We believe now is the time to make naloxone hydrochloride, Narcan ®, available to Australian IDUs to help prevent overdose deaths. Despite the decline in heroin availability and harm in late 2000, overdoses involving heroin or diverted pharmaceutical opioids continue to account for most illicit drug related deaths in this country. In 2000 Lenton and Hargreaves concluded that an Australian trial was needed before naloxone was made more widely available in this country. The heroin ‘shortage’ meant that the proposed trial did not proceed. However, accumulating international evidence since 2000 shows that the provision of naloxone, with appropriate training, to IDU peers, family members and outreach workers can lead to successful heroin overdose reversals with few, if any, adverse effects. Indeed, many thousands of doses of naloxone have been distributed for this purpose. In the US alone, over a thousand cases of overdose reversal by peers using naloxone have been documented. Specific ‘Good Samaritan’ legislation has been enacted in the UK and some states of the USA in order to indemnify against prosecution those third-parties who in good-faith administer a life-saving drug. Intranasal naloxone kits are distributed by health authorities in New Mexico and Massachusetts. These developments show that the barriers to wider naloxone distribution are certainly surmountable We believe that existing international evidence clearly suggests that making naloxone more widely available in Australia will prevent many overdose fatalities. Given the existing evidence, a trial in this country is now unnecessary and Australian governments should take steps to increase access to naloxone. At a minimum, Australian states should begin by promptly enacting Good Samaritan legislation to protect lay people using naloxone in an emergency situation. Beyond this, re-scheduling naloxone to make it available across the counter would greatly facilitate access to the drug.