Had an otherwise healthy person collapse from #overdose 5 wks post #sublocade 100 mg (stable for months). UDS positive #fentanyl and cocaine on immunoassay (limited panel, often false neg for benzos). If episode was due to opioid, I would have thought this would be prevented by the depo #buprenorphine even if 7d late (am I too optimistic?). I’m waiting for GCMS, querying benzos +/- #xylaxine . Any experiences like this from others out there? #addiction

In addition to causing horrendous skin wounds (below) #xylaxine is not reversible with naloxone (narcan) leading to challenges with bystander and prehospital care.

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