Global InformationOpioid overdose information
| Opioid overdose | |
|---|---|
| Other names | Narcotic overdose, opioid poisoning |
 | |
| A naloxone kit distributed in British Columbia, Canada | |
| Specialty | Emergency medicine |
| Symptoms | Respiratory depression, small pupils, unconsciousness |
| Complications | Permanent brain damage |
| Causes | Opioids (morphine, codeine, heroin, fentanyl, tramadol, methadone, etc.) |
| Risk factors | Opioid dependence, metabolic disorders, use of high doses of opioids, injection of opioids, use with antidepressants, alcohol, benzodiazepines and cocaine.[1][2] |
| Diagnostic method | Based on symptoms[3] |
| Differential diagnosis | Low blood sugar, alcohol intoxication, head trauma, stroke[4] |
| Prevention | Improved access to naloxone, treatment of opioid dependence |
| Treatment | Supporting a person's breathing and naloxone |
| Deaths | over 110,000 (2017) |
An opioid overdose is toxicity due to excessive consumption of opioids, such as morphine, codeine, heroin, fentanyl, tramadol, and methadone.[3][5] This preventable pathology can be fatal if it leads to respiratory depression, a lethal condition that can cause hypoxia from slow and shallow breathing.[3] Other symptoms include small pupils[note 1] and unconsciousness; however, its onset can depend on the method of ingestion, the dosage and individual risk factors.[6] Although there were over 110,000 deaths in 2017 due to opioids, individuals who survived also faced adverse complications, including permanent brain damage.[7][8]
Opioid overdoses are diagnosed based on symptoms and examination.[3] Risk factors for opioid overdose include high levels of opioid dependence, use of opioids via injection, high dosed opioid usage, having a mental disorder or having a predisposition for one, and use of opioids in combination with other substances, such as alcohol, benzodiazepines, or cocaine.[1][9][2] Dependence on prescription opioids can occur from their use to treat chronic pain in individuals.[1] Additionally, if following a period of detoxification, which allows the tolerance level to fall, the risk of overdose upon return to use is high.[1]
Initial treatment of an overdose involves supporting the person's breathing and providing oxygen to reduce the risk of hypoxia.[10] Naloxone is then recommended to those who cannot reverse the opioid's effects through breathing.[10][3] Giving naloxone via nasal administration or as an injection into a muscle has shown to be equally effective.[11] Other efforts to prevent deaths from overdose include increasing access to naloxone and treatment for opioid dependence.[1][12]
Drug use contributes to 500,000 deaths worldwide, with opioid overdose resulting in approximately 115,000 of these deaths in 2018.[1] This is up from 18,000 deaths in 1990.[13][14] In 2018, approximately 269 million people had engaged in drug usage at least once, 58 million of which used opioids.[1] Drug use disorders have affected around 35.6 million people worldwide in 2018.[1] The WHO estimates that 70% of deaths due to drug use are in relation to opioids, with 30% being due to overdose.[1] It is believed that the opioid epidemic has partly been caused due to assurances that prescription opioids were safe, by the pharmaceutical industry in the 1990s.[15] This led to unwarranted trust and a subsequent heavy reliance on opioids.[15] Though there are treatment interventions which can effectively reduce the risk of overdose in people with opioid dependence, less than 10% of affected individuals receive it.[1]
- ^ a b c d e f g h i j "Information sheet on opioid overdose". World Health Organization. November 2014. Archived from the original on 6 October 2022.
- ^ a b Cite error: The named reference
NIDA-deathswas invoked but never defined (see the help page). - ^ a b c d e Boyer EW (July 2012). "Management of opioid analgesic overdose". The New England Journal of Medicine. 367 (2): 146–155. doi:10.1056/NEJMra1202561. PMC 3739053. PMID 22784117.
- ^ Adams JG (2008). Emergency Medicine: Expert Consult -- Online. Elsevier Health Sciences. p. PT4876. ISBN 978-1437721294.
- ^ Rosenblum A, Marsch LA, Joseph H, Portenoy RK (October 2008). "Opioids and the treatment of chronic pain: controversies, current status, and future directions". Experimental and Clinical Psychopharmacology. 16 (5): 405–416. doi:10.1037/a0013628. PMC 2711509. PMID 18837637.
- ^ Malamed SF (2007). Medical emergencies in the dental office (6th ed.). St. Louis, Mo.: Mosby. ISBN 978-0-323-07594-7. OCLC 769189432.
- ^ Cite error: The named reference
:13was invoked but never defined (see the help page). - ^ Ritchie H, Roser M (16 March 2018). "Opioids, cocaine, cannabis and illicit drugs". Our World in Data.
- ^ Park TW, Lin LA, Hosanagar A, Kogowski A, Paige K, Bohnert AS (2016). "Understanding Risk Factors for Opioid Overdose in Clinical Populations to Inform Treatment and Policy". Journal of Addiction Medicine. 10 (6): 369–381. doi:10.1097/ADM.0000000000000245. PMID 27525471. S2CID 8871126.
- ^ a b de Caen AR, Berg MD, Chameides L, Gooden CK, Hickey RW, Scott HF, Sutton RM, Tijssen JA, Topjian A, van der Jagt ÉW, Schexnayder SM, Samson RA (November 2015). "Part 12: Pediatric Advanced Life Support: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 132 (18 Suppl 2): S526–S542. doi:10.1161/cir.0000000000000266. PMC 6191296. PMID 26473000.
- ^ Chou R, Korthuis PT, McCarty D, Coffin PO, Griffin JC, Davis-O'Reilly C, Grusing S, Daya M (December 2017). "Management of Suspected Opioid Overdose With Naloxone in Out-of-Hospital Settings: A Systematic Review". Annals of Internal Medicine. 167 (12): 867–875. doi:10.7326/M17-2224. PMID 29181532.
- ^ "Opioid epidemic: 6 key steps that states should take now". American Medical Association. 9 September 2019. Retrieved 14 October 2020.
- ^ Wang H, Naghavi M, Allen C, Barber RM, Bhutta ZA, Carter A, Casey DC, Charlson FJ, Chen AZ, Coates MM, Coggeshall M, Dandona L, Dicker DJ, Erskine HE, Ferrari AJ, Fitzmaurice C, Foreman K, Forouzanfar MH, Fraser MS, Fullman N, Gething PW, Goldberg EM, Graetz N, Haagsma JA, Hay SI, Huynh C, Johnson CO, Kassebaum NJ, Kinfu Y, Kulikoff XR (October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1459–1544. doi:10.1016/s0140-6736(16)31012-1. PMC 5388903. PMID 27733281.
- ^ GBD 2013 Mortality Causes of Death Collaborators, et al. (GBD 2013 Mortality Causes of Death Collaborators) (January 2015). "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013". Lancet. 385 (9963): 117–171. doi:10.1016/S0140-6736(14)61682-2. PMC 4340604. PMID 25530442.
{{cite journal}}:|author1=has generic name (help)CS1 maint: numeric names: authors list (link) - ^ a b "Opioid Overdose Crisis". National Institute on Drug Abuse. 1 June 2017. Retrieved 29 November 2017.
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