The FDA-approved Narcan nasal spray delivers more of the antidote into the blood than the improvised naloxone device
A recent study conducted by the National Institute on Drug Abuse (NIDA) found that improvised nasal naloxone devices (INNDs) are significantly less effective at administering high enough doses of the overdose-reversing medication than the FDA-approved Narcan.
Naloxone is the drug that can reverse opioid overdoses that kill tens of thousands of people in the U.S. every year. Efforts to make it available, particularly in the form of Narcan, are a part of the national fight against the deadly opioid epidemic.
INNDs, according to Psych Congress, “consisting of a prefilled naloxone syringe attached to a mucosal atomization device” and have been used by first responders and others to successfully reverse overdoses for 25 years.
However, the study, first reported on by NIDA on March 15, found that Narcan does a better job of delivering high enough doses of naloxone to be maximally effective.
“Scientists found that the approved naloxone devices deliver higher blood levels of naloxone than the improvised nasal devices,” the report reads. “In fact, levels in the plasma concentration of naloxone are considerably lower when improvised devices are used. The FDA-approved 4-mg dose nasal spray produced the highest blood level of naloxone of all the products tested.”
Speed and plasma concentration of naloxone are especially important as overdoses of the highly potent synthetic opioid fentanyl have skyrocketed in the past few years. Data from the Centers for Disease Control and Prevention (CDC) found that fentanyl-related overdose deaths doubled each year from 2013 to 2016.
The fastest way to administer naloxone to counter an opioid overdose is with an IV, but first responders might not have access to the equipment they need to give a naloxone IV when time is of the essence.
Narcan is a simple nasal spray that does not require assembly and can be administered in one nostril while the patient is lying on their back. Members of the public, including people with opioid use disorders, can be easily trained to administer Narcan, and it is available to anyone without a prescription. Health insurance may even cover some or all of the cost.
“Using the FDA-approved nasal Narcan spray is a great choice for average consumers, who will likely keep only one or two devices on hand,” said NIDA’s Dr. Philip A. Krieter. “It is smaller, easier to use, and doesn’t require much if any training to use properly. The Narcan spray is a ready-to-use device; the improvised device needs assembly, and lay persons may not able to use it correctly in a panic situation.”
However, according to TIME, a Narcan kit with two doses costs around $135 without insurance, which may be prohibitively expensive for some.
Another option is the auto-injection device Ezvio, which has also been approved by the FDA. According to Dr. Krieter, a generic version of Ezvio will become available “later this year for some purchasers.”
