The opioid crisis means that rescuers must be trained in the management of emergencies related to the use of these drugs. Opioid analgesics are primarily used for the management of pain (hydrocodone and morphine). However, there are also illegal opioid drugs such as heroin. All opioids, whether legal or illegal, have a high risk of misuse, addiction, and overdose.

Opioids can cause depression of the respiratory system, which may lead to respiratory arrest. If using opioids in combination with other CNS depressants or alcohol, the risk of respiratory arrest increases. Fortunately, the provider who suspects opioid-related respiratory depression can use the opioid antagonist naloxone to counteract the effects of an opioid overdose. Naloxone is available for use as an injection or nasal spray. 

In addition to CPR in an unresponsive patient, the rescuer should also consider naloxone.

If opioids are suspected, and even if the patient has a pulse, the trained rescuer should follow protocol when administering naloxone. Naloxone can be given intramuscularly (IM) with an autoinjector or via the intranasal route. Rescuers should be aware that the patient who receives naloxone may be combative as they awaken.