Protocole de traitement de l’intoxication aiguë aux opioïdes [Protocol for the treatment of acute opioid overdose; available in French only]

Bulletin d'information toxicologique [Toxicology newsletter], Institut national de santé publique du Québec (INSPQ)

Opioids are a vast class of drugs that includes natural derivatives of the Papaver somniferum plant and semi-synthetic and synthetic compounds. Opioid overdose is common and can have serious, even fatal, consequences. These drugs mainly act on three large families of receptors: mu, delta and kappa. The classic opioid overdose triad consists of respiratory depression, decreased level of consciousness and miosis. Of these three, respiratory depression is responsible for the majority of morbidity and mortality associated with opioid overdose. Diagnosis of opioid overdose is primarily clinical and treatment involves maintaining an adequate airway and oxygenation and ventilation functions as well as the rational use of naloxone, a competitive mu receptor antagonist that can completely reverse the effects of opioid overdose. Monitoring, both for subjects exposed to an opioid who are initially asymptomatic and for subjects who require treatment with naloxone, is of the utmost importance and the best guarantee of safety in these circumstances.