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this post was submitted on 11 Mar 2025
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I recommend watching Juno's entire playlist on naloxone harm reduction. they're a harm reduction educator and substance user and they have more intimate knowledge than the sterile pamphlets that medical institutions put out.
people often get agitated because you're forcing them into acute opioid withdrawal by administering too much naloxone. the nasal type that most civilians have access to contains 4 mg vs the 0.4 mg intramuscular that EMS workers administer. this comes out to a 5 times higher dose than strictly necessary. source:
I can't say there's an easy alternative but anyone who's able should contact harm reduction orgs to get trained in administering intramuscular naloxone. nasal works too, but be mindful that the person you're "helping" is gonna have probably the worst day of their life.
people should also be aware there's a lot of seemingly helpful information out there influenced by copaganda warning civilians that substance users are dangerous/violent and to stay away/call the cops. this is a fucked up way to do harm reduction and really dehumanizing to substance users.
edit: replaced precipitated withdrawal with acute opioid withdrawal.
Great advice, the site covers this.
Just to note that injections bring their own risks and require additional training.
Nasal Nalaxone doses are much higher to make them easier to administer and to ensure the Nalxone can make it though the mucus membrane.
If you give Nalaxone / Narcan to an experienced opioid user (someone with chemical dependency) Be ready to run as they could come out of it VERY mad. They are going to miserable, sick and until the Nalaxone is gone not going to be able to relieve their symptoms.
I would argue just like Juno did that the naloxone dose being too high has nothing to do with ease of administration as that's already ensured by the spray being so easy to use. it looks more like severe negligence and ableism from the pharma companies to me.
as far as I understand, accounting for the nasal route only having 50% bioavailability, shouldn't a nasal spray have a maximum of 0.8 mg of naloxone? Juno said that there are people working on putting lower doses on the market for general distribution.
they also mention that it's possible to stop the overdose without ruining someone's high but that probably requires more educated training than most harm reduction resources offer. sounds to me like people are shifting blame from themselves forcing someone into withdrawal to the substance user being "violent" (this is extremely rare and mostly a rumor started by copaganda and ableist healthcare workers).