Single-step versus multi-step intranasal naloxone devices for overdose response: A randomized usability study in an at-risk population.
Am J Emerg MedMay 12, 2026 (epub)
Clinical ResearchEmergency Medicine
Jennifer Mondle, Ashlee De Leon, Benoit Stryckman et al.
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In 30 seconds
This randomized usability study evaluated single-step versus multi-step intranasal naloxone devices among 40 participants without prior training in an urban emergency department. The single-step device demonstrated significantly higher success rates (85% vs 20%) and faster administration times (30 seconds vs 58 seconds) during simulated overdose scenarios, highlighting the impact of device complexity on naloxone effectiveness.
Key findings
- 85% of participants successfully completed critical steps with the single-step device compared to 20% with the multi-step device.
- Median time to administration was significantly shorter with the single-step device at 30 seconds versus 58 seconds for the multi-step device.
- After education, success rates improved to 100% for the single-step device and 90% for the multi-step device.
Why it matters
Understanding the usability of naloxone devices is crucial for optimizing overdose response strategies. Simplified devices may enhance the effectiveness of take-home naloxone programs, especially among untrained lay responders.