Opioid overdoses: Emerging clinical challenges

Abstract

Objective: Analysis of a large consecutive case series of cases brought to an Emergency Department (ED).

Design: Retrospective chart review.

Setting: Emergency Department in Broward County, Florida.

Patients: Medical records of patients with registered diagnoses of opioid overdose in 2016 and 2017.

Outcomes: Demographics, toxicology results, mental-health comorbidities, use/response to naloxone, and hospital disposition.

Results: Seven hundred and seventy nine opioid-overdose cases were identified (35 percent female, 65 percent male; age 36.2). Her-oin intoxication was registered in 77 percent of discharge diagnoses, and 17.7 percent were prescription pain medications. Urine sam-ples were collected in 39 percent and 81.5 percent of patients received naloxone (mean dose 4.0 mg ± 2.2). Sixty-five percent of cases were discharged home, 17.5 percent left the ED against medical advice, and 17.5 percent were admitted to the hospital/intensive care unit/behavioral unit.

Conclusion: There is an alarming number of visits to the ED due to opioid overdoses with differences in age and gender. Clinicians are facing diagnostic, treatment and follow-up challenges for the management of these cases.