20.04 Toxicity to Opioids

A number of causes can underlie the toxicity to opioid.  The causes include accidental clinical overdosage, accidental overdosage in addicts, and suicide attempts.

Opioid poisoning is easily recognise by the triad (combination) of coma, pinpoint pupils, and depressed respiration.  Treatment of poisoning is always treating the subject first, and then treating the poison.  Thus, the initial treatment is artificial ventilation to overcome the depressed respiration.

Then the poison opioid is treated with naloxone, a non-selective opioid antagonist.  In subjects who are physically dependent, naloxone can precipitate the opioid withdrawal syndrome.  To prevent, this there is the slow administration of low dose of naloxone, with constant monitoring of respiration.