Understanding heroin overdose: A study of the acute respiratory depressant effects of injected pharmaceutical heroin

PLoS ONE

Volumn 10, Issue 10, 2015, Pages

  Jolley, Caroline J ^a   Bell, James ^a,b   Rafferty, Gerrard F ^a   Moxham, John ^a   Strang, John ^a,b  

^a KING'S COLLEGE LONDON   (United Kingdom)

^b KING'S COLLEGE LONDON   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

DIAMORPHINE; METHADONE; MORPHINE; NARCOTIC ANALGESIC AGENT;

ACUTE DRUG ADMINISTRATION; ADULT; ARTICLE; CAPNOMETRY; CLINICAL ARTICLE; DISEASE SEVERITY; DRUG MEGADOSE; DRUG OVERDOSE; ELECTROMYOGRAPHY; END TIDAL CARBON DIOXIDE TENSION; FEMALE; HEROIN DEPENDENCE; HUMAN; HYPOVENTILATION; MALE; OXYGEN TENSION; PULSE OXIMETRY; RESPIRATION DEPRESSION; RESPIRATORY DRIVE; TREATMENT OUTCOME; INTRAMUSCULAR DRUG ADMINISTRATION; MIDDLE AGED; ORAL DRUG ADMINISTRATION; OXIMETRY; PATHOPHYSIOLOGY; PULMONARY DISEASE, CHRONIC OBSTRUCTIVE;

ADMINISTRATION, ORAL; ADULT; ANALGESICS, OPIOID; CAPNOGRAPHY; DRUG OVERDOSE; ELECTROMYOGRAPHY; FEMALE; HEROIN; HEROIN DEPENDENCE; HUMANS; HYPOVENTILATION; INJECTIONS, INTRAMUSCULAR; MALE; METHADONE; MIDDLE AGED; MORPHINE; OXIMETRY; PULMONARY DISEASE, CHRONIC OBSTRUCTIVE;

EID: 84949509623     PISSN: None     EISSN: 19326203     Source Type: Journal    
DOI: 10.1371/journal.pone.0140995     Document Type: Article

References (46)

1. World Health Organisation (WHO). Community management of opioid overdose. Available: http://www.who.int/substance-abuse/publications/management-opioid-overdose/en/. 2014.
2. Deaths Related to Drug Poisoning in England and Wales, 2014. Statistical Bulletin. Office for National Statistics. Available: http://www.ons.gov.uk/ons/dcp171778-414574.pdf. 2015.
3. Cornish R, Macleod J, Strang J, Vickerman P, Hickman M. Risk of death during and after opiate substitution treatment in primary care: prospective observational study in UK General Practice Research Database2010 2010-10-26 23:14:00.
4. Madadi P, Hildebrandt D, Lauwers AE, Koren G. Characteristics of opioid-users whose death was related to opioid-toxicity: a population-based study in Ontario, Canada. PLoS One. 2013; 8(4):e60600. PMID: 23577131. Pubmed Central PMCID: PMC3618438. Epub 2013/04/12. eng. doi: 10.1371/journal. pone.0060600
5. Fugelstad A, Ahlner J, Brandt L, Ceder G, Eksborg S, Rajs J, et al. Use of morphine and 6-monoacetylmorphine in blood for the evaluation of possible risk factors for sudden death in 192 heroin users. Addiction. 2003 Apr; 98(4):463-70. PMID: 12653816. Epub 2003/03/26. eng.
6. Passarino G, Ciccone G, Siragusa R, Tappero P, Mollo F. Histopathological Findings in 851 Autopsies of Drug Addicts, With Toxicologic and Virologic Correlations. The American Journal of Forensic Medicine and Pathology. 2005; 26(2):106-16. PMID: 15894841
7. Strang J, Metrebian N, Lintzeris N, Potts L, Carnwath T, Mayet S, et al. Supervised injectable heroin or injectable methadone versus optimised oral methadone as treatment for chronic heroin addicts in England after persistent failure in orthodox treatment (RIOTT): a randomised trial. Lancet. 2010 May 29; 375(9729):1885-95. PMID: 20511018. Epub 2010/06/01. eng. doi: 10.1016/S0140-6736(10) 60349-2
8. Strang J, Groshkova T, Uchtenhagen A, van den Brink W, Haasen C, Schechter MT, et al. Heroin on trial: systematic review and meta-analysis of randomised trials of diamorphine-prescribing as treatment for refractory heroin addictiondagger. The British journal of psychiatry: the journal of mental science. 2015 Jul; 207(1):5-14. PMID: 26135571.
9. Perneger TV, Giner F, del Rio M, Mino A. Randomised trial of heroin maintenance programme for addicts who fail in conventional drug treatments. BMJ. 1998 Jul 4; 317(7150):13-8. PMID: 9651260. Pubmed Central PMCID: PMC28595. Epub 1998/07/04. eng.
10. van den Brink W, Hendriks VM, Blanken P, Koeter MW, van Zwieten BJ, van Ree JM. Medical prescription of heroin to treatment resistant heroin addicts: two randomised controlled trials. BMJ. 2003 Aug 9; 327(7410):310. PMID: 12907482. Pubmed Central PMCID: PMC169643. Epub 2003/08/09. eng.
11. March JC, Oviedo-Joekes E, Perea-Milla E, Carrasco F. Controlled trial of prescribed heroin in the treatment of opioid addiction. J Subst Abuse Treat. 2006 Sep; 31(2):203-11. PMID: 16919749. Epub 2006/08/22. eng.
12. Haasen C, Verthein U, Degkwitz P, Berger J, Krausz M, Naber D. Heroin-assisted treatment for opioid dependence: randomised controlled trial. The British journal of psychiatry: the journal of mental science. 2007 Jul; 191:55-62. PMID: 17602126. Epub 2007/07/03. eng.
13. Oviedo-Joekes E, Brissette S, Marsh DC, Lauzon P, Guh D, Anis A, et al. Diacetylmorphine versus methadone for the treatment of opioid addiction. N Engl J Med. 2009 Aug 20; 361(8):777-86. PMID: 19692689. Epub 2009/08/21. eng. doi: 10.1056/NEJMoa0810635
14. Reimer J, Verthein U, Karow A, Schafer I, Naber D, Haasen C. Physical and mental health in severe opioid-dependent patients within a randomized controlled maintenance treatment trial. Addiction. 2011 Sep; 106(9):1647-55. PMID: 21489005. Epub 2011/04/15. eng. doi: 10.1111/j.1360-0443.2011.03463.x
15. Jolley CJ, Luo Y-M, Steier J, Reilly C, Seymour J, Lunt A, et al. Neural respiratory drive in healthy subjects and in COPD. Eur Respir J. 2009 February 1, 2009; 33(2):289-97. doi: 10.1183/09031936. 00093408 PMID: 18829678
16. Murphy PB, Kumar A, Reilly C, Jolley C, Walterspacher S, Fedele F, et al. Neural respiratory drive as a physiological biomarker to monitor change during acute exacerbations of COPD. Thorax. 2011 Jul; 66 (7):602-8. PMID: 21597112. Epub 2011/05/21. eng. doi: 10.1136/thx.2010.151332
17. Reilly CC, Ward K, Jolley CJ, Lunt AC, Steier J, Elston C, et al. Neural respiratory drive, pulmonary mechanics and breathlessness in patients with cystic fibrosis. Thorax. 2011 Mar; 66(3):240-6. PMID: 21285244. Epub 2011/02/03. eng. doi: 10.1136/thx.2010.142646
18. Steier J, Jolley CJ, Polkey MI, Moxham J. Nocturnal asthma monitoring by chest wall electromyography. Thorax. 2011 Jul; 66(7):609-14. PMID: 21502097. Epub 2011/04/20. eng. doi: 10.1136/thx.2010.152462
19. Duiverman ML, van Eykern LA, Vennik PW, Koeter GH, Maarsingh EJ, Wijkstra PJ. Reproducibility and responsiveness of a noninvasive EMG technique of the respiratory muscles in COPD patients and in healthy subjects. J Appl Physiol. 2004 May; 96(5):1723-9. PMID: 14660508.
20. Gilbert R, Auchincloss JH Jr, Brodsky J, Boden W. Changes in tidal volume, frequency, and ventilation induced by their measurement. J Appl Physiol. 1972 Aug; 33(2):252-4. PMID: 5054434. Epub 1972/08/01. eng.
21. Tabatabai M, Kitahata LM, Collins JG. Disruption of the rhythmic activity of the medullary inspiratory neurons and phrenic nerve by fentanyl and reversal with nalbuphine. Anesthesiology. 1989 Mar; 70 (3):489-95. PMID: 2923296. Epub 1989/03/01. eng.
22. Weil JV, McCullough RE, Kline JS, Sodal IE. Diminished ventilatory response to hypoxia and hypercapnia after morphine in normal man. N Engl J Med. 1975 May 22; 292(21):1103-6. PMID: 1128555.
23. Teichtahl H, Wang D, Cunnington D, Quinnell T, Tran H, Kronborg I, et al. Ventilatory responses to hypoxia and hypercapnia in stable methadone maintenance treatment patients. CHEST Journal. 2005; 128(3):1339-47.
24. Stoermer R, Drewe J, Dursteler-Mac Farland KM, Hock C, Mueller-Spahn F, Ladewig D, et al. Safety of injectable opioid maintenance treatment for heroin dependence. Biological Psychiatry. 2003; 54 (8):854-61. PMID: 14550686
25. Duersteler-MacFarland KM, Stormer R, Seifritz E, Hug I, Muller-Spahn F, Ladewig D, et al. Opioidassociated effects on oxygen saturation in humans. Addiction. 2000; 95(2):285-7. PMID: 10723857
26. Rook EJ, Beijnen JH, van den Brink W, van Ree JM. Changes in Oxygen Saturation Rate in Opioid-Dependent Patients on Heroin-Assisted Treatment. Basic & Clinical Pharmacology & Toxicology. 2006; 98:00- (online).
27. Conti G, Pierdominici S, Ferro G, Bocci MG, Antonelli M, Proietti R. Effects of low-dose alfentanil administration on central respiratory drive and respiratory pattern in spontaneously breathing ASA 1 patients. Anaesthesia. 2002; 57(6):540-3. PMID: 12010267
28. Pierdominici S, Conti G, Scalise T, Lappa A, Cristaldi A, Pelaia P, et al. Effect of low dose fentanyldroperidol administration on respiratory drive, respiratory pattern and gas exchange in ASA 1 spontaneously breathing patients. Acta Anaesthesiol Belg. 1997; 48(2):85-91. PMID: 9259872. Epub 1997/01/01. eng.
29. Kopka A, Wallace E, Reilly G, Binning A. Observational study of perioperative Ptcco2 and Spo2 in nonventilated patients receiving epidural infusion or patient-controlled analgesia using a single earlobe monitor (TOSCA)†. British Journal of Anaesthesia. 2007 October 1, 2007; 99(4):567-71. PMID: 17656354
30. Dalchow S, Lubeigt O, Peters G, Harvey A, Duggan T, Binning A. Transcutaneous carbon dioxide levels and oxygen saturation following caesarean section performed under spinal anaesthesia with intrathecal opioids. International journal of obstetric anesthesia. 2013; 22(3):217-22. doi: 10.1016/j.ijoa. 2013.04.003 PMID: 23707035
31. Herman NL, Choi KC, Affleck PJ, Calicott R, Brackin R, Singhal A, et al. Analgesia, pruritus, and ventilation exhibit a dose-response relationship in parturients receiving intrathecal fentanyl during labor. Anesth Analg. 1999 Aug; 89(2):378-83. PMID: 10439751. Epub 1999/08/10. eng.
32. Cronin AJ, Aucutt-Walter NM, Budinetz T, Bonafide CP, DiVittore NA, Gordin V, et al. Low-dose remifentanil infusion does not impair natural killer cell function in healthy volunteers. British Journal of Anaesthesia. 2003 December 1, 2003; 91(6):805-9. PMID: 14633749
33. Clemens KE, Klaschik E. Symptomatic Therapy of Dyspnea with Strong Opioids and Its Effect on Ventilation in Palliative Care Patients. Journal of Pain and Symptom Management. 2007/4//; 33(4):473-81. PMID: 17397708
34. Clemens KE, Quednau I, Klaschik E. Is there a higher risk of respiratory depression in opioid-naive palliative care patients during symptomatic therapy of dyspnea with strong opioids? J Palliat Med. 2008 Mar; 11(2):204-16. PMID: 18333735. Epub 2008/03/13. eng. doi: 10.1089/jpm.2007.0131
35. Murphy PB, Kumar A, Reilly C, Jolley C, Walterspacher S, Fedele F, et al. Neural respiratory drive as a physiological biomarker to monitor change during acute exacerbations of COPD. Thorax. 2011 July 1, 2011; 66(7):602-8. doi: 10.1136/thx.2010.151332 PMID: 21597112
36. Reilly CC, Jolley CJ, Elston C, Moxham J, Rafferty GF. Measurement of parasternal intercostal electromyogram during an infective exacerbation in patients with cystic fibrosis. European Respiratory Journal. 2012 October 1, 2012; 40(4):977-81. PMID: 22267769
37. Sinderby C, Beck J, Spahija J, Weinberg J, Grassino A. Voluntary activation of the human diaphragm in health and disease. J Appl Physiol. 1998 Dec; 85(6):2146-58. PMID: 9843538.
38. Sinderby C, Spahija J, Beck J, Kaminski D, Yan S, Comtois N, et al. Diaphragm activation during exercise in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2001 Jun; 163(7):1637-41. PMID: 11401887.
39. Maarsingh EJ, van Eykern LA, de Haan RJ, Griffioen RW, Hoekstra MO, van Aalderen WM. Airflow limitation in asthmatic children assessed with a non-invasive EMG technique. Respir Physiol Neurobiol. 2002 Oct 23; 133(1-2):89-97. PMID: 12385734.
40. Guydish J, Passalacqua E, Tajima B, Chan M, Chun J, Bostrom A. Smoking prevalence in addiction treatment: a review. Nicotine Tob Res. 2011 Jun; 13(6):401-11. PMID: 21464202. Pubmed Central PMCID: PMC3103720. Epub 2011/04/06. eng. doi: 10.1093/ntr/ntr048
41. Palmer F, Jaffray M, Moffat MA, Matheson C, McLernon DJ, Coutts A, et al. Prevalence of common chronic respiratory diseases in drug misusers: a cohort study. Primary Care Respiratory Journal. 2012/12//; 21(4):377-83. doi: 10.4104/pcrj.2012.00069 PMID: 22875144
42. Darke S, Zador D. Fatal heroin 'overdose': a review. Addiction. 1996; 91(12):1765-72. PMID: 8997759
43. MacBean V, Hughes C, Nicol G, Reilly C, Rafferty G. P212 Parasternal Intercostal Electromyography To Assess Neural Respiratory Drive In Healthy Adult Subjects. Thorax. 2014 December 1, 2014; 69 (Suppl 2):A170.
44. Hall W, Darke S. Trends in opiate overdose deaths in Australia 1979-1995. Drug and Alcohol Dependence. 1998/9/1/; 52(1):71-7. PMID: 9788009
45. Warner-Smith M, Darke S, Lynskey M, Hall W. Heroin overdose: causes and consequences. Addiction. 2001; 96(8):1113-25. PMID: 11487418
46. Jolley CJ, Luo YM, Steier J, Rafferty GF, Polkey MI, Moxham J. Neural respiratory drive and breathlessness in chronic obstructive pulmonary disease. Eur Respir J. 2015; 45(2):355-64. Epub 2014 Oct 16. doi: 10.1183/09031936.00063014 PMID: 25323229