Naloxone in the First-Aid Kit: What Employers Need to Know About Emerging State Mandates

Historical data from the last 15 years highlights a sustained upward trend in workplace overdose deaths. The Bureau of Labor Statistics reported 525 workplace deaths from unintentional overdoses in 2022—a 13.1% increase over the prior year and the tenth consecutive annual increase. The National Safety Council reports that workplace overdose deaths involving drugs or alcohol have risen more than 460 percent since 2011.

Naloxone in the Workplace

Against that backdrop, state legislatures are beginning to mandate that employers stock opioid-reversal agents—primarily naloxone—alongside bandages and CPR masks in workplace first-aid supplies. New York has enacted the first comprehensive requirement, California is directing its workplace safety agency to follow suit, and other states are likely watching. Here is what employers need to know now.

What the New York Law Requires

New York enacted Labor Law § 27-f, requiring employers that are already federally mandated under the Occupational Safety and Health Act to maintain first-aid supplies to also stock an opioid antagonist for first-aid or emergency treatment at the workplace. The trigger is the existing OSHA general-industry standard, 29 C.F.R. § 1910.151(b), which requires adequate first-aid supplies whenever no clinic or hospital is in “near proximity.” In practice, this likely covers the vast majority of employers with a physical workplace.

The statute defines “opioid antagonist” by reference to Public Health Law § 3309—meaning naloxone and any other medication approved by the Food and Drug Administration (FDA) that negates or neutralizes opioid effects. The law directs the Labor Commissioner, in coordination with the Health Commissioner, to promulgate regulations addressing the appropriate number of doses based on workplace size, training requirements and other implementation matters. The amended statute takes effect in December 2026, giving employers a limited runway to prepare.

California Is Moving in the Same Direction

California Assembly Bill 1976 directs Cal/OSHA to submit, before Dec. 1, 2027, a draft rulemaking proposal to revise its existing first-aid regulations (Title 8, Sections 1512 and 3400) to require workplace first-aid materials to include naloxone hydrochloride or another FDA-approved opioid antagonist, along with instructions for use.

While the mandate itself is not yet in effect, as Cal/OSHA must still complete its rulemaking, employers should anticipate that California will impose a stocking requirement once final regulations are adopted.

No Federal Mandate—Yet

There is currently no federal OSHA standard requiring employers to stock naloxone or maintain a workplace opioid-response program. However, the FDA approved naloxone hydrochloride nasal sprays for over-the-counter sale in March 2023, making the medication widely accessible without a prescription. And the National Institute for Occupational Safety and Health (NIOSH) has published voluntary guidance for employers considering a naloxone availability program, covering site assessments, storage, training and response protocols.

Liability Protections

All 50 states and the District of Columbia have some form of naloxone access or Good Samaritan law, though protections vary widely. In California, for example, Health and Safety Code § 1799.113 provides that a person who, in good faith and not for compensation, administers an opioid antagonist at the scene of a suspected overdose is not liable for civil damages, except for gross negligence or willful misconduct. New York’s framework similarly provides protections for good-faith administration. Employers should confirm the scope of protections available in each state where they operate, because the standard of care and scope of immunity differ.

Training, Storage and Administration Guidance

NIOSH recommends that employers stock at least two doses of naloxone, stored according to manufacturer instructions (room temperature, 59–77°F, protected from light), and placed in multiple accessible locations, depending on workplace size and layout. Expiration dates should be monitored, and expired or used stock should be replaced promptly.

Training should cover recognizing the signs of opioid overdose, calling 911 immediately (because naloxone alone may be insufficient for potent or long-acting opioids), scene-safety assessment, use of personal protective equipment such as nitrile gloves, and proper administration technique. CDC guidance notes that naloxone can restore normal breathing within two to three minutes, and a second dose should be given if breathing does not resume within that window.

What Employers Should Do Now

Multistate employers should take the following steps to stay ahead of these evolving requirements:

• Conduct a site assessment. Determine which locations are subject to OSHA’s first-aid supply obligation and whether any state-specific naloxone mandate applies.
• Monitor rulemaking. Track Cal/OSHA’s rulemaking progress and any forthcoming New York regulations on dose quantities and training specifics.
• Update first-aid policies. Incorporate opioid-reversal agents into written first-aid and emergency-response plans.
• Train designated responders. Identify and train personnel to recognize overdose symptoms, administer naloxone, call 911 and use PPE during a response.
• Address storage and expiration. Store naloxone per manufacturer specifications, track expiration dates and restock after use.
• Document everything. Maintain records of training, inspections, administration events and policy updates.
• Consult state-specific rules. Because liability protections, training requirements and coverage triggers differ across jurisdictions, employers should work with counsel to ensure compliance in each state.

Key Takeaways

The opioid crisis is increasingly affecting the workplace, and legislatures are responding. New York’s mandate takes effect in December 2026, California’s rulemaking must begin by late 2027, and other states may follow.

Employers do not need to wait for a federal standard to act. Those that proactively integrate naloxone into their first-aid programs, with proper training, storage protocols and legal review, will be better positioned to protect their workers and manage compliance risk as the regulatory landscape continues to evolve.