title: Two cases of intranasal naloxone self-administration in opioid overdose.
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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: a Department of General Emergency Medicine, Rhode Island Hospital , Providence , Rhode Island , USA.
authors.forename: Traci C
authors.initials: TC
authors.lastname: Green
authors.forename: Madeline
authors.initials: M
authors.lastname: Ray
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Bowman
authors.forename: Michelle
authors.initials: M
authors.lastname: McKenzie
authors.forename: Josiah D
authors.initials: JD
authors.lastname: Rich
mesh_terms: D000281:Administration, Intranasal; D000328:Adult; D062787:Drug Overdose / Q000188:drug therapy* / Q000517:prevention & control; D005260:Female; D003932:Heroin / Q000037:antagonists & inhibitors / Q000633:toxicity*; D006801:Humans; D008297:Male; D009270:Naloxone / Q000008:administration & dosage*; D009292:Narcotic Antagonists / Q000008:administration & dosage*; D009294:Narcotics / Q000633:toxicity*; D012651:Self Medication
chemical_list: D009292:Narcotic Antagonists; D009294:Narcotics; D009270:Naloxone; D003932:Heroin
keywords: Criminal justice; naloxone; overdose