Opioid overdose-related deaths can be prevented when naloxone is administered in a timely manner. As an opioid antagonist, naloxone displaces opioids from receptor sites in the brain and reverses respiratory depression that usually is the cause of overdose deaths. Naloxone does not have the potential for abuse.
Clinicians should consider prescribing naloxone to patients at high-risk for overdose: history of overdose, history of substance use disorder, higher opioid dosage (≥ 50 MME/day), concurrent benzodiazepine use. Prior to the FDA approval of two recent products, injectable naloxone was typically supplied as a kit with two syringes. These kits require training on how to administer naloxone using a syringe. The FDA has approved an intranasal naloxone product and a naloxone auto-injector. The intranasal spray is a pre-filled, needle-free device that requires no assembly. The auto-injector can deliver a dose of naloxone through clothing, if necessary, when placed on the outer thigh.