Two cases of intranasal naloxone self-administration in opioid overdose.

Abstract

BACKGROUND:

Overdose is a leading cause of death for former prisoners, exacting its greatest toll during the first 2 weeks post release. Protective effects have been observed with training individuals at high risk of overdose and prescribing them naloxone, an opioid antagonist that reverses the effects of the opioid-induced respiratory depression that causes death.

CASES:

The authors report 2 people with opiate use histories who self-administered intranasal naloxone to treat their own heroin overdoses following release from prison. Patient A is a 34-year-old male, who reported having experienced an overdose on heroin the day after he was released from incarceration. Patient B is a 29-year-old female, who reported an overdose on her first injection of heroin, 17 days post release from incarceration. Both patients self-administered the medication but were assisted at some point during the injury by a witness whom they had personally instructed in how to prepare and administer the medication. Neither patient experienced withdrawal symptoms following exposure to naloxone.

DISCUSSION:

Self-administration of naloxone should not be a goal of overdose death prevention training. A safer, more reliable approach is to prescribe naloxone to at-risk patients and train and also equip members of their household and social or drug-using networks in overdose prevention and response.

• Authors: Traci C Green, Madeline Ray, Sarah E Bowman, Michelle McKenzie, Josiah D Rich
• Journal: Substance abuse (Subst Abus) Vol. 35 Issue 2 Pg. 129-32 ( 2014) ISSN: 1547-0164 [Electronic] United States
• PMID: 24821348 (Publication Type: Case Reports, Journal Article, Research Support, N.I.H., Extramural)

Chemical References

• Narcotic Antagonists
• Narcotics
• Naloxone
• Heroin

Topics

• Administration, Intranasal
• Adult
• Drug Overdose (drug therapy, prevention & control)
• Female
• Heroin (antagonists & inhibitors, toxicity)
• Humans
• Male
• Naloxone (administration & dosage)
• Narcotic Antagonists (administration & dosage)
• Narcotics (toxicity)
• Self Medication