A chronic pain patient being treated with opioids may benefit from the added safety of being prescribed naloxone.

Indications for naloxone:

(1) history of overdose

(2) history of substance use disorder

(3) daily opioid dose > 50 MME

(4) comorbidities or medications associated with respiratory depression and/or sedation and/or sleep apnea


Intranasal naloxone is the preferred formulation.


The naloxone should be readily available to the patient. It may be stored in a cabinet with a prominent sign indicating its location. The storage location should have a stable temperature and avoid temperature extremes.


Family and friends should be educated in how to administer the naloxone and what steps to take afterwards.


Most formulations of intranasal naloxone have a shelf life of 18 months. Expired naloxone should be replaced.

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