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Respiratory depression (also referred to as respiratory suppression or respiratory insufficiency) is a decline in the ability of a person to inhale and exhale.
It can be a common side effect of drugs that suppress functions of the central nervous system. When respiratory depression is a result of use of drugs, it is often referred to as substance-induced respiratory suppression (depression).
According According to Mosby’s Medical Dictionary, when an individual’s rate of breathing (respiration) falls to or below a sustained rate of 12 breaths per minute or the individual’s breathing rate fails to fully ventilate or profuse their lungs, the individual is suffering from respiratory insufficiency. Substance-induced respiratory suppression/depression occurs when an individual experiences a significant decline in their inhalations and exhalations as a result of using some drug or medication. Substance-induced respiratory depression can occur in conjunction with the use of numerous drugs, the majority of which are classified as sedatives or central nervous system depressant drugs. These can include:
Substance-induced respiratory depression is considered to be a side effect of the use of these drugs. Even though this effect is associated with the drug’s primary mechanism of action, it is not the therapeutic or medicinal effect that these drugs are often used for. The level of respiratory depression that occurs with the use of drugs or alcohol is dose-dependent. According to clinical guides, such as Rosen’s Emergency Medicine: Concepts and Clinical Practice, there are four levels of substance-induced respiratory depression.
Central nervous system depressants induce respiratory suppression and respiratory failure by attaching to the receptor sites in the brain stem in areas that are responsible for the control of automatic life-sustaining functions, such as heart rate and breathing. Central nervous system depressant drugs have the effect of decreasing the firing of the neurons in all areas of the brain, including these areas. As a result, when taken in sufficient doses, these drugs can stop the functioning of the neurons in these vital areas of the brain, leading to serious brain and other tissue damage, and resulting in potential fatalities as an individual’s breathing rate becomes dangerously slow or halts altogether.
Some of the subjective signs that may occur when an individual is displaying respiratory depression include:
Individuals who suffer respiratory suppression at lower levels (levels 1 and 2) often need to adjust the dosage of medications they are taking if these effects are resulting in distress for them. Individuals who use central nervous system depressant drugs illicitly can only reduce their use of the drugs in order to control these effects.
Treatment for more severe respiratory suppression, or for respiratory arrest, induced by opiate use can be administered by using drugs such as naloxone, an opioid antagonist. Naloxone immediately attaches to the receptor sites in the brain that opioid drugs occupy, removes them from the sites, and reverses the effects associated with opiate drug use. This drug may also be useful in treating overdoses for other types of drugs such as GHB. Treatment with naloxone should only be administered by individuals trained in its administration and use.
For other types of drug-induced respiratory suppression, medical treatment is mandatory.
Individuals may need numerous medications to counteract the effects of the drugs and may need to be placed on a ventilator.
Obviously, individuals who suffer serious issues with respiratory suppression as a result of drug overdose or chronic use of drugs need to be evaluated and treated for a potential substance use disorder and perhaps also need to be evaluated for potential suicidality.