Naloxone to revert synthetic opioids overdose

Summary of the evidence

  • Likely to be beneficial

Naloxone is recommended in an evidence-based guidance (Neptune, 2018) to be used in case of suspected synthetic opioids, both in community and hospital settings.

Specificities with regard to fentanyls in comparison to heroin overdoses are the followings:

  • a more rapid administration of naloxone is warranted because of the rapid onset of fentanyls,
  • a more rapid escalation of additional doses for naloxone may be needed in comparison with heroin or other opioids,
  • overall, higher doses of naloxone may be needed for fentanyl patients in comparison with heroin patients,
  • Fentanyl patients may require a longer period of observation in hospital than heroin patients.