Serious Injuries Can Linger After Opioid Overdose : Shots - Health News Emergency room doctors are just beginning to study a new kind of casualty in the opioid epidemic — patients who survive an overdose, but walk away with brain damage, kidney failure or dead muscle.
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What Doesn't Kill You Can Maim: Unexpected Injuries From Opioids

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What Doesn't Kill You Can Maim: Unexpected Injuries From Opioids

What Doesn't Kill You Can Maim: Unexpected Injuries From Opioids

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KELLY MCEVERS, HOST:

Emergency room doctors are just beginning to study a new kind of casualty in the opioid epidemic. They're taking a closer look at patients who survive an overdose but walk away with other injuries that happen during drug use and as a result of the overdose. From member station WBUR, Martha Bebinger reports.

MARTHA BEBINGER, BYLINE: Lisa's trouble started when she took methadone, a drug used to help wean patients off heroin, along with a pill meant to control blood pressure and one used to treat seizures.

LISA: I inadvertently did the methadone cocktail, and I went to sleep for, like, 48 hours. Like, it really kicked my butt.

BEBINGER: The 46-year-old passed out slumped over the washer at her mom's.

LISA: My daughter brought me up and put me to bed. And I hate the fact that she saw me like that, you know?

BEBINGER: Lisa lay with her right leg bent under her body, arms folded across her chest for more than a day. Family members checked to make sure she was breathing.

LISA: My daughter - when I was asleep, she said my leg was white, white, white - looked shriveled up and white. She came and massaged it really, really vigorously. I think if she hadn't have done that, I don't think I'd be walking on this leg. I think I would have killed it.

BEBINGER: As it is, almost five years after the injury, Lisa sometimes limps.

LISA: Or I have what I call flabberfoot. My foot, like, slaps the ground.

BEBINGER: Lisa, whose last name we aren't including because she's used illegal drugs, says she was too embarrassed to tell a doctor. So it's not clear if she had nerve damage or something called compartment syndrome, where muscles are damaged or die because blood flow stops. Dr. Ed Boyer, an emergency room physician at Brigham and Women's Hospital, remembers a patient who injected heroin while sitting.

ED BOYER: And when he woke up, he had a compartment syndrome of his buttock. And then they had to remove half of it. Now this individual has great difficulty even walking.

MELISSA LAI BECKER: Another injury related to spending hours on the floor is renal failure or kidney failure.

BEBINGER: Dr. Melissa Lai Becker runs an emergency room just north of Boston. When blood stops circulating through the buttocks or leg muscles, they break down, releasing chemicals.

LAI BECKER: And they can clog up the filtration system in the kidneys, and when that happens, the kidneys can shut down completely.

BEBINGER: What's more common, says Lai Becker, is lung damage in patients revived after an overdose.

LAI BECKER: The lungs become so waterlogged that you can't get any more oxygen into the body even though a patient is wide awake and they're struggling to breathe.

BEBINGER: There are lots of questions among ER docs about why this is happening. Centers for Disease Control scientist Mark Faul says there are no definitive answers yet.

MARK FAUL: We're only beginning to scratch the surface and try to understand what is going on on this front.

BEBINGER: Doctors tell stories of patients with broken bones, temporary blindness and amnesia. Hypothermia is a problem in the winter. Dr. Ali Raja says 3 out of 4 overdose patients he sees at Mass General Hospital have some sort of injury, and many don't take it seriously.

ALI RAJA: They often believe that they're just fine, and they repeat the exact same circumstances that led to the overdose in the first place and the same other injuries we just talked about.

BEBINGER: There's another compounding factor - fentanyl. The high is more intense than heroin, but it wears off quickly. That means people use fentanyl more times a day, says epidemiologist Traci Green.

TRACI GREEN: Simple math tells us that we're going to have more visits to the emergency department and we're going to potentially have more injury, and injury will beget in this instance.

BEBINGER: But some doctors say fentanyl kills so quickly there's no time for other injuries. That's a sobering twist for emergency medicine as doctors struggle to keep up with the raging opioid epidemic. For NPR News, I'm Martha Bebinger in Boston.

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MCEVERS: That story is part of a reporting partnership with NPR, WBUR and Kaiser Health News.

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