MS Contin Overdose

MS Contin is an extended-release version of the opioid morphine. MS Contin is prescribed to treat severe chronic pain. MS Contin should only be used if less potent, shorter-acting opioids and non-opioid painkillers are ineffective. The minimum effective dose should be used to avoid the risk of complications. Doses should be titrated gradually until the minimum effective dosage is achieved.

The risk of overdose is high with extended-release opioids like MS Contin. This is because they contain significantly more of the drug than immediate-release formulas. MS Contin is designed to be released gradually over an extended period of time; however, the extended-release feature can be bypassed by crushing the pills. This can lead to severe respiratory depression and fatal overdose.

The amount of MS Contin necessary to overdose varies dramatically based on the unique metabolic factors of each patient. Age, weight, body fat percentage, and genetic tendencies are among the many factors that influence MS Contin metabolism.

MS Contin is a full opioid agonist. This means that it binds primarily to mu-opioid receptors in the body. The only exception to this rule is during high doses, at which time MS Contin may bind with other opioid receptors as well. Full opioid agonists do not produce the “ceiling effect” that is common with partial opioids. As a result, individuals will continue to feel increasingly “high” on the drug up until the point of overdose. Full opioid agonists like MS Contin are much more likely to result in overdose as people who use the drug recreationally chase the euphoria associated with morphine use.

The primary symptoms of MS Contin overdose are referred to as the “opioid overdose triad.” These include severely decreased respiration, significantly decreased level of consciousness, and pinpoint pupils. A depressed respiratory drive is the most critical risk factor during an overdose.

MS Contin is a powerful central nervous system depressant. MS Contin acts directly on the brain stem to inhibit its ability to monitor carbon dioxide levels in the blood. Under normal circumstances, elevated carbon dioxide levels cause the brain stem to trigger respiration. In the event of a severe overdose, the brain remains unaware of the need to breathe.

Pinpoint pupils may be unresponsive to light. As the patient’s condition deteriorates and oxygen deprivation becomes severe, the pupils may transition to full dilation (the opposite of pinpoint).

The patient may progress rapidly from responding to questions in full sentences to being entirely unaware of their surroundings and unresponsive. If left untreated, the patient may experience muscle spasms, seizures, pulmonary edema, rhabdomyolysis, compartment syndrome, and permanent brain damage.

The amount of MS Contin necessary to overdose varies greatly among patients. Factors that can influence opioid metabolism include genetic tendencies, body weight, liver and kidney health, size, body fat percentage, and opioid tolerance. Certain individuals have genetic abnormalities that lead to either rapid or slow metabolism of the drug. In general, larger patients with a higher body fat percentage tend to be more tolerant of higher doses, whereas smaller patients may be at risk for overdose when taking lower doses.

Age is a factor because older patients tend to have slower metabolisms. A slower metabolism increases the likelihood of overdose. MS Contin is primarily metabolized by the liver. Impaired liver function increases the chance of overdose due to elevated plasma concentrations and extended clearance times. The minimum lethal dose of morphine is 120 mg. In individuals who are hypersensitive, doses as low as 60 mg can be fatal. Severely opioid-dependent persons may take up to 3000 mg per day without noticeable complications.

Overdoses are treated by supporting the patient’s breathing while administering drugs to reverse the effects of MS Contin. The patient may require respiratory support in the form of assisted or controlled ventilation. Ventilations may be assisted with a bag-valve mask if the patient is still conscious. Fully unconscious patients may require placement of an endotracheal tube.

If clinically significant respiratory depression is present, an opioid antagonist like naloxone will be administered to reverse the effects of MS Contin. Naloxone can take effect within seconds when it is injected or inhaled. Multiple doses may be necessary in cases of severe overdose. Naloxone use can trigger the onset of severe opioid withdrawals.

If you or someone you love is struggling with an opioid misuse or abuse disorder, The Recovery Village is available to answer any questions you may have.

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