Speed of Revival:
Naloxone in Overdose Emergencies
By Sydney Parsons, Lexis Pokorny, and Emma Swanda
As nursing students, we were intrigued by naloxone( Narcan ®), one of the most important life-saving medications on the market today. The drug has been critical in preventing deaths from overdoses, which cause 10.6 deaths per 100,000 standard population, according to the Centers for Disease Control and Prevention( CDC)( 2023). As nursing students, we wanted to compare the different ways naloxone is administered and its effectiveness in an emergency.
We began by interviewing Kathy Swanda, RN, Assistant Director of Nursing at Johnson County Hospital in Tecumseh, Nebraska( K. Swanda, personal communication, October 18, 2025). Ms. Swanda has administered naloxone in the hospital and in the community while on the volunteer rescue squad. We learned from Ms. Swanda that the route of naloxone administration depends on the location of the healthcare professional and the client, as well as the provider ' s knowledge and preference in administering naloxone. Ms. Swanda shared with us her experience administering naloxone through intravenous, intramuscular, and intranasal routes.
Her experience and background gave insight into assessments of patients with suspected opioid overdose and how to determine the need for naloxone administration. She stressed how important it is to assess the respiratory status of the patient, including respirations per minute, respiratory quality( depth), skin color( cyanosis), and blood oxygen saturation.
In Ms. Swanda’ s experience, intravenous naloxone administration has been the preferred route in a controlled, clinical setting. It provides the fastest onset and allows precise dosing to reverse opioid overdose while minimizing severe withdrawal symptoms. When comparing intramuscular versus intranasal administration, Ms. Swanda explained that intramuscular administration has a faster onset and requires fewer repeat doses, whereas in an uncontrolled emergency, intranasal administration is easier to access and is less invasive. Intranasal is also safer in her opinion, as it avoids accidental needle sticks and incorrect administration.
She pointed out that intranasal naloxone is the safest route, and most accessible in uncontrolled settings. Intramuscular is rarely used due to limited ability to control the medication and limited availability to emergency medical technicians, firefighters, and police officers in the field.
Reflecting On Naloxone
We learned from research that naloxone has been used in the healthcare industry for the past 64 years, making its appearance in 1961 as the reversal for opioid overdose( Campbell, 2019). In 2015, the FDA approved the purchase of over-the-counter intranasal naloxone for the public in case of an emergency( FDA, 2023); however, there has been debate about whether this is truly safe and whether the ready availability of naloxone has furthered the acceptance of opioid use.
Research on which method of naloxone administration works best to reverse drug overdose has determined that both
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