Opioid intoxication, opioid overdose, and opioid withdrawal are the acute disorders caused by opioid use- all they require medical management. Psychotherapy, opioid agonist therapy (OAT), and treatment of the acute pain symptom in patients who are on the maintenance therapy are considered a treatment for long-term opioid abuse.
For opioid intoxication, here are the general supportive measures:
- Assess and clear the airway of the patient.
- Provide support ventilation, if needed.
- Assess and support his/her cardiac function.
- IV fluids should be provided.
- The vital signs and cardiopulmonary status should be monitored frequently until the patient’s system is cleaned from opioids.
- IV naloxone should be provided if necessary.
Naloxone acts as an opiate antagonist and its contents do not have agonist or euphoriant properties.
With the provision of Naloxone, the person will be able to rapidly reverse the effects, specifically respiratory system depression. The drug is also able to counter sedation caused by intoxication of heroin.
FDA approved the intranasal naloxone back in November 2015 after conducting fast track designation and priority review.
It has been approved to give an emergency treatment for a suspected opioid overdose, which is oftentimes characterized by assessing respiratory and central nervous system depression. The intranasal naloxone is formulated by combining 4mg dose that is ready-to-use single-dose sprayer.
The basis of its approval was from the studies conducted by pharmacokinetic studies, which compared intranasal dosage forms from IM route. The National Institute on Drug Abuse (NIDA) was also crucial for conducting trials and experiments of naloxone as an intranasal formulation. It is also readily available as an injection.
Another naloxone (Evzio) was approved by the FDA in April 2014 as an autoinjector dosage.
The kind of mostly used by families’ home use. It can be administered by intramuscular or subcutaneous in the anterolateral aspect of the thigh. It comes with visual and voice instructions, including the instructions related to emergency medical care for the use of naloxone.
Back in 1996, the community-based programs provided naloxone and other opioid overdose prevention services to those who abused opioids. Since naloxone is effective in treating acute overdose in opioid, it was distributed to over 53,000 persons diagnosed with opioid dependence.
Since overdose cases are frequently happening, at-home piloted naloxone programs are now in several countries.
However, this program has continually received negative feedback as reportedly it promotes heroin use, discourages medical care, and produces side effects that cannot be managed at home. Careful monitoring is highly advised to promote optimum efficiency as well as reduce potential cases of mortality.
To reduce cravings and withdrawal symptoms, pharmacologic therapy for heroin addiction is made by substituting heroin with the legally obtained opioid agonist.
With this therapy, several factors can be mitigated. Methadone maintenance therapy (MMT), for one, is offered as a standard care. However, with the existence of buprenorphine maintenance therapy (BMT) changes, the trend of treatment efficiency amongst opioid-dependent patients have changed.
Methadone can be dosed once per day due to its long-acting synthetic opioid agonist and can be a substitute for the daily heroin doses. It can lower cases of drug-abusing lifestyles, reduce criminal behaviors, and the risk of transferring HIV disease.