Intranasal naloxone for the treatment of suspected heroin overdose
Abstract
AIMS: This paper reviews available literature regarding the effectiveness, safety and utility of intranasal (i.n.) naloxone for the treatment of heroin overdose. METHODS: Scientific literature in the form of published articles during the period January 1984 to August 2007 were identified by searching several databases including Medline, Cinahl and Embase for the following terms: naloxone, narcan, intranasal, nose. The data extracted included study design, patient selection, numbers, outcomes and adverse events. RESULTS: Reports of the pharmacological investigation and administration of i.n. naloxone for heroin overdose are included in this review. Treatment of heroin overdose by administration of i.n. naloxone has been introduced as first-line treatment in some jurisdictions in North America, and is currently under investigation in Australia. CONCLUSION: Currently there is not enough evidence to support i.n. naloxone as first-line intervention by paramedics for treatment of heroin overdose in the pre-hospital setting. Further research is required to confirm its clinical effectiveness, safety and utility. If proved effective, the i.n. route may be useful for drug administration in community settings (including peer-based administration), as it reduces risk of needlestick injury in a population at higher risk of blood-borne viruses. Problematically, naloxone is not manufactured currently in an ideal form for i.n. administration.
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The common dose used for NAL nasal spray in prehospital settings with heroin overdose is 2 mg.
“Today, the common dose used for NAL nasal spray in prehospital settings with heroin overdose is 2 mg (58, 62).”
From Oxytocin under opioid antagonism leads to supralinear enhancement of social attention (2017) · cites this paper as [62]
In a randomized controlled trial of 172 patients suspected of heroin overdose, intranasal and intramuscular naloxone produced similar adverse events, which were generally mild.
“The adverse events seen were similar between the two groups; they were generally mild in nature and included agitation, nausea, and vomiting.”
From Oxytocin under opioid antagonism leads to supralinear enhancement of social attention (2017) · cites this paper as [62]
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- Authors
- Kerr, D., Dietze, P., & Kelly, A.
- Affiliations
- The University of Melbourne (AU)
- Burnet Institute (AU)
- Corresponding author
- Kerr, Debra
- Venue
- Addiction
- Publisher
- Wiley
- Published
- 2008-02-05
- Volume
- 103
- Issue
- 3
- Pages
- 379-386
- ISSN
- 0965-2140 (ISSN-L)
- 1360-0443
- OpenAlex
- W1968579884
- Cited by
- 51
- References
- 68
- Citations by year
- 2024: 4 · 2023: 4 · 2022: 1 · 2021: 3 · 2020: 1 · 2019: 2 · 2018: 1 · 2017: 9 · 2016: 4 · 2015: 5 · 2014: 4 · 2012: 2
- FWCI
- 0.55
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Addiction (publishedVersion)
- PubMed (publishedVersion)
- Victoria University Research Repository (Victoria University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Emergency Medicine › Poisoning and overdose treatments
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- intranasal naloxone, heroin overdose, opioid overdose treatment, prehospital care, paramedics, first-line intervention, adverse events, needlestick injuries, blood-borne viruses
- MeSH terms
- Administration, Intranasal, Heroin, Emergencies, Humans, Naloxone, Narcotic Antagonists, Drug Overdose
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