{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T15:34:45Z","timestamp":1770824085826,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,7,21]],"date-time":"2019-07-21T00:00:00Z","timestamp":1563667200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100002076","name":"Emergency Medicine Foundation","doi-asserted-by":"publisher","award":["EMRF\u2010001R22\u20102014"],"award-info":[{"award-number":["EMRF\u2010001R22\u20102014"]}],"id":[{"id":"10.13039\/100002076","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Naloxone is an established antidote for the treatment of heroin poisoning; however, dosing regimens vary widely, with a current trend towards small titrated intravenous dosing. This study aims to characterise naloxone use in the treatment of patients presenting with suspected heroin poisoning.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective review of poisoned patients presenting to a clinical toxicology unit in Brisbane from January 2015 to December 2017. Patient demographics, clinical effects, naloxone dosing, observation periods and complications were extracted from the patient's medical records.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 117 presentations accounted for by 108 patients. Prehospital naloxone was provided to 57 (49%) patients, 46 of which received a standardised 1.6 mg i.m. dose. The remaining 60 (51%) patients received their first naloxone in hospital, with 58 (97%) receiving this by titrated i.v. doses. A subsequent naloxone infusion was required significantly more often in those treated with i.v. titrated naloxone compared to i.m. dose (27\/69 [39%] <jats:italic>vs<\/jats:italic> 5\/48 [10%], <jats:italic>P<\/jats:italic> = 0.0006). The need for parenteral sedation to manage acute behavioural disturbance following naloxone provision was rare (3\/117 [3%]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this retrospective observational study, a single large i.m. dose of naloxone reversed the toxicity of suspected heroin overdose in the majority of patients. In addition, patients were less likely to require repeated intermittent doses or naloxone infusion than those treated solely with i.v. naloxone. Further comparison in a prospective study is warranted to validate these observations in confirmed heroin overdose. Requirement for sedation secondary to acute behavioural disturbance was rare regardless of the route.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1742-6723.13344","type":"journal-article","created":{"date-parts":[[2019,7,21]],"date-time":"2019-07-21T23:59:12Z","timestamp":1563753552000},"page":"88-92","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["One single large intramuscular dose of naloxone is effective and safe in suspected heroin poisoning"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0724-1088","authenticated-orcid":false,"given":"Keith","family":"Harris","sequence":"first","affiliation":[{"name":"Clinical Toxicology Unit Princess Alexandra Hospital  Brisbane Queensland Australia"},{"name":"School of Medicine The University of Queensland  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colin B","family":"Page","sequence":"additional","affiliation":[{"name":"Clinical Toxicology Unit Princess Alexandra Hospital  Brisbane Queensland Australia"},{"name":"School of Medicine The University of Queensland  Brisbane Queensland Australia"},{"name":"Clinical Toxicology Research Group The University of Newcastle  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sikta","family":"Samantray","sequence":"additional","affiliation":[{"name":"School of Medicine The University of Queensland  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lachlan","family":"Parker","sequence":"additional","affiliation":[{"name":"Medical Directors Office, Queensland Ambulance Service  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew JA","family":"Brier","sequence":"additional","affiliation":[{"name":"Clinical Toxicology Unit Princess Alexandra Hospital  Brisbane Queensland Australia"},{"name":"School of Medicine The University of Queensland  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine Z","family":"Isoardi","sequence":"additional","affiliation":[{"name":"Clinical Toxicology Unit Princess Alexandra Hospital  Brisbane Queensland Australia"},{"name":"School of Medicine The University of Queensland  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,7,21]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/dar.12539"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00161-6"},{"key":"e_1_2_7_4_1","unstructured":"Australian Criminal Intelligence Commission. National Wastewater Drug Monitoring Program \u2013 Report 5 August2018. [Cited 15 Jul 2019.] Available from URL:https:\/\/apo.org.au\/sites\/default\/files\/resource\u2010files\/2018\/10\/apo\u2010nid196081\u20101223411.pdf."},{"key":"e_1_2_7_5_1","unstructured":"Australian Institute of Health and Welfare. Opioid harm in Australia: and comparisons between Australia and Canada. Cat. no. HSE 210. 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