# Adrenaline shots to the heart for drug OD? **URL:** \ **Category:** Factual Questions\ **Created:** [August 29, 2004, 4:55am UTC](https://boards.straightdope.com/t/adrenaline-shots-to-the-heart-for-drug-od/262058 "2004-08-29T04:55:12Z")\ **Posts on this page:** 9\ **Page:** 1
**Author:** ![beltbuckle](https://avatars.discourse-cdn.com/v4/letter/b/3da27b/32.png) [@beltbuckle](https://boards.straightdope.com/u/beltbuckle)\ **Post date:** [August 29, 2004, 4:55am UTC](https://boards.straightdope.com/t/adrenaline-shots-to-the-heart-for-drug-od/262058/1 "2004-08-29T04:55:12Z")
I was watching one of my favorite movies, Pulp Fiction, again tonight, and in true doper fashion, I had a question about one of the parts of the movie. In the movie, Mia Wallace snorts some of Vincent’s “mad man” heroin, thinking it is cocaine. She OD’s on the stuff. and is apparently almost dead. Needless to say, the cure was to give her an adrenaline shot straight into her heart. Vincent jabbed a huge syringe into her heart, and plunged the adrenaline in. In the movie, of course, she “woke up” startled, and was fine thereafter. Can anyone in the medical practice say if this was a valid treatment for this type of drug overdose, or was this purley (pulp) fiction? ---
**Author:** ![BMax](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bmax/32/4267_2.png) [@BMax](https://boards.straightdope.com/u/BMax)\ **Post date:** [August 29, 2004, 6:15am UTC](https://boards.straightdope.com/t/adrenaline-shots-to-the-heart-for-drug-od/262058/2 "2004-08-29T06:15:43Z")
according to [this site](http://www.nlm.nih.gov/medlineplus/print/ency/article/002861.htm), > [@](#): > > What to expect at the emergency room > > Some or all of the following procedures may be performed: > Use gastric lavage. > Administer activated charcoal. > Administer a laxative. > **Give a counteracting drug (narcotic antagonist)**–multiple doses if needed. > Administer intravenous fluids as needed. > Monitor breathing. > Treat the symptoms. > Expectations (prognosis) > > If an antidote can be given, recovery from an acute overdose occurs within 24 to 48 hours. _bolding mine_ But it doesn’t specify just what counteracting drug to use as an antidote. [Eureka!](http://www.druglibrary.org/schaffer/Library/studies/cu/cu12.htm) > [@](#): > > death from an overdose of opiates is ordinarily a slow process. “In cases of fatal poisoning with morphine, the time of death may vary roughly from one to twelve hours.” 9 The first signs are lethargy and stupor, followed by prolonged coma. If, after a period of hours, death does ensue, it is usually from respiratory failure. During the minutes or hours following the injection of a potentially fatal overdose, death can be readily forestalled by administering an effective antidote: a narcotic antagonist known as **nalorphine (Nalline). 10 Nalorphine brings a victim of opiate overdose out of his stupor or coma within a few minutes**. Since there is plenty of time and since nalorphine is stocked in pharmacies and hospital emergency rooms throughout the country, the death of anyone due to heroin overdose is very rarely excusable. _bolding mine_ So, my buddy Ben didn’t have to be wrapped in a blanket & dumped in the river by his junkie “friends” 9 years ago ☹ Which left me wondering if nalorphine is related to epinephrine or norepinephrine (adrenaline), so I looked [here](http://www.encyclopedia.com/html/n1/nalorphi.asp) > [@](#): > > (năl´erfēn) , derivative of morphine that acts to reverse the effects of morphine and other narcotics . It counteracts narcotic-induced nervous system and respiratory system depression but is not effective against depression induced by other sedatives such as barbiturates. Interesting…Using a derivative of dope to treat an overdose of dope… Still no info re: the giant hypo rig. I already knew that they don’t stab through the sternum (Tarantino had Stolz call it a “breastplate”) but go between the ribs for a direct injection to the heart. I have heard of such an injection being done to restart a stopped heart before, but don’t know if this is ever done for a heroin OD. Based on my research so far, I’m calling bullshit on Tarantino. It’s still a great movie though. Is **Quadgop** still around? ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [August 29, 2004, 7:47am UTC](https://boards.straightdope.com/t/adrenaline-shots-to-the-heart-for-drug-od/262058/3 "2004-08-29T07:47:12Z")
Naloxone (Narcan), another narcotic antagonist (possession of which is generally a good indicator of a habitual heroin user), is indicated for subcutaneous, intravenous, or intramuscular use. Nothing suggests that it can be administered via intracardial injection. Intracardial injections of epinephrine might be administered to a overdose victim who is flatlining, if compression and/or defibrillation don’t work. However, it would be to prevent cardiac arrest caused by the overdose, not to treat the overdose itself. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [August 29, 2004, 2:39pm UTC](https://boards.straightdope.com/t/adrenaline-shots-to-the-heart-for-drug-od/262058/4 "2004-08-29T14:39:10Z")
That movie scene was a gross example of medical mistreatment. :eek: I was hollering those very words at the movie screen when I saw it! (which got me some strange looks, let me tell you!) Anyway, the most likely clinical scenario from an overdose of heroin would be respiratory arrest. Not cardiac arrest. What that gal needed was a dose of an opiate antagonist such as naloxone, right quick, to knock the heroin out of the opiate receptors and let her resume breathing. However, if I had no other meds available except epi, I suppose I would consider injecting epi, and performing rescue breathing, to see if I could stabilize her enough that way. And frankly, intracardiac injection, though not the desired route, would be effective. It just has a hell of a lot more risks associated with it. I’ve never done intracardiac injections on anyone who wasn’t about to be dead without _drastic_ intervention. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [August 29, 2004, 6:01pm UTC](https://boards.straightdope.com/t/adrenaline-shots-to-the-heart-for-drug-od/262058/5 "2004-08-29T18:01:03Z")
Yeah, over the top, but **Qadgop** , they’re drug addicts. A bunch of half-addled, freaked out, panicked junkies and dealers will do weird, peculiar and even really dumb stuff. Sure, the medicine was crap, but the running around and hollering sure captured the emotion of the moment. Not to mention that lovely bit where Vicent drops Mia face down on the lawn like a sack of dirty laundry to argue his point with gestures as well as voice. I didn’t think the “treatment” meshed with reality, nor did I think she’d be walking back into her house under her own power just a short while later if it was all real life - but it wasn’t real life. At the time the movie came out in the theaters, I was still working at the clinic and we did have some concern that some our “clients” would do something of the sort. Because they did do weird, inexplicable, bizarre things from time to time. ---
**Author:** ![EmtMike](https://avatars.discourse-cdn.com/v4/letter/e/a9adbd/32.png) [@EmtMike](https://boards.straightdope.com/u/EmtMike)\ **Post date:** [January 25, 2012, 6:06am UTC](https://boards.straightdope.com/t/adrenaline-shots-to-the-heart-for-drug-od/262058/6 "2012-01-25T06:06:17Z")
I’ve been having this same question recently, and fighting with a friend over its validity. After much research I found a nursing website which talks about its potential use as a last resort- not favorable but possible. “If venous access cannot be obtained and the patient is intubated, adrenaline can be given via the endotracheal tube directly into the lungs. Manufacturers suggest that adrenaline may be injected directly into the heart through the chest wall if no other route is available (eMC, 2006). This can be a difficult procedure and should only be attempted by a competent clinician and when all other attempts to gain access have failed.” > **[Understanding the drugs used during cardiac arrest response | Nursing Times](https://www.nursingtimes.net/clinical-archive/cardiovascular-clinical-archive/understanding-the-drugs-used-during-cardiac-arrest-response-06-06-2006/)** > > Abstract VOL: 102, ISSUE: 23, PAGE NO: 24 David Gallimore, MSc, BSc, RGN, is tutor in adult nursing, School of Health Science, University of Wales Swansea ---
**Author:** ![Accidental\_Martyr](https://avatars.discourse-cdn.com/v4/letter/a/ce7236/32.png) [@Accidental\_Martyr](https://boards.straightdope.com/u/Accidental_Martyr)\ **Post date:** [January 25, 2012, 7:42am UTC](https://boards.straightdope.com/t/adrenaline-shots-to-the-heart-for-drug-od/262058/7 "2012-01-25T07:42:58Z")
The scene in **Pulp Fiction** was inspired by a story told in the 1978 documentary **American Boy: A Profile of Steven Prince** directed by Martin Scorsese. Here is the scene from the documentary juxtaposed with the scene from **Pulp Fiction** followed by a later interview with Prince. I don’t know if Prince was telling the truth, but this is where Tarantino got the idea. [![](https://img.youtube.com/vi/yV-tXWwohAU/hqdefault.jpg "American Boy / American Prince (Scorsese) - The Pulp Fiction tale") ](https://www.youtube.com/watch?v=yV-tXWwohAU) ETA: strong language warning NSFW ---
**Author:** ![Princhester](https://avatars.discourse-cdn.com/v4/letter/p/3e96dc/32.png) [@Princhester](https://boards.straightdope.com/u/Princhester)\ **Post date:** [January 25, 2012, 7:59am UTC](https://boards.straightdope.com/t/adrenaline-shots-to-the-heart-for-drug-od/262058/8 "2012-01-25T07:59:49Z")
[Earlier thread](http://boards.straightdope.com/sdmb/showthread.php?t=63249) started by me on the same topic. Eleven years earlier. This place is getting old. \*\*QtM \*\*relates more of what he yelled at the movie screen in the earlier thread. ---
**Author:** ![outlierrn](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/outlierrn/32/3005_2.png) [@outlierrn](https://boards.straightdope.com/u/outlierrn)\ **Post date:** [January 26, 2012, 5:59am UTC](https://boards.straightdope.com/t/adrenaline-shots-to-the-heart-for-drug-od/262058/9 "2012-01-26T05:59:07Z")
While you could make a case for a last ditch ‘the pt was as good as dead anyway,’ injection of epi into the heart, the pt emphatically would not sit up, gasp and then be able to walk to the car.