Study: The Efficiency of Intranasal vs Intramuscular Naloxone for Opioid Overdose

A study conducted by the Uniting Medically Supervised Injecting Centre in Sydney, Australia found that intranasally administered naloxone can reverse opioid overdose, but not as efficiently as intramuscularly administered naloxone can.

A double-blind, randomized clinical trial was conducted from February 1, 2012 to January 3, 2017. Clients were 18 or older with a history of injecting drug use. All participants who received both intranasal and intramuscular modes of treatment were analyzed with an intention-to-treat method.

Participants received either an intranasal administration of naloxone hydrochloride and intramuscular administration of placebo or intramuscular administration of naloxone hydrochloride and intranasal administration of placebo.

Out of the 197 clients who completed the trial, the ones who were randomized to intramuscular naloxone administration were less likely to require a rescue dose of naloxone compared with those randomized to intranasal naloxone administration. No major adverse reactions were reported for either group.

Reference

Dietze Paul, Jauncey Marianne, Salmon Allison, et al. Effect of intranasal vs intramuscular naloxone on opioid overdose. JAMA Network. 2019; 2(11): e1914977. doi: 10.1001/jamanetworkopen.2019.14977.