Grant: Operating Grant: Opioid Crisis Knowledge Synthesis

Background: By the end of 2017, over 3,000 Canadians will have died from an illicit opioid overdose. Ultra-potent opioids, such as fentanyl, have contributed to this sharply rising death toll. Public Health agencies are distributing Take Home Naloxone Kits containing naloxone, an antidote to opioids as an effective means of treating overdoses immediately and preventing deaths. However, the optimal dose and route of naloxone administration are unknown. Objective: Our objectives are to synthesize the available evidence on Naloxone's dose and route of administration when treating overdoses from suspected ultra-potent opioids in non-medical settings. Methods and Design: We will perform a systematic search of the published literature. We will search MEDLINE, Embase, Cochrane Central Register of Controlled Trials, CINHAL, and Science Citation Index. We will also search for poison centre documentation, professional organization websites, reference lists and other grey literature to capture a diversity of sources. Two reviewers will screen identified data and studies for inclusion and exclusion criteria. Two reviewers will extract data from full text using standardized data collection forms, and independently review study quality using standardized tools. We will meta-analyze data if we find homogenous studies reporting similar outcome measures on the same interventions. Otherwise, we will synthesize data qualitatively. Anticipated Results: The results of this systematic review will provide evidence-based information on naloxone's optimal dosing strategy and route of administration. Our findings will inform the naloxone dose and formulation made available in BC and in Take Home Naloxone Kits, community outreach programs, guidelines and public policy.