ArticleDrug and alcohol dependence2024
Examination of naloxone dosing patterns for opioid overdose by emergency medical services in Kentucky during increased fentanyl use from 2018 to 2021.
Article in Drug and alcohol dependence, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- The effectiveness of the communities that HEAL intervention on reducing non-fatal opioid overdoses: A prespecified secondary analysis of a waitlist cluster control randomized controlled trial.The International journal on drug policy · 2025Trial
- Organizational perspectives on the impacts of scaling up overdose education and naloxone distribution in Kentucky.Addiction science & clinical practice · 2025Trial
- Article
- Quantum-topological simulation of Berry phase-induced fentanyl-μ-opioid receptor dissociation via terahertz vortex fields.Journal of molecular modeling · 2025Article
- Naloxone dosing in the era of synthetic opioids: Applying the Goldilocks principle.Addiction (Abingdon, England) · 2025Review
- Reported outcomes from a community naloxone training and distribution program.Drug and alcohol dependence reports · 2025Article
- Treating Opioid Use Disorder and Opioid Withdrawal in the Context of Fentanyl.Annual review of clinical psychology · 2025Review
- Naloxone dosing by non-medical first-responders at opioid overdoses: findings from a qualitative interview study.Harm reduction journal · 2025Article
- Article
- Fentanyl, Heroin, Methamphetamine, and Cocaine Analyte Concentrations in Urine Drug Testing Specimens.JAMA network open · 2024Article
- Synthetic opioids have disrupted conventional wisdom for treating opioid overdose.Drug and alcohol dependence reports · 2024Article
- Article
- Comparison of intranasal naloxone and intranasal nalmefene in a translational model assessing the impact of synthetic opioid overdose on respiratory depression and cardiac arrest.Frontiers in psychiatry · 2024Article
- Implementing a "Naloxone Hub With Many Spokes" Model in Kentucky: Partner Agency Perspectives on Implementation Strategies.Implementation research and practiceArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundFatal overdoses involving fentanyl/fentanyl analogs (F/FA) have increased in the US, raising questions about naloxone doses for F/FA overdose reversal. Emergency medical services (EMS) data provide an opportunity to examine naloxone administration changes as fentanyl increases in the illicit opioid supply.
methodsAdministered naloxone intranasal-equivalent total dose (INTD) in milligrams (mg) was calculated for Kentucky EMS suspected opioid overdose (SOO) encounters (n=33,846), 2018-2021, and patterns of administration were examined. County-level F/FA availability was measured as 1) proportion of fatal drug overdoses involving F/FA, and 2) F/FA police seizures. Linear mixed models estimated changes in INTD in relation to local F/FA availability accounting for patient characteristics.
resultsFrom 2018-2021, SOOs increased by 44% (6853 to 9888) with an average INTD increase from 4.5mg to 4.7mg, with more than 99% of encounters resulting in successful reversal each year. For SOO encounters examined by outcome at the scene (i.e., non-fatal fatal vs fatal), average INTD for non-fatal were 4.6mg compared to 5.9mg for fatal overdoses. Mixed modeling found no significant relationship between INTD and the two measures for local F/FA availability.
conclusionAs F/FA-involved overdose risk increased, we observed a modest increase in INTD administered in SOO EMS encounters - just slightly higher than the 4mg standard dose. The lack of significant relationship between F/FA and naloxone dose suggests that naloxone utilization in SOO with EMS involvement remains effective for overdose reversal, and that EMS naloxone dosing patterns have not changed substantially.
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