Background: Opioid overdoses (ODs) are a significant cause of preventable deaths. Norway has one of Europe’s highest overdose mortality rates. Take-home naloxone projects (THN) have been developed to distribute and train bystanders to use naloxone, a safe and effective antidote to reverse opioid ODs. Norway launched its THN project in 2014, becoming one of the first countries to implement such intervention at a national and multi-site level, with secure government funding. Objectives: The main objectives were (1) to explore and describe the distribution and use of THN and (2) to describe the characteristics of opioid users in the THN project in Norway. Methods: This is a retrospective cohort study using a convenience sample of volunteers who participated in Norway’s THN project between 2014 and 2018. Data was obtained from questionnaires filled by THN users at training and when freely requested a THN refill. A total of 3,621 answers were collected. Descriptive statistics were used to explore spray distribution, demographic characteristics of users, risk factors for OD, and how THN has been used. Binary logistic regression was employed to identify factors associated with having a high number of THN requests. Paired sample t-test was used to identify if opioid users’ actions when witnessing an OD differed after naloxone training. Findings: There was a high prevalence of OD risk factors among opioid users, such as combination of opioids with benzodiazepines (79%), injecting (68%), and over 10 witnessed and experienced ODs (50% and 21%). Factors associated with a high number of THN requests were age (OR: 0.96 [95%CI: .94-.99]), over 10 witnessed ODs (OR: 1.91 [1.20-3.30]), and not being released from prison recently (OR: 4.24 [1.31-13.76]). No decrease in taking crucial actions when attending an OD after THN training was found. Most of the sprays were used in ODs (65%), which frequently involved polydrug use, depressants in particular (37%). The training provided appeared to be effective for the correct use of sprays. ODs treated with THN in Norway were successfully reversed in 97% of cases. Conclusions: This study, the first examining the first years of THN Norway, supports the universal provision of naloxone to reduce mortality by opioid overdose. Large-scale and widespread distribution of THN is feasible when implemented under an existing network of drug and health services and when it receives sufficient national funding.