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Risks of naloxone: a local service evaluation
  1. Rajendra Raman,
  2. Joshua Haggart,
  3. Jennifer Wood
  1. Victoria Hospital, Emergency Department, NHS Fife, Kirkcaldy, UK
  1. Correspondence to Dr Rajendra Raman, Victoria Hospital, Emergency Department, NHS Fife, Kirkcaldy, UK; rajendra.raman{at}nhs.scot

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Naloxone is a potent opioid receptor antagonist that reliably reverses life-threatening respiratory depression in opioid overdose but can precipitate severe withdrawal in opioid-dependent individuals.1 Guidelines recommend naloxone specifically for respiratory depression and not for reduced level of consciousness alone, with lower doses recommended in patients who may be opioid-dependent.2 3 The extent to which such guidelines are applied in practice has received little attention.

In Scotland, concurrent use of opioids and other central nervous system (CNS) depressants is frequent,4 and many patients are also prescribed opioid substitution therapy (OST).5 Both may affect the response to naloxone and consequent risk to patients and providers.6

We undertook a service evaluation aiming to:

(1) Describe the characteristics of patients being treated with naloxone in the pre-hospital and emergency department (ED) setting in one region of Southeast Scotland.

(2) Describe the current practice of naloxone administration and associated adverse events.

The charts of all ED patients who received naloxone from a healthcare professional in the pre-hospital or ED setting between December 2021 and November 2022 at one District General …

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Footnotes

  • Handling editor Gene Yong-Kwang Ong

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.