ToxicologyEmergency
Opioid overdose
Recognition and titrated naloxone reversal of opioid overdose, including delayed-action and long-acting agents.
Source: TOXBASE/NPIS; Resuscitation Council UK; BNF
Step 1 of ~8
action
Recognise opioid toxidrome
Classic triad: depressed consciousness + respiratory depression (RR <12) + pinpoint pupils.
ABCDE; bag-mask ventilation if RR <8 or SpO₂ <90% on high-flow O₂.
Baseline: VBG, capillary glucose, paracetamol/salicylate, ECG (QT in methadone), temperature, lactate.
Identify the opioid: short-acting (heroin, morphine, oxycodone, fentanyl) vs long-acting (methadone, buprenorphine, slow-release morphine, slow-release oxycodone, tramadol). Co-formulations matter (e.g. co-codamol = paracetamol risk).
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- NaloxoneRecommendedOpioid Antagonist
- MorphineRecommendedAnalgesic
- Tramadol hydrochlorideRecommendedAtypical opioid (μ-agonist + SNRI)
- Methadone hydrochlorideRecommendedLong-acting synthetic opioid
Same class
Pathways
- Paracetamol overdose · TOXBASE/NPIS; MHRA DSU 2012/2024; SNAP regimen (Lancet 2014); BNF
- TCA overdose · TOXBASE/NPIS; AACT/EAPCCT position statements; Resuscitation Council UK ALS
- Anticholinergic toxidrome · TOXBASE/NPIS; AACT/EAPCCT; BNF
- Benzodiazepine overdose · TOXBASE/NPIS; AACT/EAPCCT; BNF
- β-blocker overdose · TOXBASE/NPIS; AACT/EAPCCT; ESC; BNF
- Calcium channel blocker overdose · TOXBASE/NPIS; AACT/EAPCCT; ESC; BNF
Decision support only. Always apply local guidelines and clinical judgement.