Naloxone dosing in the era of synthetic opioids: Applying the Goldilocks principle

• DOI: 10.1111/add.70060
• Publication Date: 2025-04-08T13:33:44Z
• Authors: Mariana Gonzalez ...; Edward Chesney; Joanne Neale; Nicola Metrebian; Nicola Kalk; Arne Kristian Sku...; Paul Dietze; Martin Smith; John Strang
• Keywords: Opioid Overdose; Opioid antagonist

Abstract The opioid overdose epidemic remains a critical public health crisis. In recent years, synthetic opioids like fentanyl and nitazenes, have driven sharp rise in deaths. Naloxone, an receptor antagonist, has been established as key intervention for reversing overdoses saving lives. However, there need to optimize naloxone dosing strategies. This article examines the challenges of both under‐dosing over‐antagonism administration, emphasizing importance tailored approach management. A ‘just right dose’ is essential minimizing risks while still overdose. involves starting with modest dose carefully titrating it based on patient's response, considering factors such type, severity, tolerance. may present non‐medically trained responders but can ensure that many people possible receive when they it. Training programs should also emphasize first aid supportive care, including airway management alerting emergency services, well careful monitoring response.