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dc.contributor.authorBaldacchino, Alexander Mario
dc.contributor.authorTolomeo, Serenella
dc.contributor.authorKhan, Faisel
dc.contributor.authorHumphris, Gerald Michael
dc.contributor.authorCarra, Giuseppe
dc.identifier.citationBaldacchino , 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 .en
dc.identifier.otherPURE: 241581311
dc.identifier.otherPURE UUID: 98b07247-8971-4258-936b-9cd18f14d7cf
dc.identifier.otherScopus: 84981299201
dc.identifier.otherWOS: 000386191100004
dc.description.abstractBackground: 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.
dc.relation.ispartofHeroin Addiction and Related Clinical Problemsen
dc.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
dc.subjectFatal opioid overdoseen
dc.subjectAcute risk factoren
dc.subjectRC0321 Neuroscience. Biological psychiatry. Neuropsychiatryen
dc.titleAcute risk factors in fatal opioid overdoses as a result of hypoxia and cardiotoxicity. A systematic review and critical appraisalen
dc.typeJournal itemen
dc.description.versionPublisher PDFen
dc.contributor.institutionUniversity of St Andrews. School of Medicineen
dc.contributor.institutionUniversity of St Andrews. St Andrews Sustainability Instituteen
dc.contributor.institutionUniversity of St Andrews. WHO Collaborating Centre for International Child & Adolescent Health Policyen
dc.contributor.institutionUniversity of St Andrews. Health Psychologyen
dc.description.statusPeer revieweden

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