18
Treatment
Naloxone for the Treatment of Opioid Overdose
Î Naloxone should be given in case of opioid overdose.
Î Naloxone can and should be administered to pregnant women in cases
of overdose in order to save the mother's life.
Î The Guideline Committee, based on consensus opinion, recommends
that patients who are being treated for OUD and their family
members/significant others be given prescriptions for naloxone.
Patients and family members/significant others should be trained in
the use of naloxone in overdose.
Î The Guideline Committee, based on consensus opinion, recommends
that first responders such as emergency medical services personnel,
police officers, and firefighters be trained in and authorized to
administer naloxone.
Table 6. Opioid Overdose Medications
Agent Dose Indication
Naloxone injection
Evzio
®
(auto-injector)
0.4 mg/0.4 mL For emergency treatment of
overdose
Narcan
®
, generic
a
(various) Opioid depression, diagnosis
of suspected opioid overdose,
↓ BP in septic shock
a
ere is not yet an FDA-approved intranasal formulation. ere are only kits made available
to deliver the injectable formulation intranasally.
Table 7. Switching Drugs
FROM
TO
Buprenorphine Methadone Naltrexone
Buprenorphine
No delay needed 7–14 days aer
last dose of
buprenorphine
Methadone
Better tolerated
when on <30–40 mg
of methadone
Must be completely
withdrawn from
opioids
Naltrexone
Wait 1 day for oral
naltrexone and 30
days for extended-
release naltrexone
Wait 1 day for oral
naltrexone and 30
days for extended-
release naltrexone.
Use low initial dose
of methadone.
