What is the morbidity associated with opioid toxicity?

Updated: Jul 19, 2021
  • Author: Everett Stephens, MD; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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The predominant cause of morbidity and mortality from pure opioid overdoses is respiratory compromise. Less commonly, acute lung injury, status epilepticus, and cardiotoxicity occur in the overdose setting. Case reports of increased incidence of mortality have been documented in patients with coexistent stenosing lesions of the upper airway. [25]

Morbidities due to co-ingestants must be considered in polypharmacy overdoses, and they vary depending on the co-ingestant. A Canadian study found that the risk for fatal opioid toxicity was almost twofold higher in patients taking an opioid and more than 2500 mg of gabapentin daily; like opioids, gabapentin can also suppress respiration. [26] In some US states, gabapentin has been reclassified as a Schedule V controlled substance. [27]

Intent of the overdose also plays a role. The addition of suicidal intent is linked to increased emergency department usage, [28]  and such intent could suggest higher dosages of narcotics or co-ingestants

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