NEW YORK (AP) – A new high-dose nasal spray to reverse opioid overdoses didn't save more lives than the previous standard dose, but it caused more vomiting and other side effects. , researchers said in a study published Thursday.
of 8 mg naloxone spray The drug, which is twice as potent as the previous highest dose, came after pressure from experts and patient advocates who pointed out that people who suffer from an overdose are often given multiple doses of low-dose antidotes. It was approved two years ago.
new researchResearchers are being called the first to provide real data on the differences between the two sprays, although they were limited to a more rural area of New York state. The paper was published by the Centers for Disease Control and Prevention, but the federal health agency was not involved in the study.
Higher doses “obtained no additional benefit,” the authors wrote.
“What's really remarkable is that although survival was the same, people who received the 8-milligram dose had significantly more withdrawal symptoms,” said one of the authors, Albany Medicine. said Dr. Michael Daly of the university.
Daly said the study does not lead to favoring one product over another. But “it's important to recognize that the potential for increased side effects is real,” he said.
The researchers worked with New York State Police, who respond to emergencies along highways and in rural areas.
Three troops in eastern New York were given the 8-milligram spray. Eight units based further from Albany had 4-milligram doses in stock. The study results were based on 354 incidents in which police officers administered naloxone spray between late March 2022 and mid-August 2023.
If an overdose patient was still alive when officers arrived, 99% of people survived after administering naloxone, regardless of the dose given.
People who received the 4-milligram spray usually received it multiple times, with an average of 1.67 doses, equivalent to 6.7 milligrams. But those treated with the 8-milligram spray were similar, receiving an average of 1.58 doses, or 12.6 milligrams.
Disorientation and lethargy during loss of consciousness were common in both groups.
However, other problems were significantly more common in patients who received higher doses of the spray. Approximately 38% experienced withdrawal symptoms such as vomiting, abdominal pain, sweating, shaking, and diarrhea. Only 19% of people receiving lower doses had such problems, the study found.
Dr. Alexander Worley, an addiction specialist at Boston Medical Center who also works with the Massachusetts Department of Health, said this is concerning because it could actually contribute to future overdose deaths. Stated.
People who experience additional withdrawal symptoms when rescued from an overdose may remember the pain and discomfort of that experience, and experts believe they may actually have naloxone when taking the drug in the future. Worley said it could prevent people from being around.
Walley said the study was limited and the way it randomized who received which dose was imperfect, but it was still “high-quality evidence.”
“The solution to stronger (illegal) drug supply is not necessarily stronger naloxone,” he said. “Having people witness people using drugs and having someone who can administer naloxone to that witness and call for help.”
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