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As emergency physicians with a subspecialty in aviation medicine, we agree with Dr. Rieb’s comment above that having naloxone on board is a necessary tool to treat the increasingly common medical emergency of opioid intoxication. Some airlines (United, British Airways, Air Transat, Qantas, Frontier and Alaska Airlines) do currently stock naloxone in their onboard emergency medical kits (EMKs), and Air Canada is currently in the process of rolling out naloxone in its EMKs. Each airline only stocks 1-2 vials, which is insufficient to treat a large overdose, but should be enough to reverse respiratory depression to make the diagnosis of opioid intoxication and divert the aircraft to definitive treatment.
We are not aware of any airline at this time that offers intranasal naloxone. And although there has been a call from the Association of Flight Attendants in the USA to be trained to administer naloxone as first responders, this is currently not the standard. The naloxone is typically stored in the EMK, which can only be released to a health care professional.