Two Cases of Intranasal Naloxone Self-Administration in Opioid Overdose. Issue 2 (April 2014)

• Record Type: Journal Article
• Authors: Green, Traci C.; Ray, Madeline; Bowman, Sarah E.; McKenzie, Michelle; Rich, Josiah D.
• Is Part Of: Substance abuse. Volume 35:Issue 2(2014)
• Page Start: 129
• Page End: 132
• Publication Date: 2014-04
• Subjects: Criminal justice -- naloxone -- overdose; Substance abuse -- Periodicals; Medical education -- Periodicals; Education, Medical -- periodicals; Substance Abuse -- periodicals; 362.29
• DOI: 10.1080/08897077.2013.825691
• Languages: English
• ISSNs: 0889-7077

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.