Opioid use is a frequent cause of morbidity and mortality in the USA. We report a case of methadone overdose reversed with naloxone nebulization. Peripheral IV access can be difficult to obtain in patients with a history of IV drug abuse making needless routes of naloxone administration useful. When naloxone is administered as a bolus, chronically opioid dependent patients are more prone to violent withdrawal symptoms. When successful, nebulized naloxone reverses intoxication and allows the patient to self-titrate the discontinuation of naloxone when they are alert enough to remove the mask. Nebulized naloxone can provide needleless and noninvasive administration for the reversal of opioid overdose.