Opioid Overdose Case Study: Impact of Heroin Use and Naloxone

1 Case Study- Nursing Student’s Name Institutional Affiliation Course Name & Number Instructor’s Name Date

2 Question One 18-year-old Peter injected heroin intravenously, leading to rapid absorption into his bloodstream. He experienced slowed breathing and mental confusion - clear signs of opioid toxicity and overdose. For Peter, heroin's rapid absorption into the bloodstream meant potentially life-threatening effects could ensue without swift intervention (Tsekouras & Panos Macheras, 2023). Recognizing Peter's pinpoint pupils and shallow respirations, the paramedics administered 400 micrograms of naloxone intramuscularly. This rapidly reversed the life-threatening respiratory depression induced by the toxic heroin overdose by displacing the heroin molecules from the μ-opioid receptors concentrated in the brainstem regions responsible for control of breathing and respiratory drive. Naloxone has a high binding affinity for these same receptors, and by occupying them, it was able to restore Peter's breathing and respiration to a normal rate and depth within minutes (Strang, 2021). However, ongoing monitoring was still required as short-acting naloxone would soon be metabolized and excreted, allowing re-emergence of toxicity as active morphine metabolites persisted (Galbraith et al., 2022). Question 2 Illicit substance misuse poses a sizable public health burden in Australia. The 2019 National Drug Strategy Household Survey illuminated that 12.6% of Australians 14 years old or above, highlighting 2.5 million individuals, had utilized illegal drugs in the prior year. Precisely, 1.1 million people, or 5.8%, had engaged in non-medical opioid use. Opioids constitute the most frequently injected medication - approximately 100,000 persons nationally, or 11% of recent injectors, had shot up heroin (Australian Institute of Health and Welfare, 2020). These statistics

3 underscore and bring into focus the considerable extent of the opioid and injection drug utilization quandary in the country. Heroin, in particular, has a high potential for dependence and abuse. The rate of dependence has been estimated at around 23% for those exposed to heroin. Regular use leads to tolerance, requiring higher doses to achieve the same euphoric effect (Rook et al., 2020). Attempts to cease use are hindered by a heroin withdrawal syndrome consisting of muscle and bone pain, sleep problems, diarrhea, vomiting, cold flashes with goose bumps, and cravings (Australian Institute of Health and Welfare, 2020). In Peter's case, his admission that a friend obtained the heroin suggests he is at high risk of further use and dependence. The potency and illegality of heroin also increase the risks of overdose and death. In 2018, 591 opioid-induced deaths were recorded in Australia, with pharmaceutical opioids now causing more deaths annually than heroin (Miech et al., 2021). However, heroin still accounted for 27% of opioid deaths that year, highlighting its dangers. Peter's case exemplifies the dangers of experimenting with opioids like heroin. While initial use may seem recreational, dependence can develop rapidly. Obtaining heroin from illegal sources also incurs risks of unknown purity and contamination (Rook et al., 2020; Miech et al., 2021). Peter is fortunate that the paramedics arrived promptly with naloxone to reverse his overdose. However, he still faces long-term substance abuse repercussions. Prevention of recurrence and high-risk behavior requires early intervention and drug rehabilitation referral (Australian Institute of Health and Welfare, 2023).

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help

4 Question 3 Australian Institute of Health and Welfare. (2020). National Drug Strategy Household Survey 2019 . Australian Institute of Health and Welfare; Australian Institute of Health and Welfare. https://www.aihw.gov.au/reports/illicit-use-of-drugs/national-drug-strategy- household-survey-2019/contents/summary I cited alarming statistics from the 2019 National Drug Strategy Household Survey on the misuse of pharmaceutical opioids in Australia to highlight the scope and prevalence of substance abuse nationally. This supports my point that 18-year-old Peter's recreational heroin use reflects a much broader societal issue affecting Australians across demographics. The data from this survey further informs my nursing care plan for Peter by emphasizing the critical need for comprehensive education, routine monitoring, and early psychosocial intervention to prevent vulnerable young people like Peter from progressing to regular heroin injection and subsequent opioid addiction. Miech, R. A., Johnston, L. D., O’Malley, P. M., Bachman, J. G., Schulenberg, J. E., & Patrick, M. E. (2021, June 1). Monitoring the Future National Survey Results on Drug Use, 1975- 2020. Volume I, Secondary School Students . ERIC. https://eric.ed.gov/? id=ED615087#:~:text=Monitoring%20the%20Future%20(MTF)%20is This large-scale longitudinal study analyzed multi-decade trends in licit and illicit drug use initiation patterns among American adolescents. Reviewing the youth substance use trajectories over time provides perspective on the typical developmental phases of experimentation and psychosocial risk factors underpinning initial drug use in adolescence. For Peter's case, this assists my comprehension of his initiation of heroin

5 use at age 18 in relation to normative data showing peaks in onset of illegal drug use between ages 18-20 years old. Understanding these age-related trends informs my nursing approach by elucidating the need for preventive interventions targeting youth nearing this high-risk period for first substance use. Strang, J. (2021). Take-Home Naloxone and the Prevention of Deaths from Heroin Overdose: Pursuing Strong Science, Fuller Understanding, Greater Impact. European Addiction Research , 1–15. https://doi.org/10.1159/000519939 Strang's comprehensive review provided an in-depth analysis of current evidence on take- home naloxone programs for preventing heroin overdose deaths. The literature examined elucidates naloxone's pharmacodynamics as a high-affinity, non-selective opioid antagonist that rapidly displaces heroin and metabolites from opioid receptors, reversing Peter's respiratory depression and CNS symptoms like pinpoint pupils and hypoventilation. This analysis reinforces my understanding of naloxone's mechanism of action in opioid intoxication and the strong scientific rationale supporting distribution and education initiatives on its use for at-risk opioid users and their loved ones. Overall, Strang's review assists my comprehension of why naloxone was the appropriate choice for treating Peter's heroin overdose.

6 References Australian Institute of Health and Welfare. (2020). National Drug Strategy Household Survey 2019 . Australian Institute of Health and Welfare; Australian Institute of Health and Welfare. https://www.aihw.gov.au/reports/illicit-use-of-drugs/national-drug-strategy- household-survey-2019/contents/summary Australian Institute of Health and Welfare. (2023). Illicit drug use. Australian Institute of Health and Welfare. https://www.aihw.gov.au/reports/illicit-use-of-drugs/illicit-drug-use Bryant, B. J., Knights, K. M., Darroch, S., & Rowland, A. (2019). Pharmacology for health professionals (5th ed.). Elsevier. Galbraith, A., Bullock, S., Manias, E., Hunt, B. D., & Richards, A. (2022). Fundamentals of pharmacology : an applied approach for nursing and health. Routledge. Miech, R. A., Johnston, L. D., O’Malley, P. M., Bachman, J. G., Schulenberg, J. E., & Patrick, M. E. (2021, June 1). Monitoring the Future National Survey Results on Drug Use, 1975- 2020. Volume I, Secondary School Students . ERIC. https://eric.ed.gov/? id=ED615087#:~:text=Monitoring%20the%20Future%20(MTF)%20is Rook, E. J., Huitema, A. D. R., Brink, W. v d, Ree, J. M. v, & Beijnen, J. H. (2020). Pharmacokinetics and Pharmacokinetic Variability of Heroin and its Metabolites: Review of the Literature. Current Clinical Pharmacology, 1(1), 109–118. https://www.eurekaselect.com/article/115 Strang, J. (2021). Take-Home Naloxone and the Prevention of Deaths from Heroin Overdose: Pursuing Strong Science, Fuller Understanding, Greater Impact. European Addiction Research , 1–15. https://doi.org/10.1159/000519939

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help

7 Tsekouras, A. A., & Panos Macheras. (2023). Re-examining Naloxone Pharmacokinetics After Intranasal and Intramuscular Administration Using the Finite Absorption Time Concept. European Journal of Drug Metabolism and Pharmacokinetics, 48(4), 455–462. https://doi.org/10.1007/s13318-023-00831-x

Case Study-Nursingedited (1).edited

Related Documents