Clinical Scenario

An ambulance arrives at the emergency department with a 35 year old male known heroin abuser who has overdosed. The patient dies despite naloxone administration and full attempts to resuscitate him. You treated him for a non fatal overdose 8 months ago and wonder if this could have been a factor in predicting fatal overdose on this occasion.

Comment:

There are a number of variables that are related to fatal and nonfatal overdose. Each study focused on different factors and those with significantly high odds ratios have been included in the results and therefore in the clinical bottom line. No two studies directly backed each other up. It would be useful to follow up the patients to determine if they suffered from further overdoses and if these were fatal.

Clinical Bottom Line:

The evidence suggests that the three main factors contributing to overdose are; injecting heroin, chronic misuse of alcohol, and having been arrested more than three times.

Click here for NSW Health Drug & Alcohol Facts Sheets:

• http://www.health.nsw.gov.au/factsheets/drugandalcohol/index.asp

Click below to open journal articles:

• Drug abuse & alterned mental state
• Ethanol Abuse and withdrawal
• Herbal Hallucinations

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