{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T12:18:40Z","timestamp":1777897120767,"version":"3.51.4"},"reference-count":39,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2017,1,1]],"date-time":"2017-01-01T00:00:00Z","timestamp":1483228800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Substance Abuse"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:p>\n                    <jats:italic toggle=\"yes\">Background<\/jats:italic>\n                    : Opioid overdose is a growing concern in the United States and internationally. Prehospital or pre\u2013medical personnel (layperson) administration of naloxone, an opioid antagonist, to reverse overdose, is an expanding mode of harm reduction. Recently, community clinics, methadone clinics, needle exchanges, some pharmacies, and other health care facilities have made naloxone available to the community.\n                    <jats:italic toggle=\"yes\">Case<\/jats:italic>\n                    : This case describes heroin overdose reversal of a 28-year-old male who had been using about a gram of heroin intravenously for 3\u00a0years but recently reduced frequency of use in an attempt to stop. He was seen initially 1\u00a0week prior to a buprenorphine induction in our clinic. After the initial intake, he used intravenous heroin, a larger amount than over the past several weeks in anticipation of abstinence, lost consciousness, and was difficult to arouse. A friend with him noted the patient's respirations to become shallow and administered naloxone nasal spray that the patient had obtained from a needle exchange, but did so intravenously by attaching an unused drug needle to the syringe barrel in place of the nasal atomizer. The patient's overdose was reversed and he recovered.\n                    <jats:italic toggle=\"yes\">Discussion<\/jats:italic>\n                    : This is the first known published case of a community-distributed naloxone nasal spray being used intravenously by a layperson (bystander). The case emphasizes the efficacy of naloxone in overdose reversal and also the need for education or instructions on naloxone use by others (not just the user). Finally, it highlights the risk of overdose in those entering treatment, seeking intoxication one last time.\n                  <\/jats:p>","DOI":"10.1080\/08897077.2016.1267686","type":"journal-article","created":{"date-parts":[[2016,12,7]],"date-time":"2016-12-07T14:32:51Z","timestamp":1481121171000},"page":"18-21","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Intravenous Use of Intranasal Naloxone: A Case of Overdose Reversal"],"prefix":"10.1177","volume":"38","author":[{"given":"Smita","family":"Das","sequence":"first","affiliation":[{"name":"Department of Addiction Psychiatry, University of California San Francisco, San Francisco, California, USA"},{"name":"Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, USA"},{"name":"Department of Psychiatry, University of California San Francisco, San Francisco, California, USA"},{"name":"San Francisco VA Medical Center, San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina","family":"Shah","sequence":"additional","affiliation":[{"name":"Chemical Dependency Recovery Program, Kaiser Permanente San Francisco Medical Center, San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Murtuza","family":"Ghadiali","sequence":"additional","affiliation":[{"name":"Department of Addiction Psychiatry, University of California San Francisco, San Francisco, California, USA"},{"name":"Department of Addiction Medicine, Kaiser Permanente San Francisco Medical Center, San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2017,1,1]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"Centers for Disease Control and Prevention. 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Accessed February 25 2016."},{"key":"e_1_3_3_18_2","unstructured":"Naloxone (Lexi-Drugs). Lexicomp Online. http:\/\/online.lexi.com\/lco\/action\/doc\/retrieve\/docid\/patch_f\/7338. Accessed February 25 2016."},{"key":"e_1_3_3_19_2","unstructured":"Learn about EVZIO\u00ae (naloxone HCl injection). Evzio (naloxone HCl injection). http:\/\/evzio.com\/hcp\/about-evzio\/what-is-evzio.php. Accessed May 22 2016."},{"key":"e_1_3_3_20_2","article-title":"FDA moves quickly to approve easy-to-use nasal spray to treat opioid overdose","author":"Press Announcements","year":"2016","unstructured":"Press Announcements. FDA moves quickly to approve easy-to-use nasal spray to treat opioid overdose. Food and Drug Administration Web site. http:\/\/www.fda.gov\/NewsEvents\/Newsroom\/PressAnnouncements\/ucm473505.htm. Accessed February 25, 2016.","journal-title":"Food and Drug Administration Web site."},{"key":"e_1_3_3_21_2","unstructured":"Narcan Nasal Spray. 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