An opioid overdose is toxic because of excessive opioids. Examples of opioids include morphine, heroin, fentanyl, tramadol, and methadone. Symptoms include insufficient breath, small pupil, and unconsciousness. The onset of symptoms depends in part on the opioid of the route taken. Among those who initially survived, complications may include rhabdomyolysis, pulmonary edema, compartment syndrome, and permanent brain damage.
Risk factors for opioid overdose include opioid dependence, opioid injections, high dose opioids, mental disorders, and joint use with alcohol or benzodiazepines. The risk is very high after detoxification. Dependence on prescribed opioids may occur from their use to treat chronic pain. Diagnosis is generally based on symptoms.
Early treatments include supporting people's breathing and providing oxygen. Nalokson is recommended in those who are not breathing. Giving naloxone to the nose or as a shot to the muscle seems just as effective. Among those who refuse to go to the hospital after the reversal, the risk of poor outcomes in the short run seems low. Efforts to prevent death from overdosage include increasing access to naloxone and treatment for opioid dependence.
Disruption of opioid use resulted in 122,000 global deaths by 2015, up from 18,000 deaths in 1990. In the United States more than 33,000 deaths occur from opioids by 2015, 20,100 of prescription opioids and 13,000 of heroin. Opioid deaths represent more than 60% of all drug-related overdoses in the United States. The opioid epidemic is believed to be partly due to guarantees in the 1990s by the pharmaceutical industry that prescription opioids are safe.
Video Opioid overdose
Signs and symptoms
Because of its effect on the part of the brain that regulates breathing, Opioids can cause people to not breathe (respiratory depression) during an overdose and therefore result in death. Symptoms and signs of opiate overdose can be referred to as "opioid overdose triad": decreased level of consciousness, pinpoint pupils and respiratory depression. Other symptoms include seizures and muscle spasms. Sometimes a person who has an opiate overdose can cause a decreased level of consciousness so that he will not even wake up to be called or shaken by others.
Prolonged hypoxia from respiratory depression can also cause damage that damages the brain and spinal cord and can cause people unable to walk or function normally, even if treatment with naloxone is given.
Alcohol also causes respiratory depression and therefore when taken with opioids may increase the risk of respiratory depression and death.
Maps Opioid overdose
Cause
Risk factors for opioid overdose include opioid dependence, opioid injections, high doses of opioids, and use with alcohol or benzodiazepines. The risk is very high after detoxification. Dependence on prescribed opioids may occur from their use to treat chronic pain.
Ko-consumption
Opioid overdose associated with benzodiazepine conjuncture and/or alcohol use leads to contraindicated conditions. Other CNS depressants, or "downers", muscle inhibitors, painkillers, anti-convulsants, anxiolytics, various psychoactive medications or epilepsy or other such drugs with their active function intended to calm or assuage neuronal. signaling (barbiturates, etc.) may also cause deteriorating conditions with less chance of cumulative recovery for each drug added. These include drugs that are less immediately classified into slowing metabolism as with GABAergics such as GHB or glutamatergic antagonists such as PCP or ketamine.
Mechanism
Permanent brain damage can occur due to cerebral hypoxia or opioid-induced neurotoxicity.
Prevention
Although opioid overdose is responsible for the leading cause of unintentional death, it can be prevented in the primary care setting. Clear protocols for staff in emergency departments and urgent care centers may reduce opioid prescriptions for individuals present in this setting who are engaged in drug seeking behavior or who have a history of substance abuse. Providers should routinely screen patients using tools such as CAGE-AID and Drug Abuse Screening Tests (DAST-10) to screen adults and CRAFFT to screen 14-18 year olds. Other "drug-seeking" behavior and physical indications of drug use should be used as a guide for formal screening.
Individuals diagnosed with opioid dependence should be prescribed naloxone to prevent overdose and/or should be directed to one of the many options of available interventions/treatments, such as needle exchange programs and care centers. Short motivational interviews can also be performed by the doctor during patient visits and have been shown to improve the motivation of patients to change their behavior. Despite these opportunities, the spread of prevention interventions in the US has been hampered by the lack of coordination and sluggish response of the federal government.
The prescribing monitoring program enables doctors to view the individual history of prescribed opioids and other controlled substances to prevent risky behaviors, such as physician spending and drug diversion. These programs operate in 49 states and the District of Columbia, and have generally been found to reduce prescription opioid administration.
Regulative policies, such as Florida's milling law pills, have also been found to reduce prescription and opioid use, both of which are correlated with opioid overdose. The law of the Florida pills factory is directed to pill factories, or pain management clinics where prescribed medicines are prescribed inappropriately and excluded, and require these clinics to register to the state, have a doctor-owner, examination, and establishing prescribing and spending requirements for physicians at this clinic.
Treatment
Death may be prevented in opioid overdose individuals if they receive basic life support and naloxone is administered immediately after an overdose occurs. Naloxone effectively reverses the cause, not just the symptoms, an opioid overdose. A longer-lasting naloxone variant is naltrexone. Naltrexone is primarily used to treat opioid and alcohol dependence.
Programs to provide their drug users and caregivers with naloxone are highly recommended. In the United States, by 2014, more than 25,000 overdoses have been reversed. The healthcare-based naloxson prescription program has also helped reduce opioid overdose levels in the state of North Carolina, USA, and has been replicated in the US military. However, increased interventions of health-based opioid overdose are limited by the provider's inadequate knowledge and negative attitudes toward naloxone administration brought home to prevent overdose of opioids. Police training programs and firefighters in an opioid overdose response using naloxone are also promising.
Epidemiology
See also
- Hazard reduction
- List of deaths from drug overdose and intoxication
- Use of responsible drugs
References
External links
- WHO Community Management on Opioid Overdose, 2014
Source of the article : Wikipedia
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