• Nasim Zamani and Hossein Hassanian-Moghaddam.
• Toxicological Research Center, Loghman-Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, and the Excellence Center of Clinical Toxicology, Iranian Ministry of Health, Tehran, Iran.
• Ann Emerg Med. 2017 Jun 1; 69 (6): 737-739.

AbstractAdministration of naloxone is a common treatment for opioid-dependent patients who present with respiratory depression. Although safe in opioid-naive patients, naloxone may cause severe and even life-threatening complications in opioid-dependent patients, including acute respiratory distress syndrome and myocardial infarction. It has been suggested that administration of buprenorphine, a partial μ-opioid receptor agonist, to an opioid-intoxicated patient may result in reversal of respiratory depression with less severe withdrawal signs and symptoms. In addition, the longer half-life of buprenorphine compared with naloxone may reduce the need for repetitive administration of antidote. We present a 20-year-old morphine-addicted man who presented with methadone-induced respiratory depression and responded safely and effectively to intravenous administration of buprenorphine. Buprenorphine may be a useful alternative opioid reversal agent for opioid-dependent patients.Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

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