Antidotes for opioid overdose: a search for variations for their modification (literature review)

The unique physicochemical and pharmacological properties of synthetic drugs are responsible for both the morbidity and mortality associated with their overdose. Among the consequences resulting from misuse of these potent opioids, or in the case of mass casualties involving the large-scale use of weaponised synthetic opioids, is the need for higher and repeated doses of the competitive antagonist naloxone, currently the only drug available to reverse opioid overdose. We reviewed the reversal agents available worldwide, discuss the need for stronger, faster and longer-acting opioid antagonists to reverse opioid overdose, and look at possible areas of functionalization of morphinan-based opioid ligands.