Take-home naloxone

Naloxone is a competitive opioid antagonist that can rapidly reverse the respiratory depression induced by heroin and other opioids. It competes for space at the µ2 opioid receptors, temporarily removing opioids from the receptors and preventing opioids from re-attaching to the receptors. Therefore, it may be used as an antagonist drug to reverse opioid effects and opioid-related overdose. Naloxone is used worldwide in medical emergencies to reverse respiratory depression caused by opioid overdose. It has no effect on non-opioid drug overdoses, no dependency potential and a high safety margin. Discovered and patented at the beginning of the 1960s, the US Food and Drug Administration (FDA) approved the first naloxone solution for intravenous, intramuscular and subcutaneous injection in 1971. The World Health Organization (WHO) added naloxone to its model list of essential medicines in 1983, and injectable naloxone formulations have been off-patent since 1985. The use of naloxone by laypeople in emergency situations can be facilitated by formulations for nasal administration. France piloted a nasal naloxone spray in 2016 and later introduced it for distribution through low-threshold agencies. A nasal spray was approved in 2017 by the European Commission for EU-wide marketing and this medication has been introduced in several European countries since early 2018.