Which action is recommended when opioid withdrawal or opioid use disorder is suspected?

• A. Request ALS to provide treatment and transport
• B. Administer naloxone
• C. Delay transport for observation
• D. Perform immediate IV fluids only

Answer: (A)

When opioid withdrawal or opioid use disorder is suspected, the priority is to provide appropriate symptom management and get the patient to definitive care with Advanced Life Support support. This situation is not about reversing an overdose with life-threatening respiratory depression, so giving naloxone is not indicated unless there is clear evidence of overdose with respiratory compromise. Providing only IV fluids or delaying transport doesn’t address the range of withdrawal symptoms (such as agitation, tachycardia, hypertension, nausea, and tremors) that may require monitored, medication-assisted care available with ALS.

Requesting ALS to treat and transport aligns with the need for careful monitoring, potential antiemetics, anxiolysis or sedatives if needed, hydration, and rapid transport to a setting where comprehensive treatment can be provided.