Is There a Goldilocks Approach to Naloxone Use in Patients With Prolonged Opioid Overdoses in the Fentanyl Era?

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Friday, September 18, 2026, 12:00–1:30 p.m. ET (Washington, DC time)

Seminar Presentations

Is There a Goldilocks Approach to Naloxone Use in Patients With Prolonged Opioid Overdoses in the Fentanyl Era?

Presented by: Anthony Spadaro, MD, MPH

Fentanyl and other high-potency opioids have changed the presentation and treatment of opioid overdose. Naloxone spray, an opioid receptor antagonist, remains the cornerstone of acute care because it rapidly reverses life-threatening respiratory depression. However, its effects last only 30 to 90 minutes when it is sprayed into the nostrils. After initial reversal, a continuous naloxone infusion can prevent recurrent toxicity and reduce repeated dosing while the opioid clears. Some patients still require endotracheal intubation and mechanical ventilation, but naloxone infusions may reduce that risk.

Kratom and Kratom-Derived Products: Use, Availability, and the Current Policy Landscape

Presented by: Shoshana Aronowitz, PhD, MSHP

Kratom, a plant native to Southeast Asia, has stimulant effects at low doses and opioid-like effects at higher doses. Its use in the United States has grown over the past decade, driven by its availability online and in smoke shops. It is increasingly used to self-treat chronic pain, anxiety, and opioid withdrawal. Kratom and kratom-derived (KKD) products can cause dependence and withdrawal, and might increase the risk of overdose when combined with opioids, benzodiazepines, or alcohol. Natural leaf kratom remains unregulated at the federal level, though some states and municipalities have enacted bans or regulations, and some synthetic products are facing the possibility of federal scheduling. Dr. Aronowitz will share real-world clinical experiences, review the policy landscape, and present preliminary findings.