Opiate poisoning can occur at any time from birth when pethidine given to the mother in labour may suppress ventilation to terminal care. The outcome can range from minor adverse effects such as constipation to death from respiratory depression. The following drugs may be involved:. It is difficult to get reliable incidence figures. The elderly are more liable to poisoning from opiates and more likely to be taking them, especially drugs like co-codamol for arthritis.
The corresponding female rate increased slightly between to from 4. Nevertheless, the female mortality rate remains the second highest on record. An Australian study of fatal methadone and heroin toxicity cases found that methadone users were significantly more likely than heroin users to have cardiac, pulmonary, hepatic and renal disease [ 2 ].
A rise in drug-related deaths in Scotland was seen in ; this was thought to be a late effect of the increase in the use of injectable drugs in the s [ 3 ]. Heroin and morphine remain the most common cause of drug-related deaths, closely followed by methadone. However, there has been an increasing number of deaths involving tramadol deaths in compared with 83 in Polydrug use which was a signficant factor in previous years, appears to have reduced significantly in England and Wales [ 5 ].
However, it still remains an issue in Scotland [ 4 ]. The following groups are at risk of morphine toxicity and usually require a lower dose [ 9 ] :. Opiates should still be used in terminal care, even in these groups.
Since the Harold Shipman case some doctors are wary about the dose they give, even in terminal care. If this means that dying patients are denied adequate analgesia, it is to be regretted. There may be no clear indication of what the patient has taken. He or she may be a known drug abuser or there may be needle track marks on the limbs. Beware of multiple drug ingestion eg, antidepressants, alcohol or benzodiazepines , especially in drug abusers or with suicidal intent [ 10 ].
There may possibly be HIV infection. Nutrition and self-care are usually poor. The development of noncardiogenic pulmonary oedema also known as acute lung injury carries a poor prognosis it is not naloxone-reversible. Multiple drug ingestion and comorbidity eg, cardiac or renal conditions also increase the risk of death [ 26 ].
Drug abusers must be educated about the risks they face. They must understand loss of tolerance after reduction therapy or enforced abstinence as in prison. They must understand the enhanced risk with benzodiazepine use too. They are much less likely to have a serious overdose if they inhale rather than inject. See, Play and Learn Videos and Tutorials. Resources Reference Desk. For You Women Patient Handouts.
What are opioids? What is an opioid overdose? What causes an opioid overdose? An opioid overdose can happen for a variety of reasons, including if you Take an opioid to get high Take an extra dose of a prescription opioid or take it too often either accidentally or on purpose Mix an opioid with other medicines, illegal drugs, or alcohol. An overdose can be fatal when mixing an opioid and certain anxiety treatment medicines, such as Xanax or Valium.
Take an opioid medicine that was prescribed for someone else. Children are especially at risk of an accidental overdose if they take medicine not intended for them.
Who is at risk for an opioid overdose? If you think someone is having an opioid overdose, Call immediately Administer naloxone, if it is available. Naloxone is a safe medication that can quickly stop an opioid overdose. It can be injected into the muscle or sprayed into the nose to rapidly block the effects of the opioid on the body.
Try to keep the person awake and breathing Lay the person on their side to prevent choking Stay with the person until emergency workers arrive Can an opioid overdose be prevented? There are steps you can take to help prevent an overdose: Take your medicine exactly as prescribed by your health care provider. Do not take more medicine at once or take medicine more often than you are supposed to. Minus Related Pages.
Clinical description Exposure to opioids typically occurs through ingestion but also can result from transdermal absorption, inhalation via aerosolization, or injection. Laboratory criteria for diagnosis Biologic : A case in which opioids are detected in a biological fluid such as urine by hospital or commercial laboratory tests. Fentanyl derivatives and certain other synthetic and semi-synthetic opioids e. Probable : A clinically compatible case in which a high index of suspicion credible threat or patient history regarding location and time exists for opioid exposure, or an epidemiologic link exists between this case and a laboratory-confirmed case.
Confirmed : A clinically compatible case in which laboratory tests have confirmed exposure. Additional resources Nelson L, Olson D. Chapter Opioids. Sporer KA. Acute heroin overdose.
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