Intravenous use of illicit buprenorphine/naloxone to reverse an acute heroin overdose

Authors

  • Michael A. Yokell, ScB
  • Nickolas D. Zaller, PhD
  • Traci C. Green, PhD, MSc
  • Michelle McKenzie, MPH
  • Josiah D. Rich, MD, MPH

DOI:

https://doi.org/10.5055/jom.2012.0098

Keywords:

buprenorphine/naloxone, Suboxone, overdose, opioid overdose, opiate overdose, naloxone, lay responder, injection drug users

Abstract

A case of heroin overdose reversed through the intravenous (IV) administration of a crushed sublingual tablet of buprenorphine/naloxone (Suboxone®) by a lay responder is described. Although the sublingual administration of buprenorphine/naloxone to reverse an overdose has been reported elsewhere, this is the first report of IV administration. Healthcare professionals should be aware that injection drug users may respond to an opioid overdose by injecting buprenorphine/naloxone and should consequently counsel all opioid-using patients on the proper response to an overdose. Physicians should also consider prescribing naloxone to at-risk patients. The work of community-based naloxone distribution programs should be expanded.

Author Biographies

Michael A. Yokell, ScB

Division of Infectious Diseases, The Miriam Hospital, Providence, Rhode Island; Lifespan/Tufts/Brown Center for AIDS Research, Providence, Rhode Island; Medicine, Stanford University School of Medicine, Stanford, California.

Nickolas D. Zaller, PhD

Division of Infectious Diseases, The Miriam Hospital, Providence, Rhode Island; Lifespan/Tufts/Brown Center for AIDS Research, Providence, Rhode Island; Medicine (Research), Warren Alpert Medical School of Brown University, Providence, Rhode Island.

Traci C. Green, PhD, MSc

Lifespan/Tufts/Brown Center for AIDS Research, Providence, Rhode Island; Medicine (Research), Warren Alpert Medical School of Brown University, Providence, Rhode Island; Medicine (Research), Rhode Island Hospital, Providence, Rhode Island.

Michelle McKenzie, MPH

Division of Infectious Diseases, The Miriam Hospital, Providence, Rhode Island; Lifespan/Tufts/Brown Center for AIDS Research, Providence, Rhode Island.

Josiah D. Rich, MD, MPH

Division of Infectious Diseases, The Miriam Hospital, Providence, Rhode Island; Lifespan/Tufts/Brown Center for AIDS Research, Providence, Rhode Island; Medicine and Community Health, Warren Alpert Medical School of Brown University, Providence, Rhode Island.

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Published

01/01/2012

How to Cite

Yokell, ScB, M. A., N. D. Zaller, PhD, T. C. Green, PhD, MSc, M. McKenzie, MPH, and J. D. Rich, MD, MPH. “Intravenous Use of Illicit buprenorphine/Naloxone to Reverse an Acute Heroin Overdose”. Journal of Opioid Management, vol. 8, no. 1, Jan. 2012, pp. 63-66, doi:10.5055/jom.2012.0098.

Issue

Section

Case Studies