Opioid-related overdose deaths have doubled since 2000 amid a
worsening epidemic of addiction to both prescription painkillers
like oxycodone and illegal drugs like heroin, researchers note in
the American Journal of Respiratory and Critical Care Medicine.
Alongside this worsening trend, opioid overdose admissions requiring
treatment in hospital intensive care units (ICUs) surged 34 percent
from 2009 to 2015, the study found. During this same period, the
death rate for these ICU patients climbed from 7.3 percent to 9.8
“There are growing numbers of people who are so sick from their
opioid overdose that they need ICU-level care, and despite
everything we can do in the ICU more patients are dying in the ICU
with complications from their overdose than ever before,” said lead
study author Dr. Jennifer Stevens of Harvard Medical School and Beth
Israel Deaconess Medical Center in Boston.
“So when we think of overdoses, we need not to just think about
whether people died or survived, but also about the tremendous
personal and societal costs of the serious medical problems that can
come from overdoses for people who didn’t die, or didn’t die
immediately,” Stevens said by email.
She and her colleagues examined data on more than 4.1 million
patients admitted to ICUs in 162 hospitals in 44 states, including
21,705 with opioid overdoses, usually from heroin.
During the seven-year study period, the cost of caring for ICU
patients who had opioid overdoses increased from $58,517 to $92,408
in 2015 dollars.
Among the opioid overdose patients, 25 percent experienced
aspiration pneumonia, bacterial infections that happen when food,
saliva or vomit is breathed into the lungs instead of remaining in
the digestive tract.
The second most common complication was rhabdomyolysis, or the
release of dead muscle fiber into the bloodstream, which occurred
with 15 percent of the overdose patients in the ICU.
Eight percent of the patients had brain injuries and 6 percent had
septic shock, a life-threatening response to infections that can
cause serious organ damage.
One in ten people treated in the ICU after overdoses needed
mechanical ventilation machines to help them breathe.
[to top of second column]
The study wasn’t designed to explain why more overdoses are being
treated in ICUs. It’s possible that heightened awareness about
overdoses is helping more people survive long enough to be admitted
to the hospital. It’s also possible that people are having worse
overdoses today than they did in the past, the researchers note.
Most likely, both possibilities are behind the surge in overdose
patients in the ICU, said Dr. Marc LaRochelle, a researcher at
Boston Medical Center’s Grayken Center for Addiction Medicine who
wasn’t involved in the study.
“It likely reflects some contributions from at least two factors:
one is increasing potency of opioid supply with a spike in illicit
fentanyl in recent years,” LaRochelle said by email, referring to a
fast-acting, highly potent prescription opioid that’s become a
common recreational drug.
“A second would be more widespread overdose education and naloxone
distribution programs,” LaRochelle added. Naloxone can block the
effect of opioids and rapidly reverse the effects of an overdose.
“People who use injection drugs should obtain naloxone, the overdose
reversal drug, and use drugs with partners who can help them,” said
Brendan Saloner, a researcher at the Johns Hopkins Bloomberg School
of Public Health in Baltimore who wasn’t involved in the study.
In many states, family members can get naloxone, sometimes without a
prescription, Saloner said by email. Two medications, buprenorphine
and methadone, can also help reduce drug use.
“There is unfortunately a lot of stigma about medication treatments,
but they are safe and work,” Saloner added. “Long-term change is
possible and recovery is a realistic goal, but it requires time and
SOURCE: http://bit.ly/2x5aeUU American Journal of Respiratory and
Critical Care Medicine, online August 11, 2017.
[© 2017 Thomson Reuters. All rights
Copyright 2017 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.