{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T07:41:56Z","timestamp":1787730116987,"version":"build-2784847793"},"reference-count":37,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,2,8]],"date-time":"2022-02-08T00:00:00Z","timestamp":1644278400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100013232","name":"Stiftelsen Norsk Luftambulanse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013232","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011769","name":"St. Olavs Hospital Universitetssykehuset i Trondheim","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011769","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>To measure and evaluate clinical response to nasal naloxone in opioid overdoses in the pre\u2010hospital environment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Randomised, controlled, double\u2010dummy, blinded, non\u2010inferiority trial, and conducted at two centres.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Participants were included by ambulance staff in Oslo and Trondheim, Norway, and treated at the place where the overdose occurred.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Men and women age above 18\u2009years with miosis, rate of respiration \u22648\/min, and Glasgow Coma Score &lt;12\/15 were included. Informed consent was obtained through a deferred\u2010consent procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention and comparator<\/jats:title><jats:p>A commercially available 1.4\u00a0mg\/0.1\u00a0mL intranasal naloxone was compared with 0.8\u00a0mg\/2\u00a0mL naloxone administered intramuscularly.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>The primary end\u2010point was restoration of spontaneous respiration of \u226510 breaths\/min within 10\u00a0minutes. Secondary outcomes included time to restoration of spontaneous respiration, recurrence of overdose within 12\u2009hours and adverse events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>In total, 201 participants were analysed in the per\u2010protocol population. Heroin was suspected in 196 cases. With 82% of the participants being men, 105 (97.2%) in the intramuscular group and 74 (79.6%) in the intranasal group returned to adequate spontaneous respiration within 10\u00a0minutes after one dose. The estimated risk difference was 17.5% (95% CI, 8.9%\u201326.1%) in favour of the intramuscular group. The risk of receiving additional naloxone was 19.4% (95% CI, 9.0%\u201329.7%) higher in the intranasal group. Adverse reactions were evenly distributed, except for drug withdrawal reactions, where the estimated risk difference was 6.8% (95% CI, 0.2%\u201313%) in favour of the intranasal group in a <jats:italic>post hoc<\/jats:italic> analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Intranasal naloxone (1.4\u00a0mg\/0.1\u00a0mL) was less efficient than 0.8\u00a0mg intramuscular naloxone for return to spontaneous breathing within 10\u00a0minutes in overdose patients in the pre\u2010hospital environment when compared head\u2010to\u2010head. Intranasal naloxone at 1.4\u00a0mg\/0.1\u00a0mL restored breathing in 80% of participants after one dose and had few mild adverse reactions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.15806","type":"journal-article","created":{"date-parts":[[2022,2,9]],"date-time":"2022-02-09T04:05:19Z","timestamp":1644379519000},"page":"1658-1667","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Comparison of intranasal and intramuscular naloxone in opioid overdoses managed by ambulance staff: a double\u2010dummy, randomised, controlled trial"],"prefix":"10.1111","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1735-4820","authenticated-orcid":false,"given":"Arne Kristian","family":"Skulberg","sequence":"first","affiliation":[{"name":"Department of Circulation and Medical Imaging Norwegian University of Science and Technology  Trondheim Norway"},{"name":"Division of Prehospital Services Oslo University Hospital  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