Poisoning and drug overdose: Difference between revisions
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Opiate use and misuse appear to be driving the increase in poisoning deaths. Alcohol and other drug abuse are also important public health issues with enormous impacts on many types of injury and violence. | Opiate use and misuse appear to be driving the increase in poisoning deaths. Alcohol and other drug abuse are also important public health issues with enormous impacts on many types of injury and violence. | ||
==Causes of Unintentional Opiate-related Poisoning Deaths== | |||
===Legitimate medical treatment with opiates=== | |||
Pain is very common. About 24% of U. S. adults reported moderate to extreme pain in the past month.7 In 2005, about 19% of the 50 million United States adults who used Express Scripts, a large commercial pharmacy benefit program, received a prescription for opiates.8 | |||
Chronic opiate use is linked to the development of tolerance to its analgesic or pain relieving effect.9 Tolerance is defined as a decrease in a drug’s effect over time so that larger doses are required to achieve the same effect. Chronic opiate use also may be associated with hyperalgesia, an increase in abnormal pain sensitivity.9 In an attempt to maintain pain relief, the combination of tolerance and hyperalgesia may lead to rampant dose escalation.9 | |||
Respiratory depression, a decrease in the rate or depth of a patient’s breathing, is one of the side effects or risks of opiate use. Opiate poisoning deaths are often due to respiratory failure from respiratory depression. As with pain relief, tolerance to respiratory depression develops with chronic opiate use. However, research suggests that tolerance to respiratory depression is incomplete and may develop more slowly than tolerance to the pain relieving effect.10 | |||
Other risk factors for unintentional opiate-related poisoning include: | |||
* Concurrent use of other central nervous system depressants like benzodiazepines and sedative-hypnotics. | |||
* The existence of other medical conditions associated with compromised respiratory function such as chronic obstructive pulmonary disease, congestive heart failure, and sleep apnea. | |||
===Misuse of Prescription Opiates=== | |||
In addition to legitimately prescribed opiates, prescription opiates can be obtained in various other ways: | |||
* From a friend or relative with a prescription. | |||
* Obtained from emergency rooms through fraudulent drug-seeking means. | |||
* Purchased on the street or from the Internet. | |||
* Stolen from pharmacies. | |||
{{Symptoms and signs}} | {{Symptoms and signs}} | ||
Revision as of 22:01, 11 January 2009
| Poisoning and drug overdose |
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The damaging physiologic effects of ingestion, inhalation, or other exposure to a broad range of chemicals, including pesticides, heavy metals, gases/vapors, drugs, and a variety of common household substances, such as bleach and ammonia. Included are accidental overdoses of drugs, a wrong drug given or taken in error, and a drug taken inadvertently.
Opiate use and misuse appear to be driving the increase in poisoning deaths. Alcohol and other drug abuse are also important public health issues with enormous impacts on many types of injury and violence.
Legitimate medical treatment with opiates
Pain is very common. About 24% of U. S. adults reported moderate to extreme pain in the past month.7 In 2005, about 19% of the 50 million United States adults who used Express Scripts, a large commercial pharmacy benefit program, received a prescription for opiates.8
Chronic opiate use is linked to the development of tolerance to its analgesic or pain relieving effect.9 Tolerance is defined as a decrease in a drug’s effect over time so that larger doses are required to achieve the same effect. Chronic opiate use also may be associated with hyperalgesia, an increase in abnormal pain sensitivity.9 In an attempt to maintain pain relief, the combination of tolerance and hyperalgesia may lead to rampant dose escalation.9
Respiratory depression, a decrease in the rate or depth of a patient’s breathing, is one of the side effects or risks of opiate use. Opiate poisoning deaths are often due to respiratory failure from respiratory depression. As with pain relief, tolerance to respiratory depression develops with chronic opiate use. However, research suggests that tolerance to respiratory depression is incomplete and may develop more slowly than tolerance to the pain relieving effect.10
Other risk factors for unintentional opiate-related poisoning include:
- Concurrent use of other central nervous system depressants like benzodiazepines and sedative-hypnotics.
- The existence of other medical conditions associated with compromised respiratory function such as chronic obstructive pulmonary disease, congestive heart failure, and sleep apnea.
Misuse of Prescription Opiates
In addition to legitimately prescribed opiates, prescription opiates can be obtained in various other ways:
- From a friend or relative with a prescription.
- Obtained from emergency rooms through fraudulent drug-seeking means.
- Purchased on the street or from the Internet.
- Stolen from pharmacies.
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