Naloxone Infusions for Opioid Overdose: A 10-Year Retrospective Analysis.

Area of Science:

• Emergency Medicine
• Clinical Pharmacology
• Toxicology

Background:

• Naloxone is widely used for opioid overdose, but real-world data on naloxone infusions are limited.
• Understanding naloxone infusion practices is crucial for managing prolonged opioid toxicity.

Purpose of the Study:

• To describe the utilization of naloxone infusions over a decade.
• To analyze clinical decision-making processes for naloxone infusion administration.

Main Methods:

• Retrospective review of 44 naloxone infusions in adult patients at two academic medical centers (2014-2023).
• Exclusion criteria included patients under 18, non-opioid overdose indications, and non-emergency department origins.

Main Results:

• 43 patients (median age 36, 83.7% male) received naloxone infusions, primarily for fentanyl ingestion.
• Median infusion duration was 284 minutes, with a median administered dose of 4 mg and 8 mg wasted.
• 18 patients were admitted to the hospital, with a mean hospitalization of 1.7 days.

Conclusions:

• Naloxone infusions are infrequently used but associated with substantial drug waste and resource utilization.
• Optimizing treatment strategies for prolonged opioid toxicity requires further investigation.