“Using the FDA-approved nasal Narcan spray is a great choice for average consumers, who will likely keep only one or two devices on hand,” Dr. Krieter said. “It is smaller, easier to use, and doesn’t require much if any training to use properly. The Narcan spray is a ready-to-use device; the improvised device needs assembly, and lay persons may not able to use it correctly in a panic situation.”

“Consumers can also consider the FDA-approved autoinjector, Ezvio, which also delivers the naloxone efficiently,” he said. “A generic version will be available later this year for some purchasers. It is important to check with your pharmacist about cost options and potential insurance coverage before making these purchases.”

Dr. Krieter added, “Physicians and pharmacists should caution patients—and their friends and family members—that the FDA-approved nasal spray device delivers more naloxone to the bloodstream than the improvised nasal spray device.”

Dr. Jermaine Jones from Columbia University Medical Center and New York State Psychiatric Institute in New York City recently showed that patients who use opioids can be trained to respond appropriately to opioid overdoses. He told Reuters Health by email, “Although there are statically significant differences in pharmacokinetics, whether these translate to clinically significant differences in the ability of each product to reverse an overdose is unknown. A clinical research study among opioid-dependent samples is needed to gather this information.”

“Physicians should note the increased range of products available to their patients to mitigate the risk of opioid overdose,” said Dr. Jones, who was not involved in the new work. “The FDA-approved formulations work best and almost equivalently well. For those treating substance use disorder populations, providing the [Narcan spray] product should be standard clinical practice.”

Dr. Jones doesn’t think it’s time to abandon the INND, though. He said, “We know that the INND is effective at reversing opioid overdoses, because, for years, it was the only game in town for peer-based naloxone programs.”

Dr. William Eggleston from Binghamton University School of Pharmacy and Pharmaceutical Sciences in Binghamton and SUNY Upstate Medical University in Syracuse, New York, told Reuters Health by email, “The results of this study further support that nasal naloxone is a reasonable alternative for individuals with limited or no medical training. In addition to these findings, our own research has shown that community members are able to successfully administer nasal naloxone more rapidly than INNDs. These devices should be considered first-line options for community-based programs.”