who might be at risk of an opioid overdose and their friends, families and whānau are able to have emergency overdose kits containing naloxone on hand if they are required. The New Zealand Drug Foundation(external link) has informed us that this is a critical component of their opioid harm reduction efforts.

These arrangements apply to the injectable form of naloxone only. We have a funding application for the naloxone nasal spray (branded as Nyxoid)(external link). Information about this can be found on the Application Tracker.

If you have any questions about this decision, email us at or call our toll free number (9 am to 5 pm, Monday to Friday) on 0800 660 050.