Naloxone Use Among Emergency Department Patients with Opioid Overdose

Background: Emergency department (ED) visits for unintentional opioid overdoses have increased dramatically. Naloxone hydrochloride (Narcan®) is an opioid antagonist commonly used to treat these overdoses. Objective: This study was undertaken to identify experiences regarding naloxone use among ED patients with opioid overdose. Methods: This prospective survey study was conducted at an urban level I trauma center. A survey was administered to eligible ED patients after unintentional opioid overdose. This study identified current and previous use of naloxone among ED patients with opioid overdose. Results: Eight-nine ED patients with accidental overdose of opioids participated (90% participation rate). Most participants reported a history of opioid overdose (n = 62 [70%]). A significant minority stated they have had access to a naloxone kit (n = 28 [31%]). Most participants with a naloxone kit stated that their frequency and dosage of opiate use did not change after access to naloxone (n = 17 [63%]), and a few used opiates more often (n = 1 [4%]) or less often (n = 9 [33%]). There was a significant negative correlation between total dose and age (Spearman ρ –0.27; p = 0.01). There was no association between dose and sex. Conclusions: Many patients presenting with opioid overdose have had a history of opioid overdose. Patients with opioid overdose required a highly variable dose of naloxone. Higher doses of naloxone were associated with lower age. Despite widespread availability of naloxone to consumers, a minority of patients in this study reported access to naloxone. Participants who had access to a naloxone kit stated that their frequency and dosage of opioid use did not change.