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Prehospital Treatment of Patients with IV Heroin Overdose: What Are We Treating?

Published online by Cambridge University Press:  28 June 2012

Carsten Boe Pedersen ,
Anni Steentoft ,
Karen Worm ,
Michael Sprehn ,
Torben Mogensen  and
Mogens Bredgaard Sørensen
Carsten Boe Pedersen*
Affiliation:
The Mobile Intensive Care Unit of Copenhagen, Denmark
Anni Steentoft
Affiliation:
Institute of Forensic Chemistry; University of Copenhagen, Denmark
Karen Worm
Affiliation:
Institute of Forensic Chemistry; University of Copenhagen, Denmark
Michael Sprehn
Affiliation:
The Mobile Intensive Care Unit of Copenhagen, Denmark
Torben Mogensen
Affiliation:
The Mobile Intensive Care Unit of Copenhagen, Denmark
Mogens Bredgaard Sørensen
Affiliation:
The Mobile Intensive Care Unit of Copenhagen, Denmark
*
The Mobile Intensive Care Unit of Copenhagen, Østerfarigmagsgade 5, Villa 1, 1399 Copenhagen K., Denmark
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Abstract

Objective:

To measure blood levels of morphine and additional drugs in patients suspected of intravenous (IV) heroin abuse and to evaluate the effects of antidote treatment.

Design:

Prehospital blood sampling in 52 patients.

Results:

Forty-five patients were blood-positive for heroin, eight of whom were hospitalized. Forty-one patients also had abused additional drugs: minor tranquilizers, ethanol, amphetamine, cocaine, and/or carbamazepine. Seven patients had taken either only methadone or ketobemidione: one was admitted. Treatment with increasing doses of naloxone indicated a necessity for hospitalization. Six of 14 patients treated with naloxone (1.8 mg were hospitalized. Seven patients had an extremely high blood level of morphine (0.2 mg/kg), that could be reverted with naloxone in moderate doses.

Conclusion:

This study indicates that under prehospital conditions, it is difficult to identify a patient intoxicated only with intravenous heroin. Nearly all patients treated were cases of multiple drug/alcohol overdoses. Even the symptoms associated with extremely high blood levels of morphine could be reversed with naloxone in moderate doses.

Keywords

abuseantidoteamphetaminecarbamazepinecocainedrug abuseethanolflumazenileheroinketobemidionemethadonemorphinenaloxonenarcoticsoverdoseprehospital
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 12 , Issue 2 , June 1997 , pp. 92 - 95
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1997

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