title: Emergency management of inadvertent accelerated opiate withdrawal in dependent opiate users.
abstract: Six opiate-dependent drug users presented to the local emergency department within a 10-day period with symptoms of severe opioid withdrawal immediately following intravenous use of recently acquired street 'heroin'. The withdrawal picture was similar to that described in patients undergoing rapid opioid detoxification, suggesting that the substance injected was contaminated with an opiate antagonist. A number of potential compounds are discussed, including naltrexone and buprenorphine, and recommendations for the medical management of severe opiate withdrawal within an emergency setting are outlined. [Lubman DI, Koutsogiannis Z, Kronborg I. Emergency management of inadvertent accelerated opiate withdrawal in dependent opiate users.
authors.affiliation: Substance Use Research and Recovery Focussed (SURRF) Program, ORYGEN Research Centre, University of Melbourne, Victoria, Australia. dan.lubman@mh.org.au
authors.forename: Dan
authors.initials: D
authors.lastname: Lubman
authors.forename: Zeff
authors.initials: Z
authors.lastname: Koutsogiannis
authors.forename: Ian
authors.initials: I
authors.lastname: Kronborg
mesh_terms: D000328:Adult; D002047:Buprenorphine / Q000627:therapeutic use*; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008658:Inactivation, Metabolic; D008297:Male; D009271:Naltrexone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D009294:Narcotics / Q000009:adverse effects*; D009293:Opioid-Related Disorders / Q000534:rehabilitation*; D012720:Severity of Illness Index; D015819:Substance Abuse, Intravenous / Q000534:rehabilitation*; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy* / Q000209:etiology*
chemical_list: D009292:Narcotic Antagonists; D009294:Narcotics; D002047:Buprenorphine; D009271:Naltrexone