Alexandra Amaducci, DO; Kim Aldy, DO; Sharan L. Campleman, PhD; Shao Li, MPH; Alison Meyn, MPH; Stephanie Abston, BSN; Rachel E. Culbreth, PhD; Alex Krotulski, PhD; Barry Logan, PhD; PaulWax, MD; Jeffrey Brent, MD; Alex F. Manini, MD; for the Toxicology Investigators Consortium Fentalog Study Group


Lehigh Valley Health Network-USF Morsani College of Medicine, Allentown, Pennsylvania (Amaducci); American College of Medical Toxicology, Phoenix, Arizona (Aldy, Campleman, Li, Meyn, Abston, Culbreth,Wax); Baylor University Medical Center, Dallas, Texas (Aldy); Center for Forensic Science Research and Education at the Fredric Rieders Family Foundation, Willow Grove, Pennsylvania (Krotulski, Logan); NMS Labs, Horsham, Pennsylvania (Logan); University of Texas Southwestern Medical Center, Dallas (Wax); University of Colorado School of Medicine, Aurora (Brent); NYC Health and Hospitals, Elmhurst, New York (Manini); Icahn School of Medicine at Mount Sinai, New York, New York (Manini).


In this cohort study of 537 patients, all patients with NPO overdose presented with opioid overdose symptoms and received multiple doses of naloxone. Compared with fentanyl overdose, patients with NPO overdose had a higher number of naloxone doses administered in-hospital; metonitazene overdose was associated with cardiac arrest and more naloxone doses overall.

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