Skip to main content
Log in

Reversal of Pediatric Opioid Toxicity with Take-Home Naloxone: a Case Report

  • Case Report
  • Published:
Journal of Medical Toxicology Aims and scope Submit manuscript

Abstract

Background

Take-home naloxone, an opioid antagonist, has become part of a multimodal approach to curbing opioid-related mortality. However, there is little information about the utility of take-home naloxone in pediatric patients. We report a case of opioid toxicity after exposure to methadone in a pediatric patient, which was successfully reversed with take-home naloxone.

Case

A previously healthy 22-month-old girl ingested an unknown amount of liquid methadone. The child became progressively somnolent. The mother administered intranasal naloxone at home with reversal of somnolence. The patient presented to the emergency department and had recurrence of symptoms. The patient was placed on a naloxone infusion and discharged from a tertiary care facility, uneventfully, 2 days after ingestion.

Results

To our knowledge, we report the first case of pediatric opioid toxicity reversed by take-home naloxone. In the setting of rising opioid-related mortality, providers and public health officials should consider expanding access of take-home naloxone for children at high risk for opioid overdose.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Walley AY, Xuan Z, Hackman HH, Quinn E, Doe-Simkins M, Sorensen-Alawad A, et al. Opioid overdose rates and implementation of overdose education and nasal naloxone distribution in Massachusetts: interrupted time series analysis. BMJ. 2013;346:f174.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Tadros A, Layman SM, Davis SM, Bozeman R, Davidov DM. Emergency department visits by pediatric patients for poisoning by prescription opioids. Am J Drug Alcohol Abuse. 2016;42:550–5.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Doyon S, Aks SE, Schaeffer S. Expanding access to naloxone in the United States. J Med Toxicol. 2014;10:431–4.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Davis CS, Carr D. Legal changes to increase access to naloxone for opioid overdose reversal in the United States. Drug Alcohol Depend. 2015;157:112–20.

    Article  PubMed  Google Scholar 

  5. Akers JL, Hansen RN, Oftebro RD. Implementing take-home naloxone in an urban community pharmacy. J Am Pharm Assoc. 2017;57:S161–7.

    Article  Google Scholar 

  6. Kerr D, Kelly AM, Dietze P, Jolley D, Barger B. Randomized controlled trial comparing the effectiveness and safety of intranasal and intramuscular naloxone for the treatment of suspected heroin overdose. Addiction. 2009;104:2067–74.

    Article  PubMed  Google Scholar 

  7. Kim HK, Nelson LS. Reducing the harm of opioid overdose with the safe use of naloxone: a pharmacologic review. Expert Opin Drug Saf. 2015;14:1137–46.

    Article  CAS  PubMed  Google Scholar 

  8. Barton ED, Colwell CB, Wolfe T, Fosnocht D, Gravitz C, Bryan T, et al. Efficacy of intranasal naloxone as a needleless alternative for treatment of opioid overdose in the prehospital setting. J Emerg Med. 2005;29:265–71.

    Article  PubMed  Google Scholar 

  9. Wermeling DP. Review of naloxone safety for opioid overdose: practical considerations for new technology and expanded public access. Ther Adv Drug Saf. 2015;6:20–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Hasan RA, Benko AS, Nolan BM, et al. Cardiorespiratory effects of naloxone in children. Ann Pharmacother. 2003;37:1587–92.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jacob A. Lebin.

Ethics declarations

Consent for publication of this case was obtained and provided to the journal in accordance with JMT policy.

Conflicts of Interest

None.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lebin, J.A., Chen, B.C. & Valento, M.J. Reversal of Pediatric Opioid Toxicity with Take-Home Naloxone: a Case Report. J. Med. Toxicol. 15, 134–135 (2019). https://doi.org/10.1007/s13181-018-0695-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13181-018-0695-z

Navigation