Overdose

ABOUT OVERDOSE

Abstaining from drugs and alcohol is the only way to keep yourself 100% safe from harms associated with their use. However, this is not a realistic goal for everyone, at all times. Practising moderation and knowing strategies for safer use increase your chances of staying safe and healthy if you use drugs and alcohol.

Overdose is a real risk of drug uses, especially if you combine drugs with other drugs (illegal, over-the-counter, or prescription) or alcohol. Anyone can overdose – first-time users, long-time users, and everyone in between. There is no exact formula for determining how much of a certain drug you can take without overdosing. Individual factors such as a person’s weight, health, or tolerance for a drug; drug potency; route of administration; and speed of use can all play a role in how much a person’s body can handle.

If you use drugs, or even if you don’t use them yourself, but party with people who do, it’s important to know what to do in case of an overdose. Overdose symptoms and treatment are different for different drugs, and the proper response can save someone’s life (or your own.)

For the purposes of talking about overdose, drugs fall into two broad categories – depressants, which slow down central nervous system functions, and stimulants, which speed up central nervous system processes.

Widely used depressants include opiates (such as heroin, methadone, and opium), benzodiazepines (such as Valium and Klonopin), barbiturates (such as phenobarbital), and alcohol. GHB and Ketamine are also depressants.

A person overdosing on depressants may become unresponsive or unconscious, vomit, have difficulty breathing, or stop breathing. Most fatal overdoses are the result of breathing failure.

Widely used stimulants include cocaine and amphetamine-type stimulants (ATS), including speed, methamphetamine, and ecstasy. Poppers (amyl nitrite), while classified as an inhalant and not a stimulant, makes the heart speed up.

Although less common than depressant overdoses, stimulant overdoses do occur. A person overdosing on stimulants may have seizures, suddenly collapse or lose consciousness, stop breathing, or experience stroke or heart attack.


ALCOHOL OVERDOSE

Alcohol poisoning or overdose can happen when someone drinks a lot of alcohol in a short period of time. Drinking too much too fast can affect a person’s breathing, heart rate and gag reflex. It can also lead to coma or death. Youth, who are not as familiar with the effects of alcohol, and tend to drink in more risky ways, are especially vulnerable. A person with alcohol poisoning needs immediate medical attention. If you suspect someone has alcohol poisoning, call 911 or your local poison control center right away.

Tips for preventing alcohol poisoning

  • Know your limit. Most people find they can have one drink per hour without any harmful effects, with an advised maximum of four drinks (for men) or three (for women) on any one day.
  • Eat food while you drink. Food, especially high protein food such as meat, cheese and peanuts, will help slow the absorption of alcohol into your body.
  • Don’t participate in “chugging” contests or other drinking games.
  • Have a non-alcoholic drink between alcoholic ones. This will help keep your blood alcohol content level down.
  • Don’t just sit around and drink. If you stay active you tend to drink less and to be more aware of any effects alcohol may be having on you.

What to do if someone has alcohol poisoning

People experience the effects of alcohol differently. If a large amount of alcohol is in a person’s system, it can result in unconsciousness.

  • Try to wake the person up by calling their name, shaking or pinching them. If they don’t respond, get help.
  • Put the person in the recovery position so they will not choke to death on their vomit if they get sick.
  • Check the person’s skin. If his or her skin is pale or bluish, or is cold or clammy, get help.
  • Check the person’s breathing. If it is irregular, or too slow or shallow (less than eight breaths per minute or more than 10 seconds between breaths), get help.
  • If you discover any of the above problems, stay with the person and call 911. It is important to contact emergency services quickly.

If you aren’t sure what to do, it’s always better to be safe than sorry. Get help if you suspect an alcohol overdose, even if the person is underage.

The recovery position

If someone passes out from drinking too much, you can help by putting them in the recovery position. The most important thing is to keep the person’s airway open so fluids like vomit can drain from their mouth.

  • Raise the person’s closest arm above their head. Prepare the person to roll toward you.
  • Gently roll the person’s entire body toward you. Guard their head while you roll them.
  • Tilt the person’s head to keep their airway open. Tuck their nearest hand under their cheek to help keep their head tilted.
  • Do not leave the person alone. Stay with them until help arrives.

HEROIN OVERDOSE

The main factors that contribute to heroin overdose are: variability in potency of the drug; decreased tolerance due to not using for even just a few days; switching to a more direct administration route (such as from sniffing to injecting); and mixing heroin with other drugs, especially depressants and alcohol.

Symptoms of heroin overdose include unconsciousness, lack of pulse, slowed breathing or respiratory failure. If someone experiences these symptoms:

  • Call 911 immediately.
  • Begin rescue breathing.
  • Because there are antidotes to opioids, when the paramedics arrive, it is very important to tell them what the person used.
  • Put the person in a position that makes it easy for them to breathe.
  • Monitor the person. Do not leave someone who’s overdosing alone.
  • If you have to leave to call for help or any other reason, put the person on their side so that he or she will be unlikely to choke if they vomit.
  • Do not give the person anything to drink, or induce vomiting – this could cause choking.

About Naloxone

Naloxone, commonly called Narcan®, is a drug used to counter the effects of an opiate (i.e. heroin or morphine) overdose.  It has been the standard care for emergency departments and paramedics for the past few decades. Naloxone works by binding to the opioid receptor in the brain and reversing the depression of the central nervous and respiratory systems.  It “tricks” the brain into thinking there are no opiates in the body.  If someone is overdosing on an opiate, administering naloxone can speed up their breathing and temporarily bring them out of an overdose. For more information about naloxone visit the Chicago Recovery Alliance.

COCAINE OVERDOSE

Because the euphoric feelings produced by cocaine wear off before the entire dose is eliminated from the body, repeated doses, especially in combination with other drugs or alcohol, increase overdose risk. Unlike methamphetamine or other amphetamines, cocaine also has direct toxic effects on the heart and circulatory system that make it, in comparison to other stimulants, more dangerous in terms of overdose risk.

High or frequent doses can cause increased blood pressure, dangerous rise in body temperature, delirium, seizures, strokes, heart attacks, and death.

If someone who has taken cocaine exhibits any of these symptoms, the following actions should be taken:

  • Call 911 immediately.
  • Try to keep the individual hydrated, conscious, and as calm as possible.
  • Try to keep the individual’s body temperature from rising too quickly. Place cool, wet cloths under the armpits, on back of knees, and/or on the forehead to keep body temperature at a safe level.
  • In the event someone’s heart has stopped beating, begin CPR.

METH/AMPHETAMINE OVERDOSE

Meth/amphetamine users tend to re-dose every 3-8 hours to maintain the euphoria and avoid the “crash” and resultant depression of coming down. The longer the session, the larger the dose needed to produce the desired effects. Although rare, repeated use in this way may result in overdose.

A person experiencing meth/amphetamine overdose may experience the following symptoms:

  • Psychosis
  • Severe agitation
  • Severe headache
  • Severe sweating
  • Severe muscle spasms or rigidity
  • Rapidly escalating body temperature
  • Racing pulse
  • Chest pains
  • Seizures
  • Stroke
  • Cardiac arrest

If someone who has taken meth/amphetamines exhibits any of these symptoms, the following actions should be taken:

  • Call 911.
  • Try to keep the individual hydrated, conscious, and as calm as possible.
  • Try to keep the individual’s body temperature from rising too quickly. Place cool, wet cloths under the armpits, on back of knees, and/or on the forehead to keep body temperature at a safe level.
  • In the event someone’s heart has stopped beating, begin CPR.

ECSTASY (MDMA) OVERDOSE

Actual Ecstasy overdose is rare. When it occurs is most often linked to dehydration and heat-stroke, due to users dancing in hot clubs for long periods of time; or to the mixing of Ecstasy with other drugs or alcohol.

Counterfeit Ecstasy – ecstasy that has been mixed with other ingredients such as speed, caffeine, PMA (a dangerous stimulant), Ketamine, PCP, cocaine, atropine, and other substances – is common, and poses a potentially serious risk to users. If someone who has taken ecstasy appears to be overdosing, respondents should react based on the person’s symptoms, even if they are not characteristic to ecstasy use.

Symptoms of dehydration and heat-stroke include:

  • Failure to sweat
  • Cramps in the legs, arms and back
  • Giddiness, dizziness, headache, fatigue
  • Vomiting
  • Fainting or loss of consciousness
  • Suddenly feeling really tired, irritable and confused

If someone experiences these symptoms or collapses:

  1. Call 911
  2. Get the person to a cool place.
  3. If they are conscious, give them water.
  4. Drench them with water (as cold as possible) to decrease their body temperature.
  5. Tell medical responders what the person has taken (if you know) and that they may have heat-stroke.

HIV-positive people who take the protease inhibitor Ritonavir should not take ecstasy because of a potentially life-threatening interaction.

GHB

High doses of GHB, especially mixed with other depressants or alcohol can cause vomiting, muscle spasms, loss of consciousness, slowed breathing, and respiratory failure.

If someone shows symptoms of GHB overdose:

  • Call 911 immediately.
  • If they are not breathing, begin rescue breathing.
  • Put them on their side so they don’t choke if they vomit.

KETAMINE

High doses of ketamine can depress consciousness and breathing. It is extremely dangerous to combine ketamine with other depressants like alcohol, Valium or GHB.

Injecting ketamine increases the risk of overdose.

If someone who has taken ketamine becomes unconscious or stops breathing

  • Call 911 immediately.
  • If they are not breathing, begin rescue breathing.
  • Put them on their side so they don’t choke if they vomit.

HOW TO REDUCE THE RISK OF OVERDOSE

Don’t Mix Drugs With Other Drugs or Alcohol.

Drugs taken together can interact in ways that increase their overall effect.  Mixing drugs of the same class is one of the most common reasons for overdose. Such combinations include cocaine with other stimulants like speed and ecstasy, or using alcohol with heroin and other downers. Many overdoses occur when people mix heroin and/or alcohol with benzodiazepines such as Klonopin, Valium, and Xanax.  Most fatal overdoses are the result of poly-drug use.

If You Do Mix Drugs, reduce the amount of all drugs used, and use slowly.

Don’t Use Alone. Using alone increases the chance of dying if you overdose and become unconscious or stop breathing.

If You Do Use Drugs Alone, and you are afraid you are overdosing, call 911, unlock the door, and tell the person on the phone what you have taken.

If You Are Using Drugs, Make Sure Someone Knows What You Have Taken.

Know Your Tolerance.

A person’s tolerance for a drug or combination of drugs can change for many reasons, including: weight gain or lost, depression, exhaustion, overall change in health, and if he or she is resuming use after a period of abstinence. People should be extremely mindful of reduced tolerance if they are resuming drug use after incarceration, drug treatment, detox, or self-imposed hiatus. To keep from overdosing due to lowered tolerance:

  • Decrease your usual dose.
  • Take control of your own drug preparation and intake
  • Divide your normal dose in half, do a tester shot, and allow the drugs time to take effect before you do more.
  • Change your route of administration to something that gets you high more slowly. If you usually inject, try snorting.
  • Use with someone else who knows how to help in case you overdose.

If You Have a New Dealer or Unfamiliar Supply, Use a Small Amount at First to See How Strong It Is.

Snort or Smoke Drugs Rather Than Inject Them. Injecting is more likely to cause overdose.

If You Do Inject Drugs, Inject Slowly. “Slamming,” i.e. pushing in the entire shot quickly and at once, is more likely to cause overdose.

If You Switch to Injecting From Snorting or Smoking, Use a Smaller Dose Than Usual.

Take Pills Orally Instead of Injecting Them, Especially if You Are Mixing Pills With Other Drugs or Alcohol. Wait for Pills to Take Effect Before Drinking Alcohol or Using Other Drugs.

If You are HIV-Positive, Don’t Use Antiretrovirals With Other Drugs. Since both illegal and prescription drugs are often metabolised by the same body systems, there is great potential for negative interactions to occur.

To Reduce the Risk of Overdose From So-Called “Date-Rape Drugs,” Don’t Take Drinks From Strangers or Leave Your Drinks Unattended in a Public Setting. For More Information, Please Visit SafeVibe.

Don’t Play Drinking Games. Drinking large quantities of alcohol quickly can easily lead to alcohol overdose or increase the chance of overdosing if you are also using other drugs.

If Someone Appears Very High, Stay With Them and Monitor Them to Make Sure They Don’t Go Into Overdose Once the Drugs Take Full Effect.

IF SOMEONE OVERDOSES, CALL 911. If you are afraid to say it’s an overdose, say you are with a friend who isn’t breathing. When the ambulance arrives, however, it’s better to be clear and precise about what happened and what drugs the person took.

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