title: Heroin overdose resuscitation with naloxone: patient uses own prescribed supply to save the life of a peer.
abstract: Opiate overdose is the primary cause of death among injection-drug users, representing a major public health concern worldwide. Opiate overdose can be reversed through timely administration of naloxone, and users have expressed willingness to carry the antidote for emergency use (take-home naloxone). In November 2014, new WHO guidelines identified that naloxone should be made available to anyone at risk of witnessing an overdose. We present the case of a 46-year-old man in opioid-maintenance treatment who used take-home naloxone to rescue an overdose victim. This is the first- ever account of a patient using dose titration of naloxone to restore respiratory function while minimising the risk of adverse effects. To improve the safety of take-home naloxone, the authors call for clinicians involved in the treatment of opiate users to: prescribe take-home naloxone to all patients; forewarn patients of potential side effects; and instruct patients in naloxone dose titration.
authors.affiliation: Supervised Injectable Opiate Treatment Clinic, South London & Maudsley NHS Foundation Trust, London, UK.
authors.forename: Ian
authors.initials: I
authors.lastname: Winston
authors.affiliation: Addictions Department, King's College London, London, UK.
authors.forename: Rebecca
authors.initials: R
authors.lastname: McDonald
authors.affiliation: Addictions Department, King's College London, London, UK.
authors.forename: Basak
authors.initials: B
authors.lastname: Tas
authors.affiliation: Addictions Department, King's College London, London, UK.
authors.forename: John
authors.initials: J
authors.lastname: Strang
mesh_terms: D062787:Drug Overdose / Q000188:drug therapy*; D005392:First Aid / Q000379:methods; D006556:Heroin Dependence; D006801:Humans; D008297:Male; D008875:Middle Aged; D009270:Naloxone / Q000008:administration & dosage*; D009292:Narcotic Antagonists / Q000008:administration & dosage*; D009293:Opioid-Related Disorders; D012151:Resuscitation; D016896:Treatment Outcome
chemical_list: D009292:Narcotic Antagonists; D009270:Naloxone