Impact of the Opioid Epidemic

Crit Care Clin. 2020 Oct;36(4):753-769. doi: 10.1016/j.ccc.2020.07.006.

Abstract

In recent years the prescription opioid overdose epidemic has decreased, but has been more than offset by increases in overdose caused by fentanyl and fentanyl analogues. Opioid overdose patients should receive naloxone if they have significant respiratory depression and/or loss of protective airway reflexes. Patients who receive naloxone should be observed for recurrent opioid effects. Patients with opioid overdose may be admitted to the intensive care unit for naloxone infusions, treatment of noncardiogenic pulmonary edema, autonomic instability, or sequelae of hypoxia-ischemia or cardiac arrest. Primary and secondary prevention are important to reduce the number of people with life-threatening opioid overdose.

Keywords: Cardiac arrest; Critical care; Naloxone; Opioid analgesics; Opioid use disorder; Overdose; Respiratory arrest; Resuscitation.

Publication types

  • Review

MeSH terms

  • Analgesics, Opioid* / therapeutic use
  • Drug Overdose*
  • Fentanyl / therapeutic use
  • Humans
  • Naloxone / therapeutic use
  • Opioid Epidemic*

Substances

  • Analgesics, Opioid
  • Naloxone
  • Fentanyl