heroin and Critical-Illness

Clinical judgement of intoxicated patients is difficult. In the emergency department of the inner city of Oslo this is done every day.. During a one-year period from 1998-99, a group of 429 first-time admitted intoxicated patients were included in a study. The patients and the method of observation are described.. 75% of the patients were men; 45% reported to have consumed alcohol only, while 10% had taken a heroin overdose. The rest had used various combinations of legal and illegal drugs. Female patients were younger than male patients (29 versus 36 years, p < 0.00), and patients intoxicated only on alcohol were on the average older than patients who had taken drugs (38 versus 31 years, p < 0.00). 57 patients were hospitalized, seven of them had serious intracerebral conditions.. Our study indicates that systematic observation over some hours, repeated clinical examinations, and the systematic use of a modified Glasgow Coma Scale makes it possible to sort out the seriously ill from "only" intoxicated patients.

Topics: Adult; Alcoholic Intoxication; Critical Illness; Diagnosis, Differential; Drug Overdose; Emergency Service, Hospital; Female; Glasgow Coma Scale; Heroin; Heroin Dependence; Humans; Male; Monitoring, Physiologic; Norway; Poisoning; Substance-Related Disorders; Wounds and Injuries