This review also closely assesses the methodological details of the observational reports to evaluate their value for informing the efficacy of naloxone against F/FA overdose. The focus of this review is primarily on case studies, controlled clinical trials, and epidemiological evidence; please see France et al. (2021) for a thorough review of the relevant preclinical literature. Among 1,871 overdose deaths in 43 jurisdictions with available data on circumstances, 1,090 (60.4%) occurred at the decedent’s home. Potential bystanders††† were present in 1,252 (66.9%) deaths, and 1,089 (59.4%) decedents had no pulse when first responders arrived.
Unless someone needs to grab a phone to call 911 or get naloxone, never leave someone alone during an overdose. It is important to monitor them so help can be given if they stop breathing. If someone does stop breathing, immediately administer rescue breaths. The 911 dispatcher can talk you through this process, and you can administer CPR if it becomes necessary, and you are trained to do so. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. After exposure, the patient underwent a standard decontamination procedure and a brief medical exam.
Treatment for Fentanyl Overdose
The use of an absorption enhancer may shorten the Tmax and increase the bioavailability of IN nalmefene and is currently under development (Krieter et al. 2019). The benefit of nalmefene (compared to naloxone) is its long duration of action, which may prevent the re-occurrence of respiratory depression that can occur with long-acting opioid receptor agonists, such as fentanyl. However, patient acceptance of a long-acting opioid receptor antagonist is a concern. Other alternatives to naloxone that are in the early stages of development include respiratory stimulants. However, the potential for side effects and unknown interactions with other illicit substances that could be contributing to the overdose event are major concerns with respiratory stimulants.
More than one million people have died since 1999 from a drug overdose.1 In 2021, 106,699 drug overdose deaths occurred in the United States. The age-adjusted rate of overdose deaths increased by 14% from 2020 (28.3 per 100,000) to 2021 (32.4 per 100,000). During July 2019–December 2021, a total of 1,808 adolescent overdose deaths occurred in 32 jurisdictions with available trend data. The number of monthly overdose deaths increased how long does fentanyl stay in your system 65% overall, from 31 in July 2019 to 51 in December 2021, peaking at 87 in May 2021 (Figure 1). The number of deaths involving IMFs more than doubled, from 21 to 44 during this period, peaking at 78 in May and August 2021. Median monthly overdose deaths among adolescents increased 109%, from 32.5 during July–December 2019 to 68 during July–December 2021; during the same period, deaths involving IMFs increased 182%, from 22 to 62.
Talk to your loved ones. Including your kids.
The Biden administration has pursued additional policies since taking office. Congress recently passed legislation making it easier for doctors to prescribe buprenorphine, a drug that helps people recover from opioid addiction. The administration has widened federal funding for so-called harm reduction approaches to addiction, like syringe exchanges and the distribution of drugs that can reverse overdoses. In a recent presidential debate, Nikki Haley, the former governor of South Carolina, said that fentanyl had killed more Americans than the wars in Vietnam, Iraq and Afghanistan combined.
- Illicit (illegal) fentanyl is often smuggled into the US in powder form and may be pressed into fake pills or mixed with other drugs like cocaine, heroin, and methamphetamine (“meth”).
- The argument that naloxone is not efficacious against fentanyl and fentanyl analogs rests on case studies, retrospective analyses of community outbreaks, pharmacokinetics, and pharmacodynamics.
- Alternative pharmacological approaches that are currently being studied in humans include other opioid receptor antagonists (e.g., nalmefene), respiratory stimulants, and buprenorphine.
- Treatment for fentanyl addiction is the same as for any opioid use disorder and depends on the severity of the addiction.
It is important to understand the efficacy of naloxone as a reversal agent for F/FA overdose given the recent rise in illicit F/FA overdose deaths. We were unable to find any rigorously controlled prospective clinical studies directly examining the dose–response of naloxone for the treatment of illicit F/FA overdose in humans. The FDA has not recommended a minimal naloxone dose for administration by a layperson but has advised that products developed for bystander use should achieve a minimum exposure that is similar to 0.4 mg IM naloxone with a similarly rapid onset (Adapt Pharma Operations Limited 2016).