Opioid overdose

An opioid overdose is an acute condition due to excessive use of narcotics. It should not be confused with opioid dependency.

Symptoms

Opiate overdose symptoms and signs include: decreased level of consciousness and pinpoint pupil except with meperidine (Demerol) where one sees dilated pupils, known as pinpoint pupils.^[1] Heart rate and breathing slow down, sometimes to a stop. Blue lips and nails are caused by insufficient oxygen in the blood. Other symptoms include seizures and muscle spasms. A person experiencing an opiate overdose usually will not wake up even if their name is called or if they are shaken vigorously.

Treatment

Naloxone is very effective reversing the cause, rather than just the symptoms, of an opioid overdose.^[2] A longer-acting variant is naltrexone. Naltrexone is primarily meant to treat opioid and alcohol dependence. Diprenorphine is similar in action to naloxone, only it is significantly stronger and is reserved for acting as an antagonist to the strongest, non-human opioids, such as carfentanyl (in fact, carfentanyl, and other opioids for usage on large animals such as elephants, often come packaged with Revivon to be used after carfentanyl is no longer needed in the animal).

CDC estimates that US programs for drug users and their caregivers prescribing take-home doses of naloxone and training on its utilization are estimated to have reversed 10,000 opioid overdose deaths.^[3][4] Healthcare institution-based naloxone prescription programs have also helped reduce rates of opioid overdose in the US state of North Carolina, and have been replicated in the US military.^[5][6] Nevertheless, scale-up of healthcare-based opioid overdose interventions is limited by providers’ insufficient knowledge and negative attitudes towards prescribing take-home naloxone to prevent opioid overdose.^[7] Programs training police and fire personnel in opioid overdose response using naloxone have also shown promise in the US.^[8][9]

Co-ingestion

Opioid overdoses associated with a conjunction of benzodiazepines or alcohol use leads to a contraindicated condition wherein higher instances of general negative overdose traits native to the overdose profile of opioid use alone but to a much greater extent.^[10][11] Other CNS depressants, or "downers", muscle relaxers, pain relievers, anti-convulsants, anxiolytics (anti-anxiety drugs), treatment drugs of a psychoactive or epileptic variety or any other such drug with its active function meant to calm or mitigate neuronal signaling (barbiturates, etc) can additionally cause a worsened condition with less likelihood of recovery cumulative to each added drug of a diverse or disparate hampering effect to the central or peripheral nervous system of the user. This includes drugs less immediately classed to a slowing of the metabolism such as with GABAergics like GHB or glutamatergic antagonists like PCP or Ketamine.

References

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