Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- miosis
- bradypnoea
- altered mental status
- dramatic response to naloxone
Other diagnostic factors
- fresh needle marks
- drug paraphernalia nearby
- decreased GI motility
- old track marks on arms and legs
- pulmonary rales
- frothy pink sputum
- seizures
- dysrhythmias
Risk factors
- opioid abuse and dependence
- recent abstinence in chronic users
- chronic pain
Diagnostic investigations
Investigations to consider
- chest x-ray
- abdominal x-ray
- abdominal CT scan
- opioid urine screen
- gas chromatography/mass spectrometry
Treatment algorithm
Contributors
Authors VIEW ALL
Consultant Physician and Clinical Toxicologist
National Poisons Information Service (Newcastle)
Newcastle-upon-Tyne
UK
Disclosures
RT declares that he has no competing interests.
Dr Ruben Thanacoody would like to gratefully acknowledge Dr Dean Olsen, a previous contributor to this monograph. DO declares that he has no competing interests.
Peer reviewers VIEW ALL
Staff
Gynecologic Oncologist
Northwest Cancer Specialists
Rose Quarter Cancer Center
Portland
OR
Disclosures
WW declares that he has no competing interests.
Director
Joseph Epstein Centre for Emergency Medicine Research
Western Health Sunshine Hospital
St Albans
Australia
Disclosures
AMK has received grant funding for research into intranasal delivery of naloxone in heroin overdose.
Assistant Professor
Johns Hopkins University
Baltimore
MD
Disclosures
AS declares that he has no competing interests.
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