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Acute risk factors in fatal opioid overdoses as a result of hypoxia and cardiotoxicity. A systematic review and critical appraisal

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Baldacchino_2016_Acute_HARCP_33.pdf (283.6Kb)
Date
08/2016
Author
Baldacchino, Alexander Mario
Tolomeo, Serenella
Khan, Faisel
Humphris, Gerald Michael
Carra, Giuseppe
Keywords
Fatal opioid overdose
Hypoxia
Cardiotoxicity
Acute risk factor
RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
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Abstract
Background: The rates of fatal opioid overdoses (FOO) have increased rapidly over the last 10 years. The actual phenomenon occurs as a result of a toxic opioid effect on the cardiorespiratory system. Aims: The systematic review aimed to identify the acute risk factors in fatal opioid overdose (FOO) as a result of hypoxia and cardiotoxicity. Methods: A systematic review was undertaken. The selection of papers has utilised rigorous criteria of inclusion/exclusion, controlled for heterogeneity. Results: A total of thirteen articles met the inclusion criteria. Ten of the thirteen studies included were retrospective and the other three studies employed different designs namely longitudinal cohort, case control and case cohort. Factors that were modestly described with increased acute risk of FOO due to hypoxia and cardiotoxicity include multiple sedative use (opioids and alcohol), reduced tolerance and presence of an acute painful condition. Conclusion: This systematic review has highlighted the lack of information on acute risk factors of FOO due to hypoxia and cardiotoxicity. Future studies need to explore possible mechanisms underlying cardiotoxicity such as reported changes in arterial stiffness in opioid dependent populations and the unexplored potential effects on endothelial function.
Citation
Baldacchino , A M , Tolomeo , S , Khan , F , Humphris , G M & Carra , G 2016 , ' Acute risk factors in fatal opioid overdoses as a result of hypoxia and cardiotoxicity. A systematic review and critical appraisal ' , Heroin Addiction and Related Clinical Problems , vol. 18 , no. 4 , pp. 33-42 .
Publication
Heroin Addiction and Related Clinical Problems
Status
Peer reviewed
ISSN
1592-1638
Type
Journal item
Rights
© 2016, Publisher / the Author(s). This work is made available online in accordance with the publisher’s policies. This is the final published version of the work, which was originally published at heroinaddictionrelatedclinicalproblems.org/
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  • University of St Andrews Research
URI
http://hdl.handle.net/10023/9504

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