Opioid overdose reversal medications (OORMs) are lifesaving medications that reverse the effects of an acute opioid overdose and restore breathing. Naloxone is a safe and effective lifesaving FDA-approved medication that is used to reverse the effects of an opioid overdose. Naloxone can support the restoration of normal breathing to a person if their breathing has slowed or stopped because of an opioid overdose. Naloxone has no effect on someone who does not have opioids in their system, and it is not a treatment for opioid use disorder. It is available in nasal or injectable forms, and access varies by state. Community-based naloxone distribution prioritizes populations at high risk of overdose, such as those in criminal justice systems.
Naloxone Administration
Naloxone can be administered intravenously, intramuscularly, intranasally, or subcutaneously. Currently, the most common administration method for overdose rescue programs is intranasally (IN). During this mode of administration, a liquid form of naloxone is sprayed into the victim’s nostrils. Many practitioners prefer IN delivery because it does not involve needles, eliminating the risk of an accidental needle-stick injury. Naloxone is FDA-approved as an injectable drug and was approved by the FDA through IN delivery in November 2015. The needleless syringe containing the naloxone vial is first connected to a separate device called an atomizer that converts the liquid stream of the drug into a fine mist. The different components are typically sold separately, although limited quantities of pre-packaged IN rescue kits may be available from regional compounding pharmacies. Preloaded devices for intranasal or injectable delivery are available for use.
One alternative way to deliver naloxone is through intramuscular (IM) injection. This is an FDA-approved delivery process, utilized for decades in medical settings. Many community-based opioid overdose prevention programs distribute IM naloxone to families and other potential opioid overdose bystanders because of its lower cost. With IM, naloxone is drawn from a vial into a syringe and then injected into the victim’s thigh or another large muscle.
