Despite these disadvantages, intranasal naloxone may be well suited for use in emergency situations that involve well-trained responders such as police officers and emergency medical technicians (EMTs), specifically in states where EMTs are not permitted to administer injections, Mr. Fudin explained.

Intramuscular and intravenous injections

Naloxone administered via traditional intramuscular injection is another inexpensive and effective option for emergency responders who are well trained; however, it may be difficult to administer in an emergency situation in the home setting by someone who is unfamiliar with manipulating a syringe and vial. 

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Intravenous injections are more complicated and therefore must be administered exclusively by medical professionals. If a patient who has overdosed has not been breathing for a while, venous access may be compromised; this situation may also occur with substance abusers.

Downsides to intravenous administration include the risk for needle stick and regulations in certain municipalities that restrict EMTs from injecting any drugs, whether intramuscularly or intravenously.

Auto-injector formulation

The naloxone auto-injector is the only FDA-approved formulation for in-home use in cases where there is known or suspected opioid overdose.  

A 2015 study by Edwards et al validated that all persons who received training from healthcare practitioners on naloxone use were able to give the auto-injector correctly, and 90% of those who received no training were also able to give it correctly.5 The retracting needle offers the added advantage of reducing needle-stick risk. 

“The greatest and perhaps only disadvantage of the auto-injector is the cost,” Dr. Fudin said. “The good news is that about 75% of third-party payers cover it. Nevertheless, somebody is paying for it in the long run.”

This article originally appeared on MPR