^Dankaholic, I can completely understand that FOR YOU... but I am talking about as a society this is something worth looking into.
In Boston, in 15 months time 74 overdoses were reversed with narcan nasal spray... those people wouldn't have had vials of narcan they swiped from a hospital lying around, those people very well could have died. Also, to reiterate the conclusion of the second study, "Problems with intranasal naloxone were uncommon. Overdose prevention education with distribution of intranasal naloxone is a feasible public health intervention to address opioid overdose. "
I understand why YOU would prefer your method given your training and resources, but what say you about NEPs giving classes on using these sprays and distributing them to heroin/opiate users? I think this could have a demonstrable effect on overdose deaths if applied throughout.
And in regards to your issue with dose; I don't doubt that IM/IV can be more precise but are you familiar with the mechanism these particular devices dispense with? Have you read the studies to see if this was ever brought up as a factor? I could be wrong, but it appears to me that your issue with dose is speculation on your part. Even if there was some small variability in dose, if I OD'd I'd rather be given this while I'm waiting for the ambulance then lay there unconscious.
Lastly, you flat out said that nasal sprays would not work, I just wanted to demonstrate (which I think I did thoroughly enough) that was a fallacious claim.
You are 100% correct & I said thank you for pointing out that it CAN be done. That is great honestly. You can understand why my views are a tad different than the average person though because I'm very used to it being done IM/IV 100% of the time. That is what you are taught to do in the ER, that is what you are taught in school, & that is what I was taught when I was an EMT & how we had always done it.
For me I can't justify using a vial meant for IM/IV on someone OD'ing any other way than it was intended to be used & that I was taught to use it. That would be IM on anyone OD'ing in my house. I can't be confident in my work as a professional if I try to give it to someone nasally. Also I have no idea what they are using to dispense this nasally & how I'm dosing someone. It seems to be overlooked as well that it isn't the Naloxone overdose im concerned of. It's the underdose I'm concerned about & wasting precious time when someone isn't breathing. I know exactly how much Naloxone to give someone in one dose IM to counteract an OD, when using nasal spray I might have to redose a few times trying to get it right because I wouldn't know how much they had actually absorbed yet or not.
I'm glad you can see why for me I just can't justify not using my training and what I know when someone is in a bad spot and overdosed & that would be an IM dose I could accurately measure out in a quick efficient manner. During OD's it's all about time and being quick to avoid brain damage when someone stops breathing.
I'm 100% with you on saying I'd rather have it nasally than not at all while waiting for the EMT's also I think if it's effective like you have shown it is I'd LOVE it if the NPE's did a class & issued nasal spray dosers of Naloxone to people who complete a class. I'd much rather they certify someone with no training on IV/IM injections on how to use a nasal spray to give someone Naloxone than give them vials of naloxone and tell them to IV/IM it to people. Although I think it would be perfectly fine to give a class through the NEP's on how to IM it as well. As I think anyone can learn how to properly IM & what is safe and what is not in a relatively short period of time. If they have proved the nasal route is as effective though and could be used while waiting for the EMT's I would rather have them go this route with releasing Naloxone to the public.
What I'd like more than anything is if these classes also gave them a course in taking care of the patient/person after the Naloxone was administered and while the EMT's were coming as well as giving basic CPR classes to get people breathing again. Make it an even 2 hour class and give out the Naloxone and a certificate at the end. Crap I'd even volunteer to teach the class in my local area.
Also I wasn't sure if I was supposed to feel bad for swiping a few vials of Narcan from the hospital while I was there cause i certainly don't. I work in an ER and if I was a stupid I could take anything especially some as easy as that but I wouldn't. Never would take anything from work, but while I was a patient there I absolutely did because the nurse was being sloppy and not doing her job. Plus those 3 vials could save 3 lives throughout the time I'm alive & are doing much more good outside the hospital than they were in. Mostly considering the fact they were issuing them, charging me for them, & when going un-used they were "wasting" them out as we say in the hospital meaning they were dumping them down the sink because I payed for them and didn't need them. Since they were already dispensed and payed for they waste them when not being used. So they were going down the drain or in my pocket.
Where are they already issuing these spray, my whole basis for my stance was the idea of making my own home brew nasal spray like suggested out of the IM/IV vials which is why I was so worried about dosage & how evenly the dosing would be. If it was a meant to spray proper dosing nasal spray package of Narcan like you are suggesting now that I'm reading closer I'm all for that as it is medically meant for nasal dosing & obviously has to have some kind of method of proper dosing. That's much different then the original statement I responded to where it said to make my own home brew nasal spray out of the vials from the hospital mean to be injected. I just don't know how I could feel comfortable making my own nasal spray & being confident in it during an OD.
You OD at my house your getting the needle buddy :-D
i think it should also be said that its damn near impossible (like 200 times the average dose) to OD on naloxone so i really don't think you need to be precise, just give a lot for good measure.
The problem is I'm not worried about an OD as I already know that isn't likely to do anything unless the dose is heroic. it's the time wasted under dosing a few times & trying to re-dose and wait until I've finally hit the spot I neede to be. I can accurately KNOW I'm at a good common dose with a syringe and doing it IM like I was taught in the hospital setting.
It'[s a great idea it just would have to be proven to me how to accurately dose. Just read the paragraph above me to Cane2 to see my stance on the situation. The nasal spray is great and if that effective like it seems to be it could be a totally great tool for the public. Id even teach the classes to certify people if i could in my area.
