TPR Podcast Episode #13: Naloxone in the Age of Carfentanil

In this “Lucky 13” episode of the TPR podcast, Steven and Leon discuss naloxone, and address the following issues:

Does the concept of a “heroin overdose patient” have meaning anymore in this age of U-47700, fentanyl, and carfentanil?
Given the adulteration of both heroin and counterfeit prescription medications with extremely potent synthetic opioids, do we have to reconsider our entire approach to opioid overdose patients?
Can past medical literature guide us in our management of these patients?(Hint: the answer is no.)
What medical toxicology paper do Steve and Leon — in an unusual state of agreement — feel was the best to appear in 2016?

Here are links to some of the articles discussed in the podcast:

Fentanyl Outpaces Heroin as the Deadliest Drug on Long Island. New York Times Dec 28, 2016

Do heroin overdose patients require observation after receiving naloxone? Willman MW et al. Clin Toxicol 2017 Feb;55:81-87.

Fatal Fentanyl: One Pill Can Kill. Sutter ME et al. Acad Emerg Med 2017 Jan;24:106-113.

Experts weigh minimum naloxone dose as opioid crisis evolves. Traynor I. Am J Health Syst Pharm 2016 Dec 1;73:1892-1894.

The Rising Price of Naloxone — Risks to Efforts to Stem Overdose Deaths. Gupta R et al. N Engl J Med 2016 Dec 8;375:2213-2215.

Fentanyl epidemic in Chicago, Illinois and surrounding Cook County. Schumann H Erickson T, Thompson TM et al. Clin Toxicol 2008 Jul;46: 501-6.

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Source: The Poison Review - January 19, 2017 Category: Toxicology Authors: Leon Gussow The Poison Review Tags: Podcast Source Type: news