The World Health Organization (WHO) has released new guidelines aiming to reduce the number of opioid-related deaths globally, including expanding naloxone access.

In the updated publication “Community Management of Opioid Overdose,” the WHO states that the number of opioid overdoses has increased worldwide, resulting in an estimated 69,000 deaths each year.

Along with community management of opioid overdose with naloxone, an opioid antagonist indicated for reversal of opioid depression including respiratory and diagnosis of acute opioid overdose, these preventative measures are encouraged:

  • Monitoring opioid prescribing practices;
  • Curbing inappropriate opioid prescribing;
  • Curbing inappropriate over-the-counter sales of opioids; and
  • Increasing the rate of treatment of opioid dependence, including for those dependent on prescription opioids.

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Based on a review of existing research, the following recommendations have been made, with strength of recommendation and quality of evidence noted respectively:

  • Those likely to witness an opioid overdose should have access to naloxone and receive instructions in its administration to enable them to use it for the emergency management of suspected opioid overdose (strong, very low).
  • Naloxone is effective when delivered by intravenous, intramuscular, subcutaneous and intranasal routes of administration.
  • Individuals using naloxone should select a route of administration based on the formulation available, their skills in administration, the setting, and local context (conditional, very low).
  • In suspected opioid overdose, first responders should focus on airway management, assisting ventilation and administering naloxone (strong, very low).
  • After successful resuscitation following the administration of naloxone, the level of consciousness and breathing of the affected person should be closely observed until full recovery has been achieved (strong, very low).

Currently Evizio (naloxone HCl injection; Kaléo, Inc.), a prefilled auto-injector for intramuscular or subcutaneous injection, is the only product indicated for emergency treatment of known or suspected opioid overdose, as manifested by respiratory and/or central nervous system depression that is available to patients, family members or caregivers via a prescription.

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