title: Is admission after intravenous heroin overdose necessary?
abstract: OBJECTIVE
  To investigate the time of onset and incidence of complications in patients presenting to the emergency department with an IV heroin overdose and the need for routine admission of such patients.
  
  
  METHODS
  A retrospective chart review of hospital and emergency medical service records of 124 patient visits involving IV heroin overdose over a five-month period. We also reviewed the death certificates of 115 persons having succumbed to a narcotic overdose over a 44-month period and compared these with our hospital records.
  
  
  METHODS
  Urban county hospital.
  
  
  METHODS
  Patients presenting to the ED with an IV heroin overdose.
  
  
  RESULTS
  There were five deaths in the ED, 12 hospital admissions, and 107 patients who were discharged home. Neither delayed onset of pulmonary edema nor recurrence of respiratory depression was observed. Of the 115 persons having succumbed to a narcotic overdose, eight had been seen previously at our hospital for a heroin overdose. There is no evidence that any of these eight deaths would have been prevented by a 24-hour hospital observation period.
  
  
  CONCLUSIONS
  Complications arising from an IV overdose of heroin are usually evident on arrival in the ED or shortly thereafter. On retrospective review we have found no evidence that admission to the hospital and 24 hours of observation are of benefit to patients who are awake, alert, and lacking evidence of pulmonary complications after an IV heroin overdose.
authors.affiliation: Division of Emergency Medicine, Texas A&M University College of Medicine, College Station, Texas.
authors.forename: D A
authors.initials: DA
authors.lastname: Smith
authors.forename: L
authors.initials: L
authors.lastname: Leake
authors.forename: J R
authors.initials: JR
authors.lastname: Loflin
authors.forename: D M
authors.initials: DM
authors.lastname: Yealy
mesh_terms: D000328:Adult; D062787:Drug Overdose; D005260:Female; D003932:Heroin / Q000506:poisoning*; D006801:Humans; D002534:Hypoxia, Brain / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D012189:Retrospective Studies; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000401:mortality
chemical_list: D003932:Heroin