Acute Opioid Toxicity

Acute opioid toxicity may result from clinical overdosage, accidental overdosage in addicts, or attempts at suicide. Occasionally, a delayed type of toxicity may occur from the injection of an opioid into chilled skin areas or in patients with low blood pressure and shock. The drug is not fully absorbed, and therefore, a subsequent dose may be given. When normal circulation is restored, an excessive amount may be absorbed suddenly. It is difficult to define the exact amount of any opioid that is toxic or lethal to humans. In nontolerant individuals, serious toxicity may follow the oral ingestion of 40-60 mg of methadone. A normal, pain-free adult is not likely to die after oral doses of morphine of <120 mg or to have serious toxicity with <30 mg parenterally.

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