heroin and Respiratory-Aspiration-of-Gastric-Contents

The primary objective of this study was to investigate whether the fatalities of opioid abuse are not only related to respiratory depression but also as a result of other side effects such as emesis, delayed gastric emptying, a reduction of the cough reflex, and impaired consciousness leading to the aspiration of gastric contents, a finding regularly observed in drug-related deaths.. A retrospective exploratory study analyzing heroin/morphine/methadone-related deaths submitted to court-ordered autopsy.. Center for Forensic Medicine, Medical University of Vienna, Austria (2010-2015).. Two hundred thirty-four autopsy cases were included in the study: morphine (n = 200), heroin (n = 11), and methadone (n = 23) intoxication.. There are lower opioid concentrations in deceased with signs of aspiration, a fact which strongly points to aspiration as alternative cause of death in opioid-related fatalities. Furthermore, this study highlights the common abuse of slow-release oral morphine in Vienna and discusses alternative medications in substitution programs (buprenorphine/naloxone or tamper-resistant slow-release oral morphine preparations), as they might reduce intravenous abuse and opioid-related deaths.

Topics: Adolescent; Adult; Aged; Analgesics, Opioid; Austria; Autopsy; Cause of Death; Female; Forensic Toxicology; Heroin; Humans; Male; Methadone; Middle Aged; Morphine; Respiratory Aspiration of Gastric Contents; Retrospective Studies; Substance-Related Disorders; Young Adult