Naloxone provided by a law enforcement officer (LEO) is a useful intervention for treating prehospital opioid overdoses. For a study, researchers sought to identify the frequency and contributing causes of negative behavioral effects and efficacy after LEO naloxone injection.

The patients in the research were treated with naloxone throughout a 5-year period in one county’s EMS system. Intranasal 4 mg/0.1 mL was used by law enforcement officials to treat suspected opiate overdoses. Data were obtained from forms that LEO filled out after giving them naloxone. Descriptive statistics were used. A univariate regression analysis using the patient’s agitation/combativeness following naloxone as a secondary result and an improved neurological state as the primary outcome.

There had been 597 recorded instances of LEO administering naloxone. In 370 (62%) of these cases, the LEO thought that naloxone was successful, with 6 (1%) displaying combativeness and 57 (10%) having the composite consequence of irritability or combativity. For heroin and fentanyl particularly, the perceived rate of effectiveness was greater when an opioid, rather than a non-opioid drug, was suspected (239/346 [67%] vs. 83/165 [50%], OR 2.21, 95% CI 1.51-3.23). The secondary outcome of irritability or combativeness (7/22 [32%] vs. 45/489 [9%], OR 4.60, 95% CI 1.78-11.8) was only significantly influenced by suspected fentanyl consumption.

Naloxone provided by LEOs was still a successful intervention for overdose victims, and its perceived effectiveness was higher when opioids were explicitly involved. After LEO naloxone delivery, confrontation was uncommon. The connection between probable fentanyl intoxication and post-naloxone behavioral abnormalities required more investigation.

Reference: sciencedirect.com/science/article/pii/S0735675722006131