A 21-year-old university student presents to the emergency department with features of opioid toxicity after using isotonitazene. They respond to naloxone and their observations and mental state return to normal. What observation period should be considered before discharge?
A. Two hours
B. Four hours after the last naloxone dose only
C. Six hours after opioid use
D. Up to 12 hours
E. Up to 24 hours after the last naloxone dose
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