This is
actually an interim update because my last PubMed pull came up dry. We have
papers from New Mexico, Serbia, and Italy, as well as a case report, addressing
sociodemographics, depression, naltrexone, methadone, buprenorphine, and heart
failure.
Shah NG,
Lathrop SL, Flores JE, Landen MG.
Drug
Alcohol Depend. 2012 Apr 16.
Comment: An analysis of New Mexico overdose deaths (many of us have been
waiting with bated breath for a deeper analysis of deaths there). Authors found
that living in a border region was associated with less overdose death,
particularly from heroin or methadone; among their hypotheses is that this is a
paradoxical benefit of reduced access to medical care and opioid
prescriptions.
Jovanović
T, Lazarević D, Nikolić G.
Vojnosanit
Pregl. 2012 Apr;69(4):326-32. Serbian.
Comment: Does anyone read Serbian? I'd love to see some additional comment on
this intriguing paper. The issues around depot naltrexone versus agonist
maintenance are becoming a real issue. The concerns around overdose death in
the setting of naltrexone have not been adequately addressed. This paper
appears to compare depression scales for patients on those two therapies, but I
can't tell from the abstract exactly what the populations are or what the
analysis showed.
D'Amore A,
Romano F, Biancolillo V, Lauro G, Armenante C, Pizzirusso A, Del Tufo S,
Ruoppolo C, Auriemma F, Cassese F, Oliva P, Amato P.
Clin Drug
Investig. 2012 May 4.
Comment: A dosing scale that includes non-fatal overdose as a marker for
adjusting buprenorphine dosage. Again, I can't access the article to get
details! I'd love comments from anyone who can.
Liu SS,
Kovell LC, Horne A Jr, Chang D, Petronis JD, Zakaria S.
J
Intensive Care Med. 2012 Apr 29.
Comment: This patient overdosed on opioids and wasn't breathing. After no
response to naloxone she was intubated and eventually recovered. It appears
that the right ventricle of her heart stopped working for a while due to
hypoxia. This should serve as a reminder that medical intervention is often
needed in overdose, particularly if the overdose isn't addressed quickly.
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