UMEM Educational Pearls

  • Naloxone has technically always been able to be prescribed by physicians to individual patients.
     
  • New laws however, make it acceptable for prescribers in many states to prescribe naloxone to “third parties,” e.g parents, friends, etc. of patients, with the assumption that the overdosed patient will not be capable of administering the antidote to themselves.
  • Many states are offering short 10-20 minute training sessions on how bystanders can administer the reversal agent to the patient who has overdosed.
  • If prescribed, it should be prescribed to the individual who completed the training, not the intended patient, and may be written for intranasal or intramuscular administration.
  • Intranasal (IN) is “off label” and an approved intranasal preparation is not commercially available, but the intramuscular preparation can be prescribed along with an atomizer device. The usual IN dose is 1 mg per nostril which may be repeated in 3-5 minutes.

References

1. https://www.networkforphl.org/_asset/qz5pvn/network-naloxone-10-4.pdf (Contains each law per state as of March 15, 2014)

2. http://www.usatoday.com/story/news/nation/2014/02/20/stateline-drug-overdose-deaths/5637519/

3. Intranasal Naloxone for Treatment of Opioid Overdose. The Medical Letter. Volume 56 (Issue 1438). March 17, 2014