Opioid overdose

Abstract

Opioid overdose has reached epidemic levels secondary to the increase use of prescription opioids and increased use of heroin in the United States. Most overdoses include multiple sedatives, and each overdose presents with respiratory depression. Naloxone, titrated to restore respiration but not to complete reversal, is the antidote of choice. Because naloxone has a half-life shorter than most opioids, return of respiratory depression frequently occurs after initial improvement, thus making repeat doses or infusions necessary. Risk factors for overdose include total dose, recent increase in dose, age, pulmonary, liver or kidney disease, sleep apnea, the use of other sedatives, substance abuse, and prior overdose.