Opioid Induced delirium in Substance Use Disorder

Opioid-induced delirium comes on when one has taken too many opioids, causing an alteration in mental status.


Often times when we are seeing stroke patients they may come in with an overdose of opioids that causes stroke or mental status changes. This is often mistaken as a stroke. Many of our patients who need Narcan are actually given in this case.


The loss of consciousness is secondary to mu-opioidW receptors causing respiratory depression which can cause anoxia.





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Delerium


It is also characterized by disorientation. A state of loss of consciousness is termed as delirium. Several drugs are responsible for delirium. Delirium affects elders, most often. The prevalence rate of delirium is highest among elders. From hundreds of drugs that cause delirium, opioids are among the topmost drugs. A high dose of opioids can be a precipitating factor of delirium. Other factors include anticholinergic drugs, co-morbid conditions, and elderly patients. If an opioid dose is escalated in patients with severe pain, the paatient experiences this problem. (Lawlor et al., 2000) For the treatment of this opioid induces delirium various treatments are recommended. (Gagnon et al., 1999) (Ian maddocks, 1996)


The major purpose of management is the recognition and reversal, if possible, of all the uneven metabolic processes, the reduction of adjuvant painkillers, and hydration. However, these steps are not a complete treatment for the reversal of the patient to a normal state. There is a need to do some more arrangements for the complete reversal of the patient to routine life and to maintain his/her cognitive behavior.


Sedation



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Sedation is one of the presenting signs of patients treated with opioids.

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