Three Bronx, New York hospitals have admitted 49 cases of heroin intoxication (overdose) in adolescents during a period of three and a half years.
The patients were aged 14 to 17 years, male in 42 cases, and addicted in only two cases.
Patients presented with miosis, respiratory depression, obdundation, and, in 33 cases, thoracic rales, or rhonchi. Chest x-ray revealed infiltrates in 34 cases and blood gas analysis showed hypoxia and acidosis in 14 cases. Their course was complicated by pulmonary edema in 28 cases, pneumonia in 16, aspiration in 9, and permanent cerebral damage in 2 cases. Three cases were fatal.
Therapy of choice is immediate institution of an airway and ventilation with oxygen. Naloxone (Narcan), a new narcotic antagonist should be administered intravenously, 0.01 mg/kg, with additional doses as clinically indicated.
Heroin Intoxication Through Damaged Skin in a 7-Year-Old Girl