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May 2009, Vol 99, No. 5 | American Journal of Public Health 788-791
© 2009 American Public Health Association
DOI: 10.2105/AJPH.2008.146647

FIELD ACTION REPORT

Saved by the Nose: Bystander-Administered Intranasal Naloxone Hydrochloride for Opioid Overdose

Maya Doe-Simkins, MPH, Alexander Y. Walley, MD, MSc, Andy Epstein, RN, MPH and Peter Moyer, MD, MPH

At the time of the study, Maya Doe-Simkins was with the Boston Public Health Commission AHOPE Needle Exchange program, Boston, MA. Alexander Y. Walley is with the Boston University School of Medicine, Boston, and the Massachusetts Department of Public Health's overdose-prevention pilot program, Boston. Andy Epstein is with the Massachusetts Department of Public Health, Boston. Peter Moyer is with the Department of Emergency Medicine, Boston University School of Medicine, Boston, and Boston Emergency Medical Services, Boston Police and Fire Departments, Boston.

Correspondence: Requests for reprints should be sent to Alexander Y. Walley, MD, Section of General Internal Medicine, Boston Medical Center, 801 Massachusetts Ave, 2nd Floor, Boston, MA 02118 (e-mail: awalley{at}bu.edu).

Administering naloxone hydrochloride (naloxone) during an opioid overdose reverses the overdose and can prevent death. Although typically delivered via intramuscular or intravenous injection, naloxone may be delivered via intranasal spray device. In August 2006, the Boston Public Health Commission passed a public health regulation that authorized an opioid overdose prevention program that included intranasal naloxone education and distribution of the spray to potential bystanders. Participants were taught by trained nonmedical needle exchange staff. After 15 months, the program provided training and intranasal naloxone to 385 participants who reported 74 successful overdose reversals. Problems with intranasal naloxone were uncommon. Overdose prevention education with distribution of intranasal naloxone is a feasible public health intervention to address opioid overdose.






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