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What is an Overdose? ER Doctor Explains

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Beth Vorhees
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West Virginia Public Broadcasting

Derek Harman practices family medicine in Logan County, but he's also been an emergency room physician. He got his medical degree in 2008 from the School of Osteopathic Medicine, in Lewisburg, and completed his residency in Virginia, in 2013.

 

Even at a young age, Harman has seen his fair share of overdoses.

Heroin is a respiratory depressant, and Harman said people who overdose can have shallow breath and a low number of breaths.

“You do not have enough oxygen to feed the body,” Harman said, “and usually opioid overdoses, and heroin overdoses included, people succumb to respiratory distress and then arrest and then death."

 

But diagnosing an overdose can often be tricky.

 

“Anytime someone comes into the emergency room, there’s a whole slew of things that you go through,” he said. “It’s very algorithmic.”

 
Harman described looking for things like track marks, pain patches and talking to paramedics or any friends or family members that might be present for more information about the patient.

 
“Someone could have a stroke that could present similarly. Low glucose can present in a very same fashion.  But it is a guessing game at the beginning,” he said.

 
Still, Harman said, time is of the essence when dealing with an overdose. That's why he often relied on the opioid antagonist Naloxone, or Narcan, in the emergency room. The drug coats pain receptors in the nervous system, allowing an overdose patient to start breathing again, but one injector is not always enough. 
 
“An initial dose of Narcan at home for example is often not enough to overcome the complete dosage of heroin or opioids,” he said. “So, these patients if given Narcan in the field still need to come to the emergency room because those opioids can again reattach to those receptors after Narcan has worn off.”

 
A state law taking effect Wednesday, May 27, will allow family members and friends of addicts to get a prescription for Naloxone. The bill also calls on all first responders, not just EMTs as in the past, to carry the drug. 


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