REVERSAL OF OPIOID INTOXICATION - THERAPEUTIC GUIDELINES

Opioid intoxication is one of the most common causes of drug-related e mergency department visits in the developed world. Successful treatmen t requires the timely recognition of intoxication, early airway interv ention and the judicious use of an antidote (usually naloxone), when a ppropriate. During the last decade, naloxone treatment strategies have undergone substantial evolution. This has resulted largely from the r ecognition that the treatment of the opioid intoxicated patient must d iffer from that of the patient recovering from physician-controlled an aesthesia in the operating roam or procedure suite. The use of standar d administration of naloxone by paramedics in the field-or physicians in the emergency department is often either ineffective or produces un wanted opioid withdrawal in opioid-tolerant patients. Also, in the set ting 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.