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Reversal of Opioid Intoxication

Therapeutic Guidelines

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Summary

Opioid intoxication is one of the most common causes of drug-related emergency department visits in the developed world. Successful treatment requires the timely recognition of intoxication, early airway intervention and the judicious use of an antidote (usually naloxone), when appropriate.

During the last decade, naloxone treatment strategies have undergone substantial evolution. This has resulted largely from the recognition that the treatment of the opioid intoxicated patient must differ from that of the patient recovering from physician-controlled anaesthesia in the operating room or procedure suite. The use of standard administration of naloxone by paramedics in the field or physicians in the emergency department is often either ineffective or produces unwanted opioid withdrawal in opioid-tolerant patients. Also, in the setting of polysubstance overdose or trauma, the use of naloxone may have deleterious effects. Current management strategies emphasise the need for individualised therapy for opioid-intoxicated patients.

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Authors and Affiliations

  1. New York City Poison Control Center, 455 First Avenue, Rm 123, New York, New York, 10016, USA

    Oliver L. Hung

  2. Department of Emergency Medicine, Bellevue Hospital Center, New York University Medical Center, New York, New York, USA

    Robert S. Hoffman

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  1. Oliver L. Hung
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  2. Robert S. Hoffman
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Hung, O.L., Hoffman, R.S. Reversal of Opioid Intoxication. CNS Drugs 7, 176–186 (1997). https://doi.org/10.2165/00023210-199707030-00002

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