Whether accidentally or intentionally, drug overdose is a perennial concern in the healthcare industry, costing the U.S. government around $500 billion in treatment and preventive measures in 2017 alone.
It is quite alarming that the data released by the Centers for Disease Control and Prevention‘s National Center for Health Statistics showed about 100,306 drug overdose deaths in the U.S. for 12 months ending in April 2021. Moreover, there was a notable increase of 28.5% from the same period in 2020 with 78,056 deaths.
For the same period, the estimated number of opioid overdose deaths increased to 75,673 from 56,064 for the same period of the previous year. Overdose deaths from synthetic opioids, psychostimulants, cocaine, and natural and semi-synthetic opioids also increased for the same 12-month period ending in April 2021.
The CDC notes that the manufactured opioid fentanyl is 50 times more potent than heroin and 100 times more than morphine. These statistics reveal that there are underlying concerns as to how drug overdose created an outbreak so widespread that it requires intervention at the most basic level–the responsible dispensing of medications by pharmacists and pharmacy technicians.
As the health care practitioners responsible for drug dispensing and patient education, pharmacists and pharmacy technicians should be at the forefront of drug overdose management efforts.
What’s In The Article?
Drug Overdose
The Difference Between Intentional And Accidental Drug Overdose
Signs and Symptoms of Drug Overdose
Risk Factor of Drug Overdose
First Aid For Drug Overdose
Treatment For Drug Overdose
The Role of Pharmacy Personnel in Drug Overdose Management
Final Thoughts
Drug Overdose
Most commonly referred to as OD, drug overdose can happen accidentally or intentionally. It is a condition that occurs when one takes more than the medically recommended dose of a prescription or over-the-counter medication. However, some people are more sensitive to certain drugs, so the high end of the therapeutic range of a medicine can be toxic for them.
The Difference Between Intentional And Accidental Drug Overdose
Accidental overdose may happen in young children or adults with impaired mental abilities ingesting a table or capsule within their grasp. The elderly are also likely to take the wrong medication mistakenly.
Intentional overdose, on the other hand, may happen if an individual intentionally ingests large doses of the drug to “get high” or harm oneself.
Signs and Symptoms of Drug Overdose
In an overdose, the effects of the drug can be an intensified level of therapeutic effects seen with regular use, and side effects are more pronounced. Large overdoses may cause minimal results, but smaller overdoses may be fatal, especially to a young child. For some, the effects may worsen due to a chronic illness.
Every individual reacts differently to drugs:
Increased, decreased, or entirely absent vital signs are noted—temperature, blood pressure, pulse rate, respiratory rate—and may be
life-threatening.
Sleepiness and confusion are common and dangerous, specifically if an individual breathes vomit into the lungs. Some people may fall into a coma.
Heart or lung damage may cause chest pains and shortness of breath.
The skin may be sweaty and cool or dry and hot.
Abdominal pain, diarrhea, nausea, and vomiting are highly likely. Blood in vomit or bowel movements could be fatal.
Damage to body organs (some drugs cause specific damages).
Some people may experience dizziness, loss of coordination, and loss of balance.
Paleness and fingernails turning blue might be observed.
Paranoia, hallucinations, and extreme agitation are highly likely.
Some individuals may experience seizures.
Risk Factors of Drug Overdose
Individuals at risk of accidental overdose are:
Very young children
Elderly
People with different kinds of medications
People with mental illness
Those who are likely to overdose to harm themselves include (Cunha, 2021):
People aged between 45 to 54 years are likely to abuse opioids
People between the age of 25 to 34 years are likely to abuse heroin
Low-income earners
People with mental illness
Patients who “doctor-shop.”
Drug users who use injectables
People with a history of drug or substance addiction
People who use multiple drugs
People mixing drugs with alcohol
First Aid For Drug Overdose
When someone is already showing signs of an overdose:
Stay calm and call an ambulance.
While waiting for the ambulance, if the person fell unconscious but breathing, position the body on their side, which is the recovery
position. Check for choking hazards. Make sure their airway is open by tilting the person’s head back while lifting their chin.
Do not give them anything to drink or eat.
Do not induce them to vomit.
Secure any pill container to bring to the hospital.
Monitor their breathing and condition until help arrives.
Treatment For Drug Overdose
The treatment will depend on the following:
Kind of drug/s taken
Dosage
How the drug was taken/administered
When the drug was taken/administered
What other substance was taken with
The medical condition of the patient
For suspected drug overdose, the hospital team will:
Make full assessment – blood tests, psychological review, physical observation
Remove the drug from the body (activated charcoal, which binds the drug to prevent absorption by the body).
Give antidote, whenever possible, such as naloxone hydrochloride, for opioid overdose.
Suggest confinement for further observation and treatment.
The Role of Pharmacy Personnel in Drug Overdose Management
Pharmacy personnel plays a significant role in drug overdose management. Pharmacists and pharmacy technicians are equipped with extensive training related to the therapeutic use of pharmaceuticals.
Pharmacy professionals continuously evaluate medication use appropriateness, monitor for potentially risky uncoordinated care, and check for drug interactions. With more than 89% population within five miles of a pharmacy, you are among the community’s most readily accessible healthcare professionals.
The opioid crisis has been a perennial for years, and in 2018 alone, retail pharmacies dispensed about 169 million opioid prescriptions. Pharmacies continue to be a significant source of diverted opioids.
As a pharmacy staff, you are basically the final healthcare professional patients get in contact with before using prescription medications. You are in an excellent position to screen for diversion, monitor for potentially illicit use of prescription opioids and other drugs, and educate patients about drug-related risks.
Reviewing drug prescriptions for appropriateness is the ultimate legal and clinical responsibility of a pharmacist and pharmacy technician. You, at a minimum, are legally required to ensure that controlled substance prescriptions have a legitimate medical purpose and are not diverted. This involves carefully screening for potentially altered prescription forms.
Pharmacists and pharmacy technicians must be vigilant for possible refills at multiple pharmacies or prescriptions from several prescribers.
Final Thoughts
Deaths from drug overdose have continuously increased over the years. The U.S. healthcare system’s response has been wide-ranging, which includes expanded funding for research, intensive educational programs, and changes in health policy concerning the treatment of substance use disorders. Despite their aggressive efforts, there are still resources that have yet to tap.
Pharmacists and pharmacy technicians are ideally positioned for an important role in probing for signs of a drug overdose, contributing to programs designed to reduce harm with drug use, and assisting with treating patients diagnosed with a drug overdose.
The current state of drug overdose needs a more comprehensive and well-coordinated response. Considering new ideas like these should help put pharmacists and pharmacy technicians in an ideal position to help improve the overall care and management of drug overdose.
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