Repeat Drug Overdoses Raise Risk For Hospitalization, Ventilator Care

An opioid overdose is a situation that occurs when a person using an opioid drug or medication takes too much of the substance in question and experiences a serious slowdown or complete halt of certain critical body functions. Some people die from such an overdose, while others survive after receiving treatment. In a study scheduled for publication in April 2014 in the journal Mayo Clinic Proceedings, researchers from Harvard-affiliated Massachusetts General Hospital looked at the potential health outcomes for people who experience repeated opioid overdoses. These researchers also examined the factors that make repeated opioid overdoses more likely to occur.

What Are Opioids?

n addition to producing a pleasurable sensation called euphoria and diminishing the ability to feel physical pain, opioid drugs and medications slow down the baseline rate of activity inside both the brain and the spinal cord (known collectively as the central nervous system). If a legitimate opioid user or opioid abuser or addict keeps his or her intake within certain limits, he or she will experience only fairly modest changes in the function of these organs, which together produce and coordinate the nerve impulses required to keep the heart beating and the lungs inhaling and exhaling. However, if he or she takes too much of the opioid in question, central nervous system activity will fall below a critical point and the required nerve impulses will not be maintained. This dangerous and potentially lethal nerve signal disruption marks the onset of an opioid overdose. People who die from such an overdose typically experience an unsustainable decrease in their normal lung function.

The United Nations Office on Drugs and Crime lists a number of common contributing factors to an opioid overdose. These factors include widespread access to both legal and illicit/illegal opioid substances, the use of opioids in combination with other mind-altering substances, limited access to treatment options for people addicted to opioid substances and an increased susceptibility to the effects of opioids in people who relapse back into drug/medication abuse after a period of full or partial abstinence. All individuals who abuse opioids run the risk of experiencing a fatal or non-fatal overdose, whether or not they have an addiction to opioid use.

Repeated Overdose Consequences

In the study scheduled for publication in Mayo Clinic Proceedings, the Massachusetts General Hospital researchers used information gathered from close to 20,000 adult opioid users to assess the health consequences of experiencing more than one non-fatal opioid overdose. All of these individuals had survived at least one overdose event involving a legal or illegal opioid; 1,400 of them had survived two to five such events. Although they represented only 7 percent of the study participants, the survivors of multiple events represented roughly 15 percent of the total number of overdoses among the participants. After comparing the single overdose survivors to the multiple overdose survivors, the researchers concluded that the multiple overdose survivors are significantly more likely to require hospitalization to deal with the effects of their condition. Once hospitalized, they are also significantly more likely to require breathing assistance from a ventilator to stay alive.

Repeated Overdose Factors

The researchers concluded that several factors contribute to the likelihood that a person will experience more than one opioid overdose. These factors include having relatively few financial resources, having public health insurance rather than private health insurance, having a diagnosable case of substance addiction, having a diagnosable mental illness, having an illness that affects normal nervous system function and having a chronic lung illness. The single demographic category most likely to experience multiple opioid overdoses is middle-aged white men.

The authors of the study scheduled for publication in Mayo Clinic Proceedings note that first-time cases of opioid overdose also frequently result in hospitalization. People undergoing additional overdoses merely have a higher chance of being hospitalized. First-time victims of opioid overdoses also sometimes require the use of a mechanical ventilator. Again, victims of multiple overdoses merely have greater odds of needing this extreme medical measure. The study’s authors believe that their findings point toward a need to improve local, state and nationwide efforts to lower the opioid overdose rate. They also point toward a need for improved understanding of the factors that contribute to overdose in people using prescribed opioid painkilling medications.

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