Opioid Overdose May Cause Out-Of-Hospital Cardiac Arrests

Opioid overdose is a significant cause of death from out-of-hospital cardiac arrests among adults of age 25 to 64, as per a scientific statement from the American Heart Association, published in the Association's flagship journal Circulation.

Around 2 million people In the U.S., are affected by opioid use disorder annually, costing more than $78 billion in health care expenses. Adults between the ages of 25 to 55 accounted for approximately 128 deaths per day in 2018 for the opioid epidemic and, more than 15% of the opioid overdose emergency medical service cases in 2016 including cardiac arrest.

‘Opioid overdose is a significant cause of death from out-of-hospital cardiac arrests, especially among adults of age 25 to 64. Thus, educating everyone regarding opioid overdose and opioid-associated out-of-hospital cardiac arrest plays a critical component in the fight against it.’

The risk of opioid overdose is increased when frequently mixing it with alcohol or other toxic substances.

"This evidence-based review is valuable to help improve prevention and treatment of opioid-associated out-of-hospital cardiac arrest, which primarily affects people in the prime of adult life. And, there are important scientific elements to be aware of since this type of cardiac arrest is fundamentally different from adult out-of-hospital sudden cardiac arrests, which have been more often studied", says Cameron Dezfulian, M.D., FAHA, lead author and vice-chair of the scientific statement writing group.

Opioid-Associated Cardiac Arrest

The opioid-associated cardiac arrest differs from other cardiac arrests in the way the body functions are affected thereby guiding treatment options.

Opioid-associated cardiac arrest, hypoxia (oxygen deficiency) occur before the heart stops and implicate brain injury without the oxygen. This allows for further research that helps in understanding and appropriately treating these opioid-associated cardiac arrests and their complications.

The first emergency treatment for opioid overdose is Naloxone, that rapidly and effectively reverses the respiratory depression or hypoventilation caused by opioids. Along with this, traditional CPR including airway and rescue breathing support can also be effective.

Yet people who experience opioid-associated out-of-hospital cardiac arrest are more likely to be alone at home or in a private setting -- away from someone who would witness the early signs of cardiac arrest and act.

However, many who become the victim of overdose are found alone at home or in a private setting away from someone. Also, evidence of underreporting is present due to the stigma associated with opioid poisoning and the potential for criminal charges to others in possession of opioids.

Treatment in Opioid Overdose

As opioids tend to remain in the body for several days, predicting the outcomes is critical. Thus delaying decisions about the cessation of life-saving efforts till the medications have cleared from the patient's system, i.e., at least 72 hours after the return of spontaneous circulation and normothermia (normal body temperature) is recommended.

Educating everyone regarding opioid overdose and opioid-associated out-of-hospital cardiac arrest plays a critical component in the fight against it.

"Optimizing outcomes after cardiac arrest associated with opioid overdose requires recognition of distress by another person -- the lay public or emergency dispatchers, prompt emergency response, and treatment with naloxone or CPR ventilation coupled with compressions". "Targeted educational campaigns providing opioid use disorder education and prevention information, naloxone distribution and conventional CPR training, including rescue breathing, to those likely to have or witness an opioid overdose could help prevent and improve treatment of opioid-associated out-of-hospital cardiac arrest. Along with broader public education, legal reforms and policies aimed at preventing opioid-associated cardiac arrest can save lives and should include resources for medication treatment in order to improve recovery for a generally young otherwise healthy segment of our population", says Dezfulian.

Source: Medindia