Opioid Overdose Reversal With Nalmefene Nasal Spray: A Case Report

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Michel Sucher1, Lisa Emmans2

  • 1Substance Use and Addiction, Honor Health Addiction Medicine, Phoenix, USA.

Cureus
|June 16, 2025
PubMed

Insights

Intranasal nalmefene effectively reversed an opioid overdose, showing rapid improvement in oxygen saturation and mental status. The patient experienced no precipitated withdrawal, supporting its use in emergency overdose response.

Area of Science:

  • Emergency Medicine
  • Pharmacology

Background:

  • Recent FDA approval of intranasal (IN) nalmefene for opioid overdose reversal.
  • Limited published evidence exists on IN nalmefene's clinical utilization and potential for precipitated withdrawal.

Observation:

  • Physician investigators reviewed bodycam footage, dispatch reports, and interview data of a patient receiving IN nalmefene post-opioid overdose.
  • Clinical signs and symptoms were assessed before, during, and after IN nalmefene administration.

Findings:

  • Rapid improvement in oxygen saturation (up to 98%) within 2.5 minutes post-administration.
  • Marked improvement in patient's mental status observed.
  • No evidence of precipitated withdrawal was noted in the patient.

Implications:

  • IN nalmefene demonstrates potential for rapid and effective opioid overdose reversal.
  • Further studies are crucial to establish IN nalmefene's role for first responders and its impact on patient outcomes.
  • This case study supports the safety and efficacy of IN nalmefene in clinical settings.
Keywords:
emergency respondersnalmefeneopioid overdosepolicesubstance use disorder

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