By M.D. Peter G. Bourne
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Extra resources for Acute Drug Abuse Emergencies. A Treatment Manual
Sample text
F r e q u e n t l y , however, it m a y n o t be suspected and m a y be first diagnosed w h e n t h e lung fields fail t o clear following clinical resolution of p u l m o n a r y e d e m a . If p n e u m o n i t i s is present or strongly suspected, t h e use of antibiotics a n d steroids should be considered. F, Overdose from a Combination of Drugs: History and Laboratory Tests Further M e t h a d o n e poisoning is c o m m o n l y associated w i t h c o n c u r r e n t alco hol a n d / o r b a r b i t u r a t e a d m i n i s t r a t i o n .
T h e a t t e m p t should always be m a d e , however, t o hospitalize t o observe t h e p a t i e n t for: (a) t h e possibility of t h e presence of a long-acting n a r c o t i c ; (b) t h e d e v e l o p m e n t of p n e u m o n i a or o t h e r p u l m o n a r y or cardiovascular c o m p l i c a t i o n s ; (c) t h e presence of undiag nosed c o n d i t i o n s masked by t h e chronic opiate use. Finally, unless t h e p a t i e n t is hospitalized, t h e chance of having sufficient c o n t a c t t o get him i n t o a definitive long-term t r e a t m e n t a r r a n g e m e n t is minimal and t h u s t h e chance of repeating t h e overdose episode greatly heightened.
There is c u r r e n t evidence t h a t m e t h a d o n e diversion has been limited b y these a p p r o a c h e s b u t m e t h a d o n e is still available, particularly in certain geographical areas. IL E l e m e n t s of t h e Medical History Generally, t h e victim of m e t h a d o n e poisoning is either (a) a hard core heroin addict w h o has o b t a i n e d m e t h a d o n e illicitly and used it instead of heroin t o o b t a i n e u p h o r i c effects; (b) a drug e x p e r i m e n t e r w h o will take any drug or m i x t u r e w h e t h e r or n o t h e k n o w s w h a t it is or d o e s , and w h o might never have t a k e n a n a r c o t i c drug before; or (c) a n o n d r u g user, child or a d u l t , w h o i n a d v e r t e n t l y swallows a m e t h a d o n e p r e p a r a t i o n belonging t o a p a t i e n t in t r e a t m e n t .