Naloxone hydrochloride for acute opioid events

As part of public health initiatives, a number of countries now provide naloxone kits for use by first responders in an effort to tackle drug-related deaths within communities (Speakman et al, 2023). For those who are opioid dependent, ‘take home naloxone’ may be administered in the event of an accidental overdose, and prior to hospital admission (McAuley et al, 2023).

Naloxone hydrochloride is an opioid receptor antagonist that blocks or rapidly reverses the effects of drugs such as morphine, heroin, methadone or fentanyl. An overdose of an opioid can suppress the central nervous system, resulting in respiratory depression, bradycardia and loss of consciousness. Rapid administration of naloxone is indicated as first-line medication to reverse these symptoms which can be fatal if not treated promptly (Table 1).

Frequent monitoring of the patient's respiratory rate and level of consciousness post-naloxone administration should be undertaken as naloxone has a shorter duration of action than many opioids and repeated doses may be required (NICE, 2023a).