Jornal de Toxicologia Clínica
Acesso livre

Abstrato

Patterns of Presentation and Treatment of Opiate Overdoses at the Urban-Suburban Divide

Elizabeth Peacock, Tim Moran, Maxwell Wheaton, Kareem Daouk, L Hlavaty, Robert Dunne

Objectives: Heroin, prescription opiate and opioid overdoses have increased over the last decade in the United States. The potency of these drugs available in the communities has also increased. Our Emergency Department (ED) is in a high-volume urban hospital in Detroit, Michigan-Ascension St. John (St. John). This ED treats Acute Opioid and Opiate Overdoses (AOO) daily, often with ventilator support and administration of the antagonist, naloxone.

Methods: We performed a retrospective chart review to assess the demographic characteristics of patients with AOO in our ED from 2012 to 2018, and assessed variation and changes in naloxone dosing, treatment and disposition of patients. Charts were identified through pharmacy records of adult patients receiving naloxone in the critical care area of the ED. We excluded charts with diagnosis codes that did not relate to opiate, opioid or heroin toxicity, poisoning or drug abuse.

Results: We included 722 visits of 657 patients. AOO patients were more likely to be Caucasian (58.7%) and male (60.7%) than those presenting to the ED at large. Naloxone dosing was higher for males than females and was negatively correlated with age.

Conclusions: In congruence with national trends, AOO presentations and deaths increased over the last six years, despite increased naloxone administration, and naloxone being more available to pre-hospital personnel and laypeople.