Pulmonary Complications of Narcotic Abuse

Saba, George P.; James, A. Everette; Johnson, Burton A.; Stitik, Frederick P.; Burns, Barry

doi:10.2214/ajr.122.4.733

Cited by 10 publications

(2 citation statements)

References 12 publications

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“…While respiratory depression is the primary mechanism of death in opioid overdoses [4], previous studies frequently identified opioid concentrations generally considered to be non-lethal in a non-tolerant population, providing a strong indication of a different cause of death [5,6]. Clinical expertise suggests that asphyxiation through aspiration is a considerable factor in drug-related deaths, as aspiration of gastric contents is a common complication of drug use [7][8][9][10][11][12][13][14][15]. Previous studies have found aspiration rates between 8.5 and 66% in deceased drug users [16,17].…”

Section: Introductionmentioning

confidence: 99%

Aspiration in lethal drug abuse—a consequence of opioid intoxication

et al. 2020

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Aims The primary objective of this study was to investigate whether the fatalities of opioid abuse are not only related to respiratory depression but also as a result of other side effects such as emesis, delayed gastric emptying, a reduction of the cough reflex, and impaired consciousness leading to the aspiration of gastric contents, a finding regularly observed in drug-related deaths. Design A retrospective exploratory study analyzing heroin/morphine/methadone-related deaths submitted to court-ordered autopsy. Setting Center for Forensic Medicine, Medical University of Vienna, Austria (2010–2015). Participants Two hundred thirty-four autopsy cases were included in the study: morphine (n = 200), heroin (n = 11), and methadone (n = 23) intoxication. Findings Analyses revealed that 41.88% of all deceased showed aspiration of gastric contents with equal gender distribution (p = 0.59). Aspiration was more frequent in younger deceased (χ2 = 8.7936; p = 0.012) and in deceased with higher body mass index (BMI) (χ2 = 6.2441; p = 0.044). Blood opioid concentration was lower in deceased with signs of aspiration than in non-aspirators (p = 0.013). Toxicological evaluation revealed a high degree of concomitant substance abuse (91%)—benzodiazepines (61.6%) and/or alcohol (21.8%). Conclusions There are lower opioid concentrations in deceased with signs of aspiration, a fact which strongly points to aspiration as alternative cause of death in opioid-related fatalities. Furthermore, this study highlights the common abuse of slow-release oral morphine in Vienna and discusses alternative medications in substitution programs (buprenorphine/naloxone or tamper-resistant slow-release oral morphine preparations), as they might reduce intravenous abuse and opioid-related deaths.

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Section: Introductionmentioning

confidence: 99%

Aspiration in lethal drug abuse—a consequence of opioid intoxication

et al. 2020

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“…With appropriate therapy, the clinical findings in OIPE improve during the initial 12 to 24 hours; however, the roentgenographic findings may lag significantly behind the clinical exam. [7][8][9] In addition to the hazards of opiate intoxication and the development of ~IPE discussed above, there should be great concern regarding the use of paregoric in neonates and young infants because of its marked depressant effects on ventilation. ]4 Such effects may lead to apnea, especially in infants with a history of prematurity, apnea, or &dquo;near miss&dquo; Sudden Infant Death Syndrome, whose immature respiratory control center may be more susceptible to the effects of narcotics.…”

Section: Discussionmentioning

confidence: 99%

Paregoric Intoxication with Pulmonary Edema in Infancy

Rice

1984

Clin Pediatr (Phila)

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This report describes a 3-week-old infant with paregoric intoxication and pulmonary edema. The pulmonary edema associated with opiod use is treatable even though the precise mechanism of its formation remains undefined. The report emphasizes that the medical rationale involved in the use of paregoric is unclear. The use of this preparation in pediatric patients should be abandoned in view of such serious complications.

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Roentgenographic Aspects of Narcotic Addiction

Stern¹

1976

JAMA

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Pulmonary Complications of Narcotic Abuse

Cited by 10 publications

References 12 publications

Aspiration in lethal drug abuse—a consequence of opioid intoxication

Aspiration in lethal drug abuse—a consequence of opioid intoxication

Paregoric Intoxication with Pulmonary Edema in Infancy

Roentgenographic Aspects of Narcotic Addiction

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