Acute Heroin Overdose
Publication: Annals of Internal Medicine
Volume 130, Number 7
Abstract
Acute heroin overdose is a common daily experience in the urban and suburban United States and accounts for many preventable deaths. Heroin acts as a pro-drug that allows rapid and complete central nervous system absorption; this accounts for the drug's euphoric and toxic effects. The heroin overdose syndrome (sensitivity for diagnosing heroin overdose, 92%; specificity, 76%) consists of abnormal mental status, substantially decreased respiration, and miotic pupils. The response of naloxone does not improve the sensitivity of this diagnosis. Most overdoses occur at home in the company of others and are more common in the setting of other drugs. Heroin-related deaths are strongly associated with use of alcohol or other drugs. Patients with clinically significant respiratory compromise need treatment, which includes airway management and intravenous or subcutaneous naloxone. Hospital observation for several hours is necessary for recurrence of hypoventilation or other complications. About 3% to 7% of treated patients require hospital admission for pneumonia, noncardiogenic pulmonary edema, or other complications. Methadone maintenance is an effective preventive measure, and others strategies should be studied.
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Information & Authors
Information
Published In
Annals of Internal Medicine
Volume 130 • Number 7 • 6 April 1999
Pages: 584 - 590
History
Published in issue: 6 April 1999
Published online: 15 August 2000
Keywords
- Addiction
- Analgesics
- Biochemistry
- Central nervous system
- Diagnostic medicine
- Diagnostic techniques
- Drugs
- Edema
- Emergency medical services
- Health care
- Medical services
- Nervous system
- Neurochemistry
- Neurology
- Opioids
- Pharmacology
- Prevention, policy, and public health
- Psychiatry and mental health
- Recreational drug use
- Research and reporting methods
- Signs and symptoms
- Substance abuse
Copyright
© 1999 American College of Physicians.
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Acute Heroin Overdose. Ann Intern Med.1999;130:584-590. doi:10.7326/0003-4819-130-7-199904060-00019
Acute Heroin Overdose. Ann Intern Med.1999;130:584-590. doi:10.7326/0003-4819-130-7-199904060-00019
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