drug overdose


Summary: Accidental or deliberate use of a medication or street drug in excess of normal dosage.

Top Publications

  1. Bekhterev V, Gavrilova S, Koshkareva E, Shipanov I. [The determination of pyrovaleron in the urine by gas chromatography in the combination with the method of extractive chilling-out and centrifugation]. Sud Med Ekspert. 2017;60:27-31 pubmed publisher
    ..30 ???. ?????? ??????????? ?-pvp ? ???? - 1 ???/??. ?????????? ???????????????? ???????????? ?? ???? ? ?????????? ????????? 9-??????? ????????. ..
  2. Garg R, Fulton Kehoe D, Franklin G. Patterns of Opioid Use and Risk of Opioid Overdose Death Among Medicaid Patients. Med Care. 2017;55:661-668 pubmed publisher
    ..6; 95% CI, 1.6-19.3). Our findings support Federal guideline-recommended dosing thresholds in opioid prescribing. Concurrent sedative-hypnotic use even at low opioid doses poses substantially greater risk of opioid overdose. ..
  3. Bennett A, Golub A, Elliott L. A behavioral typology of opioid overdose risk behaviors among recent veterans in New York City. PLoS ONE. 2017;12:e0179054 pubmed publisher
  4. Kajbaf F, Lalau J. The prognostic value of blood pH and lactate and metformin concentrations in severe metformin-associated lactic acidosis. BMC Pharmacol Toxicol. 2013;14:22 pubmed publisher
    ..Strikingly, most patients survived - despite a mean pH that is incompatible with a favorable outcome under other circumstances. ..
  5. Corwin D, Topjian A, Banwell B, Osterhoudt K. Adverse events associated with a large dose of intravenous lipid emulsion for suspected local anesthetic toxicity. Clin Toxicol (Phila). 2017;55:603-607 pubmed publisher
    ..S. Food and Drug Administration for nutritional supplementation. Careful monitoring of total doses administered across institutions and hospital wards during transfers is paramount to avoid inadvertent overdose of antidotes. ..
  6. Volkow N, Frieden T, Hyde P, Cha S. Medication-assisted therapies--tackling the opioid-overdose epidemic. N Engl J Med. 2014;370:2063-6 pubmed publisher
  7. Helmerhorst G, Teunis T, Janssen S, Ring D. An epidemic of the use, misuse and overdose of opioids and deaths due to overdose, in the United States and Canada: is Europe next?. Bone Joint J. 2017;99-B:856-864 pubmed publisher
    ..Evidence is mounting that the best pain relief is obtained through resilience. Opioids are often prescribed when treatments to increase resilience would be more effective. Cite this article: Bone Joint J 2017;99-B:856-64. ..
  8. Henry S. Evaluating the Risks of Opioid Use for Chronic Pain: Moving Beyond Overdose. J Gen Intern Med. 2016;31:453-4 pubmed publisher
  9. O Donnell J, Gladden R, Seth P. Trends in Deaths Involving Heroin and Synthetic Opioids Excluding Methadone, and Law Enforcement Drug Product Reports, by Census Region - United States, 2006-2015. MMWR Morb Mortal Wkly Rep. 2017;66:897-903 pubmed publisher
    Opioid overdose deaths quadrupled from 8,050 in 1999 to 33,091 in 2015 and accounted for 63% of drug overdose deaths in the United States in 2015. During 2010-2015, heroin overdose deaths quadrupled from 3,036 to 12,989 (1)...

More Information


  1. Kuehn B. Methadone overdose deaths rise with increased prescribing for pain. JAMA. 2012;308:749-50 pubmed publisher
  2. Laurence A, Wight J, Forrest A. Fatal theophylline poisoning with rhabdomyolysis. Anaesthesia. 1992;47:82 pubmed
  3. Davis M, Vogel L. Local anesthetic safety in pediatric patients. N Y State Dent J. 1996;62:32-5 pubmed
    ..Safe dosage levels, technique recommendations and early clinical signs of possible overdose are presented here. ..
  4. Compton W, Jones C, Baldwin G. Relationship between Nonmedical Prescription-Opioid Use and Heroin Use. N Engl J Med. 2016;374:154-63 pubmed publisher
  5. Chou R, Turner J, Devine E, Hansen R, Sullivan S, Blazina I, et al. The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health Pathways to Prevention Workshop. Ann Intern Med. 2015;162:276-86 pubmed publisher
    ..Evidence is insufficient to determine the effectiveness of long-term opioid therapy for improving chronic pain and function. Evidence supports a dose-dependent risk for serious harms. Agency for Healthcare Research and Quality. ..
  6. Protti A, Fortunato F, Monti M, Vecchio S, Gatti S, Comi G, et al. Metformin overdose, but not lactic acidosis per se, inhibits oxygen consumption in pigs. Crit Care. 2012;16:R75 pubmed publisher
    ..001). Metformin intoxication induces lactic acidosis, inhibits global oxygen consumption and causes mitochondrial dysfunction in liver and other tissues. Lactic acidosis per se does not decrease whole-body respiration. ..
  7. Wu P, Juurlink D. Clinical Review: Loperamide Toxicity. Ann Emerg Med. 2017;70:245-252 pubmed publisher
    ..In patients who survive loperamide toxicity, consideration should be given to the treatment of an underlying opioid use disorder, if present. ..
  8. Khan M, Islam S, Kundi A. Parasuicide in Pakistan: experience at a university hospital. Acta Psychiatr Scand. 1996;93:264-7 pubmed
    ..In Pakistani culture, marriage appears to be a significant source of stress for women. Reports based on official police records do not reflect the true picture of the problem in Pakistan. ..
  9. Mercado Crespo M, Sumner S, Spelke M, Sugerman D, Stanley C. Notes from the field: increase in fentanyl-related overdose deaths - Rhode Island, November 2013-March 2014. MMWR Morb Mortal Wkly Rep. 2014;63:531 pubmed
    During November 2013-March 2014, twice as many all-intent drug overdose deaths were reported in Rhode Island as were reported during the same period in previous years...
  10. Hamdi E, Amin Y, Mattar T. Clinical correlates of intent in attempted suicide. Acta Psychiatr Scand. 1991;83:406-11 pubmed
    ..The SIS can distinguish between relatively homogeneous subgroups of suicide attempters for depth studies of aetiology and management. ..
  11. Stone D, Holland K, Bartholow B, E Logan J, LiKamWa McIntosh W, Trudeau A, et al. Deciphering Suicide and Other Manners of Death Associated with Drug Intoxication: A Centers for Disease Control and Prevention Consultation Meeting Summary. Am J Public Health. 2017;107:1233-1239 pubmed publisher
    ..Continued collaboration and coordination of activities are needed among stakeholders to affect prevention efforts. ..
  12. Wendon J, Harrison P, Keays R, Williams R. Cerebral blood flow and metabolism in fulminant liver failure. Hepatology. 1994;19:1407-13 pubmed
    ..Mannitol infusion should remain the main treatment of the cerebral complications of fulminant liver failure.(ABSTRACT TRUNCATED AT 250 WORDS) ..
  13. Pourmand A, Shay C, Redha W, Aalam A, Mazer Amirshahi M. Cholinergic symptoms and QTc prolongation following donepezil overdose. Am J Emerg Med. 2017;35:1386.e1-1386.e3 pubmed publisher
    ..As no specific antidote is available for donepezil overdose, this case highlights the importance of supportive care with particular attention to the management of cardiac dysrhythmias in patients displaying signs of toxicity. ..
  14. Chen X, Yang Z. Successful treatment of propafenone-induced cardiac arrest by calcium gluconate. Am J Emerg Med. 2017;35:1209.e1-1209.e2 pubmed publisher
    ..We recommend that for patients poisoned by propafenone, close monitoring for decreased blood calcium is important. ..
  15. Strang J, Powis B, Best D, Vingoe L, Griffiths P, Taylor C, et al. Preventing opiate overdose fatalities with take-home naloxone: pre-launch study of possible impact and acceptability. Addiction. 1999;94:199-204 pubmed
    ..Such a new approach would be supported by most drug misusers. On the basis of these findings, we conclude that it is appropriate to proceed to a carefully constructed trial of naloxone distribution. ..
  16. . Vital signs: overdoses of prescription opioid pain relievers---United States, 1999--2008. MMWR Morb Mortal Wkly Rep. 2011;60:1487-92 pubmed
    ..OPR were involved in 14,800 deaths (73.8%) of the 20,044 prescription drug overdose deaths. Death rates varied fivefold by state...
  17. Chacko J, Greenstein J, Ardolic B, Berwald N. Effect of an emergency department opioid prescription policy on prescribing patterns. Am J Emerg Med. 2017;35:1327-1329 pubmed publisher
    ..The opioid clinical policy had a clear effect in decreasing the number of patients prescribed opioids. Such policies may be the key to reducing the epidemic and saving lives from unintentional opioid overdoses. ..
  18. Jongbloed K, Pearce M, Pooyak S, Zamar D, Thomas V, Demerais L, et al. The Cedar Project: mortality among young Indigenous people who use drugs in British Columbia. CMAJ. 2017;189:E1352-E1359 pubmed publisher
    ..These deaths likely reflect complex intersections of historical and present-day injustices, substance use and barriers to care. ..
  19. Webster L. Risk Factors for Opioid-Use Disorder and Overdose. Anesth Analg. 2017;125:1741-1748 pubmed publisher
    ..Clinical tools and an evolving evidence base are available to assist clinicians with identifying patients whose risk factors put them at risk for adverse outcomes with opioids. ..
  20. Zheng F, Zhan C. Are pharmacokinetic approaches feasible for treatment of cocaine addiction and overdose?. Future Med Chem. 2012;4:125-8 pubmed publisher
  21. Betts A, Ritter J, Kubal W. Reversible delayed posthypoxic leukoencephalopathy after drug overdose: MRI findings in a collection of patients. Emerg Radiol. 2012;19:165-73 pubmed publisher
  22. . Vital signs: overdoses of prescription opioid pain relievers and other drugs among women--United States, 1999-2010. MMWR Morb Mortal Wkly Rep. 2013;62:537-42 pubmed
    ..In 2010, a total of 15,323 deaths among women were attributed to drug overdose, a rate of 9.8 per 100,000 population...
  23. Rana M, Bonasera L, Bordelon G. Pharmacologic Considerations of Anesthetic Agents in Geriatric Patients. Anesthesiol Clin. 2017;35:259-271 pubmed publisher
    ..This variability requires a unique approach to anesthetic delivery and drug dosing on an individual basis to avoid complications such as postoperative cognitive dysfunction and delirium. ..
  24. Sun E, Dixit A, Humphreys K, Darnall B, Baker L, Mackey S. Association between concurrent use of prescription opioids and benzodiazepines and overdose: retrospective analysis. BMJ. 2017;356:j760 pubmed publisher
    ..b>Conclusions From 2001 to 2013, concurrent benzodiazepine/opioid use sharply increased in a large sample of privately insured patients in the US and significantly contributed to the overall population risk of opioid overdose. ..
  25. Nolan S, Buxton J, Dobrer S, Dong H, Hayashi K, Milloy M, et al. Awareness, Possession, and Use of Take-Home Naloxone Among Illicit Drug Users, Vancouver, British Columbia, 2014-2015. Public Health Rep. 2017;132:563-569 pubmed publisher
    ..53; P < .001), and at least daily heroin injection (aOR = 1.69; 95% CI, 1.09-2.62; P < .02). Efforts to improve knowledge of and participation in the THN program may contribute to reduced opioid overdose mortality in Vancouver. ..
  26. Lam R, Tang M, Leung S, Chong Y, Tsui M, Mak T. Supraventricular tachycardia and acute confusion following ingestion of e-cigarette fluid containing AB-FUBINACA and ADB-FUBINACA: a case report with quantitative analysis of serum drug concentrations. Clin Toxicol (Phila). 2017;55:662-667 pubmed publisher
    ..In the context of acute poisoning, the presence of unexplained tachyarrhythmias, confusion, and a negative recreational drug screen should prompt clinicians to consider synthetic cannabinoid toxicity as a differential diagnosis. ..
  27. Yang C, Deng J. Utility of flumazenil in zopiclone overdose. Clin Toxicol (Phila). 2008;46:920-1 pubmed publisher
  28. McLellan A, Turner B. Prescription opioids, overdose deaths, and physician responsibility. JAMA. 2008;300:2672-3 pubmed publisher
  29. McCabe D, Lu J. The association of hemodialysis and survival in intubated salicylate-poisoned patients. Am J Emerg Med. 2017;35:899-903 pubmed publisher
    ..Survival was decreased in these patients if hemodialysis was not performed. Mortality increases with the measured serum salicylate level. Timely hemodialysis for intubated salicylate overdose patients decreases mortality. ..
  30. O CONNOR A, Cluroe A, Couch R, Galler L, Lawrence J, Synek B. Death from hyponatraemia-induced cerebral oedema associated with MDMA ("Ecstasy") use. N Z Med J. 1999;112:255-6 pubmed
  31. Miro O, Galicia M, Dargan P, Dines A, Giraudon I, Heyerdahl F, et al. Intoxication by gamma hydroxybutyrate and related analogues: Clinical characteristics and comparison between pure intoxication and that combined with other substances of abuse. Toxicol Lett. 2017;277:84-91 pubmed publisher
    ..The clinical features are more severe when GHB is consumed in combination with other substances of abuse. ..
  32. Kordrostami R, Akhgari M, Ameri M, Ghadipasha M, Aghakhani K. Forensic toxicology analysis of self-poisoning suicidal deaths in Tehran, Iran; trends between 2011-2015. Daru. 2017;25:15 pubmed publisher
    ..It seems that free access to suicide means such as drugs and poisons should be restricted by national and health authorities. Not applicable. ..
  33. Carvalho N, Tassi C, Dobraschinski F, Amaral G, Zemolin A, Golombieski R, et al. Reversal of bioenergetics dysfunction by diphenyl diselenide is critical to protection against the acetaminophen-induced acute liver failure. Life Sci. 2017;180:42-50 pubmed publisher
    ..In summary, the treatment with (PhSe)2 maintained mitochondrial function, promoted genes related to mitochondrial dynamic and demonstrating to play critical role in the modulation of cellular protective responses during ALF. ..
  34. . Laboratory analyses for poisoned patients: joint position paper. Ann Clin Biochem. 2002;39:328-39 pubmed
    ..spib.axl.co.uk), will enable the poisoned patient to receive appropriate, 'best practice' investigations according to their clinical needs and will avoid the use of unnecessary investigations. ..
  35. Wojciechowski V, Călina D, Tsarouhas K, Pivnik A, Sergievich A, Kodintsev V, et al. A guide to acquired vitamin K coagulophathy diagnosis and treatment: the Russian perspective. Daru. 2017;25:10 pubmed publisher
    ..With early diagnosis and prescription of appropriate therapy, prognosis is favorable. Reasons for vitamin K antagonists-dependent coagulopathy cases. ..
  36. Taney J, Anastasio H, Paternostro A, Berghella V, Roman A. Placental Abruption With Delayed Fetal Compromise in Maternal Acetaminophen Toxicity. Obstet Gynecol. 2017;130:159-162 pubmed publisher
    ..Maternal acetaminophen overdose can be associated with delayed fetal compromise, suggesting the importance of continued fetal surveillance several days after ingestion. ..
  37. Parr M, Low H, Botterill P. Hyponatraemia and death after "ecstasy" ingestion. Med J Aust. 1997;166:136-7 pubmed
    ..Advice to those using ecstasy at dance parties should be modified to suggest moderate fluid intake only and to emphasise the need to seek prompt medical attention for non-resolving symptoms. ..
  38. Porta R, Sanchez L, Nicolas M, Garcia C, Martinez M. Lack of toxicity after paracetamol overdose in a extremely preterm neonate. Eur J Clin Pharmacol. 2012;68:901-2 pubmed publisher
  39. Gomes T, Juurlink D, Antoniou T, Mamdani M, Paterson J, van den Brink W. Gabapentin, opioids, and the risk of opioid-related death: A population-based nested case-control study. PLoS Med. 2017;14:e1002396 pubmed publisher
    ..The objective of this study was to investigate whether co-prescription of opioids and gabapentin is associated with an increased risk of accidental opioid-related mortality...
  40. Okie S. A flood of opioids, a rising tide of deaths. N Engl J Med. 2010;363:1981-5 pubmed publisher
  41. . CDC grand rounds: prescription drug overdoses - a U.S. epidemic. MMWR Morb Mortal Wkly Rep. 2012;61:10-3 pubmed
    In 2007, approximately 27,000 unintentional drug overdose deaths occurred in the United States, one death every 19 minutes. Prescription drug abuse is the fastest growing drug problem in the United States...
  42. Tomassoni A, Hawk K, Jubanyik K, Nogee D, Durant T, Lynch K, et al. Multiple Fentanyl Overdoses - New Haven, Connecticut, June 23, 2016. MMWR Morb Mortal Wkly Rep. 2017;66:107-111 pubmed publisher
    ..Effective communication and timely, coordinated, collaborative actions of community partners reduced the harm caused by this event and prevented potential subsequent episodes. ..
  43. Mckay C. Acetaminophen: hidden complexities of a simple overdose. MLO Med Lab Obs. 2011;43:12-4, 16; quiz 18-9 pubmed
  44. Briassoulis G, Kalabalikis P, Tamiolaki M, Hatzis T. Lamotrigine childhood overdose. Pediatr Neurol. 1998;19:239-42 pubmed
    ..Interestingly in this child, lamotrigine overdose presented exclusively with treatment-emergent neurologic abnormalities, sparing all other systems. ..
  45. Johnson J, Williams K, Banner W. Adolescent with prolonged toxidrome. Clin Toxicol (Phila). 2017;55:364-365 pubmed publisher
    ..Though bezoar formation is a rare clinical scenario, it is one that toxicologists must consider in patients with clinical courses that persist far beyond expected based on known toxicokinetic principles. ..
  46. Rudd R, Seth P, David F, Scholl L. Increases in Drug and Opioid-Involved Overdose Deaths - United States, 2010-2015. MMWR Morb Mortal Wkly Rep. 2016;65:1445-1452 pubmed publisher
    The U.S. opioid epidemic is continuing, and drug overdose deaths nearly tripled during 1999-2014. Among 47,055 drug overdose deaths that occurred in 2014 in the United States, 28,647 (60.9%) involved an opioid (1)...
  47. Rajakumar K, Reis E, Holick M. Dosing error with over-the-counter vitamin D supplement: a risk for vitamin D toxicity in infants. Clin Pediatr (Phila). 2013;52:82-5 pubmed publisher
  48. Nair A, Paul F, Protopapas M. Management of near fatal mixed tricyclic antidepressant and selective serotonin reuptake inhibitor overdose with Intralipid®20% emulsion. Anaesth Intensive Care. 2013;41:264-5 pubmed
  49. Graham N, Gold M, Goldberger B. Prescription opioids and overdose deaths. JAMA. 2009;301:1766; author reply 1767-8 pubmed publisher
  50. Wang G, Hoppe J, Brou L, Heard K. Medication organizers (pill minders) increase the risk for unintentional pediatric ingestions. Clin Toxicol (Phila). 2017;55:897-901 pubmed publisher
    ..Further research is needed to evaluate the specific role of medication organizers, and subsequently, improve prevention strategies. ..
  51. Wong A, Sivilotti M, Graudins A. Accuracy of the paracetamol-aminotransferase multiplication product to predict hepatotoxicity in modified-release paracetamol overdose. Clin Toxicol (Phila). 2017;55:346-351 pubmed publisher
    ..When below 1500?mg/L?×?IU/L the likelihood of developing hepatotoxicity was very low. Persistently high serial multiplication product calculations were associated with the greatest risk of hepatotoxicity. ..
  52. Finlay J, Wyatt K, North C. Recovery from Cyclophosphamide Overdose in a Dog. J Am Anim Hosp Assoc. 2017;53:230-235 pubmed publisher
    ..The dog made a complete recovery with no long-term complications at the time of writing. To the author's knowledge, this is the highest inadvertently administered dose of cyclophosphamide to result in complete recovery. ..
  53. Strike C, Miskovic M. Zoning out methadone and rising opioid-related deaths in Ontario: Reforms and municipal government actions. Can J Public Health. 2017;108:e205-e207 pubmed publisher
    ..Changes that exacerbate these factors may lead to increased use of bylaws to curtail access at a time when efforts are underway to reduce alarming rates of opioid-related overdose. ..
  54. Coffin P, Behar E, Rowe C, Santos G, Coffa D, Bald M, et al. Nonrandomized Intervention Study of Naloxone Coprescription for Primary Care Patients Receiving Long-Term Opioid Therapy for Pain. Ann Intern Med. 2016;165:245-52 pubmed publisher
    ..Providing naloxone in primary care settings may have ancillary benefits, such as reducing opioid-related adverse events. National Institutes of Health. ..
  55. Coffin P, Santos G, Matheson T, Behar E, Rowe C, Rubin T, et al. Behavioral intervention to reduce opioid overdose among high-risk persons with opioid use disorder: A pilot randomized controlled trial. PLoS ONE. 2017;12:e0183354 pubmed publisher
    ..We pilot tested a behavioral intervention to reduce the occurrence of opioid overdose among opioid dependent persons at high-risk for subsequent overdose...
  56. Wheeler E, Jones T, Gilbert M, Davidson P. Opioid Overdose Prevention Programs Providing Naloxone to Laypersons - United States, 2014. MMWR Morb Mortal Wkly Rep. 2015;64:631-5 pubmed
    b>Drug overdose deaths in the United States have more than doubled since 1999. During 2013, 43,982 drug overdose deaths (unintentional, intentional [suicide or homicide], or undetermined intent) were reported...
  57. Agulnik A, Kelly D, Bruccoleri R, Yuskaitis C, Ebrahimi Fakhari D, Sahin M, et al. Combination Clearance Therapy and Barbiturate Coma for Severe Carbamazepine Overdose. Pediatrics. 2017;139: pubmed publisher
    ..Future studies are required to validate this aggressive approach. The occurrence of mitochondrial dysfunction must be confirmed in patients with carbamazepine toxicity and the need to treat it validated. ..
  58. Robinson W, Kazbour C, Nassau T, Fisher K, Sheu S, Rivera A, et al. Brief Report: Nonfatal Overdose Events Among Persons Who Inject Drugs: Findings From Seven National HIV Behavioral Surveillance Cities 2009 & 2012. J Acquir Immune Defic Syndr. 2017;75 Suppl 3:S341-S345 pubmed publisher
    ..Adapting systems such as NHBS may be useful in responding to and monitoring emergent public health problems such as the overdose epidemic. ..
  59. Chetty M, Kenworthy J, Langham S, Walker A, Dunlop W. A systematic review of health economic models of opioid agonist therapies in maintenance treatment of non-prescription opioid dependence. Addict Sci Clin Pract. 2017;12:6 pubmed publisher
    ..This could more adequately support decision-making and policy development for treatment of non-prescription opioid dependence. ..
  60. Zolot J. A Worsening Opioid Epidemic Prompts Action. Am J Nurs. 2017;117:15 pubmed publisher
    ..Multilevel approaches to address the problem are needed. ..
  61. Peterson A, Gladden R, Delcher C, Spies E, Garcia Williams A, Wang Y, et al. Increases in Fentanyl-Related Overdose Deaths - Florida and Ohio, 2013-2015. MMWR Morb Mortal Wkly Rep. 2016;65:844-9 pubmed publisher
    ..In Ohio, circumstances associated with fentanyl deaths included a current diagnosed mental health disorder(§) and recent release from an institution such as a jail, rehabilitation facility, or hospital. ..
  62. Abouchedid R, Hudson S, Thurtle N, Yamamoto T, Ho J, Bailey G, et al. Analytical confirmation of synthetic cannabinoids in a cohort of 179 presentations with acute recreational drug toxicity to an Emergency Department in London, UK in the first half of 2015. Clin Toxicol (Phila). 2017;55:338-345 pubmed publisher
    ..This suggests that presentations to the ED with acute synthetic cannabinoid receptor agonist toxicity may be more common than reported. ..
  63. Senadheera C, Marecek J, Hewage C, Wijayasiri W. A hospital-based study on trends in deliberate self-harm in children and adolescents. Ceylon Med J. 2010;55:67-8 pubmed
  64. Jones C, Logan J, Gladden R, Bohm M. Vital Signs: Demographic and Substance Use Trends Among Heroin Users - United States, 2002-2013. MMWR Morb Mortal Wkly Rep. 2015;64:719-25 pubmed
  65. Orkin A, Zhan C, Buick J, Drennan I, Klaiman M, Leece P, et al. Out-of-hospital cardiac arrest survival in drug-related versus cardiac causes in Ontario: A retrospective cohort study. PLoS ONE. 2017;12:e0176441 pubmed publisher
    b>Drug overdose causes approximately 183,000 deaths worldwide annually and 50,000 deaths in Canada and the United States combined...
  66. Gwira Baumblatt J, Wiedeman C, Dunn J, Schaffner W, Paulozzi L, Jones T. High-risk use by patients prescribed opioids for pain and its role in overdose deaths. JAMA Intern Med. 2014;174:796-801 pubmed
    From January 1, 2003, through December 31, 2010, drug overdose deaths in Tennessee increased from 422 to 1059 per year. More of these deaths involved prescription opioids than heroin and cocaine combined...
  67. Bryson E. The anesthetic implications of illicit opioid abuse. Int Anesthesiol Clin. 2011;49:67-78 pubmed publisher
  68. Boyer E. Management of opioid analgesic overdose. N Engl J Med. 2012;367:146-55 pubmed publisher
  69. . Vital signs: risk for overdose from methadone used for pain relief - United States, 1999-2010. MMWR Morb Mortal Wkly Rep. 2012;61:493-7 pubmed
    ..For chronic noncancer pain, methadone should not be considered a drug of first choice by prescribers or insurers. ..
  70. Pollak P, Verjee Z, Lyon A. Risperidone-induced QT prolongation following overdose correlates with serum drug concentration and resolves rapidly with no evidence of altered pharmacokinetics. J Clin Pharmacol. 2011;51:1112-5 pubmed publisher
  71. Daly E, Dufault K, Swenson D, Lakevicius P, METCALF E, Chan B. Use of Emergency Department Data to Monitor and Respond to an Increase in Opioid Overdoses in New Hampshire, 2011-2015. Public Health Rep. 2017;132:73S-79S pubmed publisher
    ..Data from New Hampshire's ED syndromic surveillance system provided timely situational awareness to public health partners to support the overall response to the opioid epidemic. ..
  72. Bennett T, Holloway K, Bird S. Does take-home naloxone reduce non-fatal overdose?. Lancet. 2014;383:124-5 pubmed publisher
  73. Moore J, Rodriguez R. Toxicity of fluoxetine in overdose. Am J Psychiatry. 1990;147:1089 pubmed
  74. Mowry J, Spyker D, Cantilena L, McMillan N, Ford M. 2013 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 31st Annual Report. Clin Toxicol (Phila). 2014;52:1032-283 pubmed publisher
    ..NPDS is a model system for the nation and global public health. ..
  75. Lota A, Dubrey S, Wills P. Profound hyponatraemia following a tramadol overdose. QJM. 2012;105:397-8 pubmed publisher
  76. Fleurat M, Smollin C. Case files of the University of California San Francisco Medical Toxicology Fellowship: lamotrigine toxicity. J Med Toxicol. 2012;8:52-8 pubmed publisher
  77. Avidan M, Mashour G. Prevention of intraoperative awareness with explicit recall: making sense of the evidence. Anesthesiology. 2013;118:449-56 pubmed publisher
  78. Chenoweth J, Colby D, Sutter M, Radke J, Ford J, Nilas Young J, et al. Massive diltiazem and metoprolol overdose rescued with extracorporeal life support. Am J Emerg Med. 2017;35:1581.e3-1581.e5 pubmed publisher
    ..This case highlights the potential utility of extracorporeal life support in cases of severe toxicity due to multiple cardioactive medications. ..
  79. Livingston M, Barnett T, Delcher C, Wagenaar A. Recreational Cannabis Legalization and Opioid-Related Deaths in Colorado, 2000-2015. Am J Public Health. 2017;107:1827-1829 pubmed publisher
    ..To examine the association between Colorado's legalization of recreational cannabis use and opioid-related deaths...
  80. Mack K, Jones C, Ballesteros M. Illicit Drug Use, Illicit Drug Use Disorders, and Drug Overdose Deaths in Metropolitan and Nonmetropolitan Areas - United States. MMWR Surveill Summ. 2017;66:1-12 pubmed publisher
    ..Understanding differences in illicit drug use, illicit drug use disorders, and overall drug overdose deaths in metropolitan and nonmetropolitan areas is important for informing public health programs, ..