Illicit Drug Induced Hyperthermia (IDIH)

Illicit drug induced hyperthermia (IDIH) is a life-threatening emergency requiring timely recognition and management. The pathophysiology of hyperthermia secondary to illicit drug toxicity can be associated with and complicated by additional precipitants such as exertion and high ambient temperature (> 31°C). We present cases highlighting the clinical features, morbidity and mortality associated with IDIH. The priorities of management include interventions to decrease ongoing heat production, active cooling and targeted supportive care. Temperature control should ideally be achieved within 15 min to prevent irreversible organ injury. IDIH presentations may be viewed as a high acuity low occurrence (HALO) event. As such, we recommend the use of a specific IDIH protocol and early consultation with clinical toxicology specialists for hyperthermia presentations with suspected illicit drug use.