Opioid Intoxication

Evaluation, treatment, and prevention

Franklin J. Danger, MD

Papaver somniferum 

INTRODUCTION

EPIDEMIOLOGY

Takeaway: Overdose can occur at any time with any opioid agonist. A prior overdose is the strongest predictor of a future overdose and of overdose death.

  1. Sedatives, cocaine, or alcohol.

  2. Recent abstinence.

  3. Use of illicit opioids.

  4. Higher prescribed doses.

  5. Pulmonary disease or sleep apnea.

  6. Genetic predisposition 

RISK FACTORS

CLINICAL FEATURES

  • Glucose 
  • Acetaminophen concentration. 
  • Creatine phosphokinase.
  • Serum creatinine and electrolytes
  • Urine toxicologic screens should NOT be routinely obtained.
  • ECG **
  • CXR **

LABS AND STUDIES

NALOXONE DOSING

FURTHER MANAGEMENT

PREVENTION

SOURCES

  1. UpToDate
  2. Management of Opioid Analgesic Overdose. N Engl J Med 2012;367:146-55.
  3. Okie S. A flood of opioids, a rising tide of deaths. N Engl J Med 2010;363:1981
  4. www.ASAM.org
  5. CDC
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