Which sign signals the need for naloxone in opioid overdose?

• A. Hypertension and tachycardia.
• B. Severe chest pain with diaphoresis.
• C. Nausea without respiratory effect.
• D. Respiratory depression or apnea with pinpoint pupils.

Answer: (D)

The essential signal is respiratory depression or apnea with pinpoint pupils. Opioids blunt the brainstem’s drive to breathe, causing slowed or stopped respiration, which is the life-threatening part of an overdose. The pinpoint pupils reflect opioid effects on the nervous system and are a classic clue that opioids are involved. Naloxone works by displacing opioids at receptor sites, quickly reversing the respiratory depression and restoring breathing. The other signs don’t point to opioid overdose: high blood pressure with fast heart rate can occur in many conditions, chest pain with sweating suggests a cardiac issue, and nausea without respiratory impact isn’t indicative of opioid-induced respiratory failure.