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However, there remains a critical need to optimize naloxone dosing strategies. This article examines the challenges of both under\u2010dosing and over\u2010antagonism in naloxone administration, emphasizing the importance of a tailored approach to overdose management. A \u2018just the right dose\u2019 approach is essential for minimizing the risks of over\u2010antagonism while still reversing opioid overdose. This involves starting with a modest naloxone dose and carefully titrating it based on the patient's response, considering factors such as opioid type, overdose severity, and opioid tolerance. A tailored approach to naloxone dosing may present challenges for non\u2010medically trained responders but it can ensure that as many people as possible receive the right dose of naloxone when they need it. Training programs should also emphasize the importance of first aid and supportive care, including airway management and alerting emergency services, as well as careful monitoring of the patient's response.<\/jats:p>","DOI":"10.1111\/add.70060","type":"journal-article","created":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T09:33:44Z","timestamp":1744104824000},"page":"2165-2172","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Naloxone dosing in the era of synthetic opioids: Applying the Goldilocks principle"],"prefix":"10.1111","volume":"120","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-7632-7396","authenticated-orcid":false,"given":"Mariana","family":"Gonzalez Utrilla","sequence":"first","affiliation":[{"name":"National Addiction Centre Institute of Psychiatry, Psychology &amp; Neuroscience, King\u2019s College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2851-5252","authenticated-orcid":false,"given":"Edward","family":"Chesney","sequence":"additional","affiliation":[{"name":"National Addiction Centre Institute of Psychiatry, Psychology &amp; Neuroscience, King\u2019s College London  London UK"},{"name":"South London and Maudsley NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1502-5983","authenticated-orcid":false,"given":"Joanne","family":"Neale","sequence":"additional","affiliation":[{"name":"National Addiction Centre Institute of Psychiatry, Psychology &amp; Neuroscience, King\u2019s College London  London UK"},{"name":"Centre for Social Research in Health University of New South Wales Sydney  New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3581-1703","authenticated-orcid":false,"given":"Nicola","family":"Metrebian","sequence":"additional","affiliation":[{"name":"National Addiction Centre Institute of Psychiatry, Psychology &amp; Neuroscience, King\u2019s College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3820-9243","authenticated-orcid":false,"given":"Nicola","family":"Kalk","sequence":"additional","affiliation":[{"name":"National Addiction Centre Institute of Psychiatry, Psychology &amp; Neuroscience, King\u2019s College London  London UK"},{"name":"South London and Maudsley NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1735-4820","authenticated-orcid":false,"given":"Arne Kristian","family":"Skulberg","sequence":"additional","affiliation":[{"name":"Division of Prehospital Services Oslo University Hospital  Oslo Norway"},{"name":"Department of Circulation and Medical Imaging Norwegian University of Science and Technology  Trondheim Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Dietze","sequence":"additional","affiliation":[{"name":"Disease Elimination Program Burnet Institute  Melbourne Australia"},{"name":"National Drug Research Institute and Enable Institute Curtin University  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Smith","sequence":"additional","affiliation":[{"name":"Derbyshire Healthcare NHS Foundation Trust  Derby UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5413-2725","authenticated-orcid":false,"given":"John","family":"Strang","sequence":"additional","affiliation":[{"name":"National Addiction Centre Institute of Psychiatry, Psychology &amp; Neuroscience, King\u2019s College London  London UK"},{"name":"South London and Maudsley NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,8]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"FB A JA C LM R P S. 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