Publication Title: 
Drug and Alcohol Dependence
Publication Date: 
Tuesday, June 13, 2017

This study describes patient characteristics, clinical features, and EMS response to opioid overdoses in Seattle, comparing heroin and pharmaceutical opioid (PO) overdoses from six alternating months in 2011 (February, April, June, August, October, December).

The study identifies 229 definite or probable opioid overdose cases over the six months: heroin in 98 (43%) cases (10 also involved PO), PO without heroin in 85 (37%) cases, and 46 (20%) that could not be categorized and were excluded from analyses. Heroin overdose patients were younger than PO (median age 33 v 41 (p < 0.05)), more often male (80% v 61% (p = < 0.01)), intubated less (8% v 22%, p < 0.01) and more likely to be administered naloxone (72% v 51%, p < 0.01). No significant differences were found between heroin and PO overdoses for initial respiratory rate, Glasgow Coma Scale score, or co-ingestants, but heroin users were more likely to have miotic pupils (p < 0.01).

The authors conclude that while cases were clinically similar, heroin users were more likely to receive naloxone and pharmaceutical opioid cases were much more likely to be intubated. They suggest that standardized case definitions and data documentation could aid opioid overdose surveillance as well as provide data for measuring the impact of professional and lay interventions.