Opioid overdose morbidity and mortality is recognized to have epidemic proportions. Medical and public health agencies are adopting
opioid harm reduction strategies to reduce the morbidity and mortality associated with overdose. One strategy developed by emergency medical services and public health agencies is to deliver the
opioid antidote naloxone injection intranasally to reverse the effects of
opioids. Paramedics have used this route to quickly administer
naloxone in a needle-free system and avoiding
needle-stick injuries and contracting a blood-born pathogen disease such as
hepatitis or human immunodeficiency virus. Public health officials advocate broader lay person access since civilians are likely witnesses or first responders to an
opioid overdose in a time-acute setting. The barrier to greater use of
naloxone is that a suitable and optimized needlefree drug delivery system is unavailable. The scientific basis for design and study of an intranasal
naloxone product is described. Lessons from nasal delivery of
opioid analgesics are applied to the consideration of
naloxone nasal spray.