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Review
, 102 (4), 621-634

Preventing Opioid Overdose in the Clinic and Hospital: Analgesia and Opioid Antagonists

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Review

Preventing Opioid Overdose in the Clinic and Hospital: Analgesia and Opioid Antagonists

Stephanie Lee Peglow et al. Med Clin North Am.

Abstract

Drawing from existing opioid prescribing guidelines, this article describes how medical providers can reduce the risk of overdose. Through primary prevention, providers can prevent initial exposure and associated risks by educating patients, using risk stratification, minimizing opioid dose and duration, and avoiding coprescribing with sedatives. Secondary prevention efforts include monitoring patients with urine toxicology and prescription monitoring programs, and screening for opioid use disorders. Tertiary prevention includes treating opioid use disorders and providing naloxone to prevent overdose death. Specific preventive strategies may be required for those with psychiatric disorders or substance use disorders, adolescents, the elderly, and pregnant women.

Keywords: Harm reduction; Naloxone; Opioid overdose; Opioid prescribing; Overdose education; Prevention of overdose.

Figures

Fig. 1
Fig. 1
Levels of overdose prevention.
Fig. 2
Fig. 2
States that give immunity to prescribers for prescribing naloxone to lay persons (in green) as of July 1, 2017. This figure was created under a Creative Commons Attribution-4.0 International License. (Adapted from Prescription drug abuse policy system (PDAPS). Legal Science, LLC. Naloxone overdose prevention laws. Available at: http://j.mp/2hDyf2N. Accessed September 30, 2017; with permission.)

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