The term drug overdose (or simply overdose or OD) describes the ingestion or application of a drug or other substance in quantities greater than are recommended or generally practiced. Ingestion is the consumption of a substance by an Organism. In Animals it normally is accomplished by taking in the substance through the Mouth into the A drug, broadly speaking is any chemical substance that when absorbed into the body An overdose is widely considered harmful and dangerous as it can result in death. Death is the termination of the biological functions that define living Organisms It refers both to a specific

Contents 1 Types 2 Misconceptions 3 Symptoms 4 Diagnosis 5 First aid 5.1 Depressants 5.2 Stimulants 6 Prevention 7 Causes 8 Statistics 9 See also 10 References 11 External links

Types

The word "overdose" implies that there is a safe dosage; therefore, the term is commonly only applied to drugs, not poison. A drug, broadly speaking is any chemical substance that when absorbed into the body In the context of Biology, poisons are substances that can cause damage, Illness, or Death to Organisms usually by Drug overdoses are sometimes caused intentionally to commit suicide or as self-harm, but many drug overdoses are accidental and are usually the result of either irresponsible behavior or the misreading of product labels. Self-injury ( SI) or self-harm ( SH) is deliberate Injury inflicted by a person upon their own body without suicidal intent Drug overdose can be mimicked by use of multiple drugs with counter indications simultaneously (for instance, heroin/certain prescription pain medications and cocaine/amphetamines/alcohol. Heroin ( INN: diacetylmorphine, BAN: diamorphine) is a semi-synthetic opioid synthesized from Morphine, a derivative Cocaine ( benzoylmethyl ecgonine) is a Crystalline Tropane Alkaloid that is obtained from the leaves of the Coca plant Amphetamine, and related drugs such as Methamphetamine are a group of drugs that act by increasing levels of Norepinephrine, Serotonin, and Dopamine In Chemistry, an alcohol is any Organic compound in which a Hydroxyl group ( - O[[hydrogen H]]) is bound to a Carbon ) Usage of illicit drugs after a period of abstinence or of an unexpected purity can also induce overdose. Abstinence is a voluntary restraint from indulging a desire or appetite for certain bodily activities that are widely experienced as giving pleasure Cocaine users that inject intravenous can overdose accidentally as the margin between an optimal flash and an overdose is small. Cocaine ( benzoylmethyl ecgonine) is a Crystalline Tropane Alkaloid that is obtained from the leaves of the Coca plant An injection is an infusion method of putting Liquid into the Body, usually with a hollow needle and a Syringe which is pierced through ^[1]

A common unintentional overdose in young children involves multi-vitamins containing iron. Iron is a component of the hemoglobin molecule in blood, used to transport oxygen to living cells. Iron (ˈаɪɚn is a Chemical element with the symbol Fe (ferrum and Atomic number 26 Hemoglobin ( also spelled haemoglobin and abbreviated Hb or Hgb) is the Iron -containing Oxygen -transport Metalloprotein In Chemistry, a molecule is defined as a sufficiently stable electrically neutral group of at least two Atoms in a definite arrangement held together by Blood is a specialized Bodily fluid that delivers necessary substances to the body's cells ��such as nutrients and oxygen—and transports Waste products Oxygen (from the Greek roots ὀξύς (oxys (acid literally "sharp" from the taste of acids and -γενής (-genēs (producer literally begetteris the When taken in small amounts, iron allows the body to replenish hemoglobin, but in large amounts it causes severe pH imbalances in the body. pH is the measure of the acidity or alkalinity of a Solution. If this overdose is not treated with chelation therapy, it can lead to death or permanent coma. Chelation therapy is the administration of chelating agents to remove Heavy metals from the body In Medicine, a coma (from the Greek koma, meaning deep sleep is a profound state of Unconsciousness.

Misconceptions

Deaths caused by adulterated drugs, most commonly heroin, are often incorrectly attributed to overdose. Adulterants are Chemical substances which should not be contained within other substances (eg Heroin ( INN: diacetylmorphine, BAN: diamorphine) is a semi-synthetic opioid synthesized from Morphine, a derivative

Negative drug-drug interactions have sometimes been misdiagnosed as an acute drug overdose, occasionally leading to the assumption of suicide. ^[2]

Additionally, recent psychological research indicates that "overdose" may be, in many cases, a misnomer. Most deaths attributed to heroin overdose, for example, are not technically due to "overdose" in the pharmacological sense: in most cases, Canadian researcher Shepard Siegel found, heroin abusers died taking the same dose of heroin they normally injected. The principles of classical conditioning may provide a framework for understanding how heroin abusers can die taking the same dose of heroin they have taken many times before. Classical Conditioning (also Pavlovian or Respondent Conditioning) is a form of Associative learning that was first demonstrated by Ivan Pavlov There is compelling evidence that taking heroin in a new or different environment than usual may lead to overdose. In the terms of Pavlovian conditioning, the environment where the addict usually takes the drug (for example, if he always injects in the same room with the same people) serves as the conditioned stimulus, while the drug effect of heroin serves as the unconditioned stimulus. Classical Conditioning (also Pavlovian or Respondent Conditioning) is a form of Associative learning that was first demonstrated by Ivan Pavlov Classical Conditioning (also Pavlovian or Respondent Conditioning) is a form of Associative learning that was first demonstrated by Ivan Pavlov Classical Conditioning (also Pavlovian or Respondent Conditioning) is a form of Associative learning that was first demonstrated by Ivan Pavlov The body tends to try to maintain homeostasis, so it creates a compensatory response to counteract the effects of the drug. In the case of heroin, which decreases pain sensitivity and slows breathing, the body's compensatory response would be to increase pain sensitivity and speed up breathing. As the environment (CS) and drug effect (US) are paired over and over, the environment alone becomes sufficient to evoke the body's compensatory response to heroin. This compensatory response, triggered by the environmental cues alone, is the conditioned response. Classical Conditioning (also Pavlovian or Respondent Conditioning) is a form of Associative learning that was first demonstrated by Ivan Pavlov As Pavlov's dogs learned the salivate at the ring of a bell because the bell was often paired with food, a heroin user's body creates a chemical, opposing response to heroin when the proper environmental cues are present. For this reason, the heroin abuser becomes able to take larger and larger doses of the drug, because his body creates a stronger and stronger compensatory response to its effects. "Overdose" often (more than half the time) occurs when the heroin abuser injects in a new environment. In this case, the environmental cues are not present, so the body does not produce the compensatory response required to make the usual large dose of heroin tolerable. The result is often death. ^[3]

Combined Drug Intoxication or Multiple Drug Intake, is mistakenly reported by news medias as Drug overdose, but it is not the same. CDI does not require drug overdoseage to kill a person. Death is caused by the simultaneous use of too many drugs.

One of the most common drugs to be implicated in Combined Drug Intoxication deaths, or in non-lethal overdoses causing harm to the body is acetaminophen (or paracetamol as it is known in some countries), an analgesic that is available over the counter. Paracetamol ( INN) (ˌpærəˈsiːtəmɒl -ˈsɛtə- or acetaminophen ( USAN) is a widely-used Analgesic and Antipyretic Medication Paracetamol ( INN) (ˌpærəˈsiːtəmɒl -ˈsɛtə- or acetaminophen ( USAN) is a widely-used Analgesic and Antipyretic Medication While considered harmless and beneficial when taken at recommended dosages, acetaminophen can be acutely toxic to the liver when taken in amounts exceeding its recommended dosage; this toxicity is compounded when the drug is taken in combination with alcoholic beverages, especially by chronic drinkers and people with pre-existing liver disease such as hepatitis. Toxicity is the degree to which a substance is able to damage an exposed organism The liver is a vital organ in the human body and is present in Vertebrates and some other animals Hepatitis (plural hepatitides) implies injury to the Liver characterized by the presence of Inflammatory cells in the tissue of In addition, long-term use of acetaminophen at high dosage (and especially concurrent with alcohol) is a common cause of chronic damage to the liver. See the main article on Paracetamol for more information.

Since Paracetamol is not considered, by itself, an addictive medication, complications arising from its overuse are often referred to in medical literature as Paracetamol Poisoning. Paracetamol ( INN) (ˌpærəˈsiːtəmɒl -ˈsɛtə- or acetaminophen ( USAN) is a widely-used Analgesic and Antipyretic Medication The term " addiction " is used in many contexts to describe an obsession compulsion or excessive Physical dependence or psychological dependence such as However, since paracetamol is often contained in formulations which contain other drugs with a high potential for abuse, it is often ingested in amounts far exceeding its therapeutic dose in order to get a "high" from the coexisting drug. Pharmaceutical formulation, in Pharmaceutics, is the process in which different chemical substances are combined to a pure Drug substance to produce a final medicinal Abuse refers to the use or treatment of something (a person item substance concept or vocabulary that is harmful Examples include over-the-counter cough syrup and cold remedies which include, along with paracetamol, dextromethorphan, a cough suppressant that, when taken in high amounts, can cause hallucinations and euphoria (the name dextromethorphan is often abbreviated as "DXM", particularly among those who abuse it. A cough medicine is a medicinal drug used to treat Coughing and related conditions Dextromethorphan ( DXM or DM) is an Antitussive (cough suppressant drug found in many over-the-counter cold and Cough medicines A cough medicine is a medicinal drug used to treat Coughing and related conditions A hallucination, in the broadest sense is a Perception in the absence of a stimulus. Dextromethorphan ( DXM or DM) is an Antitussive (cough suppressant drug found in many over-the-counter cold and Cough medicines ) Because of its availability as an over-the-counter preparation in most jurisdictions (in brands such as Robitussin), DXM abuse is particularly popular among teenagers because it is easy to obtain. Robitussin is a brand of cold and Cough medicines produced by Wyeth Consumer Healthcare. Many preparations contain DXM by itself, without paracetamol, or with other medications which are less dangerous like Guaifenesin, making them seemingly 'safer' to take; however, other common ingredients in cough/cold remedies can be dangerous as well, particularly pseudoephedrine. Guaifenesin (gwaɪˈfɛnəsɪn ( INN) or guaiphenesin (former BAN) is an Expectorant drug usually taken orally (by mouth to assist Pseudoephedrine (commonly abbreviated as PSE is a sympathomimetic Amine commonly used as a Decongestant. It is common for a user to ingest an entire bottle of DXM-containing syrup to obtain the amount needed to get the wanted effects, which can deliver a dose of paracetamol (when present in the formulation) that is well above levels that can cause acute toxicitiy. Refer to the main article on DXM abuse for more information.

Paracetamol is also combined with many narcotic analgesics that are, in most countries, strictly regulated as controlled substances because of their highly abusive potential. See Dextromethorphan for info on the medical use of DXM and its chemical pharmacological and other misc information The term narcotic (ναρκωτικός is believed to have been coined by the Greek physician Galen to refer to agents that benumb or deaden causing loss When patients or recreational users of these medications (examples include the brand names Vicodin, Darvocet, and Oxycontin) ingest these drug combinations in large amounts, they risk acute paracetamol poisoning (and sometimes overdose of the desired narcotic) or, over time, chronic hepatic damage. Vicodin EC is a Trademarked Brand of Narcotic Analgesics (painkillers containing Hydrocodone and Paracetamol ( Acetaminophen Dextropropoxyphene is an Analgesic in the Opioid category It is used to treat mild to moderate pain and as an Anti-tussive. Oxycodone is an Opioid Analgesic Medication synthesized from Thebaine. The liver is a vital organ in the human body and is present in Vertebrates and some other animals The abuse of these medications is on the increase, despite the fact that most physicians who prescribe them supply the patient with only a limited quantity in order to prevent their potential for chronic use and abuse. A physician, medical practitioner or medical doctor who practices Medicine, and is concerned with maintaining or restoring human Health However, it is relatively simple for a user to find supplies of these medications, either on the street or by "jumping" from one physician to the other; dentists are often approached for prescriptions, since narcotic medications are given quite frequently to patients with dental pain, due to their efficacy in pain management for many dental problems. A toothache, also known as odontalgia or less frequently as odontalgy, is an aching Pain in or around a Tooth. Efficacy is the capacity to produce a desired size of an effect under Ideal or Optimal conditions However, most dentists give prescriptions for a very limited supply of a narcotic analgesic, because, with treatment, most cases of tooth pain are relatively short-lived. An opioid is a chemical Substance that has a Morphine -like action in the body NSDEA

Symptoms

Symptoms of overdose occur in various forms:

• Exaggerated form of normal action (e. g. , sleepiness on antiepileptics, hypoglycemia on insulin)
• Other effects due to chemical properties of the medication (e. Somnolence (or " drowsiness " is a state of near- Sleep, a strong desire for sleep or sleeping for unusually long periods (c Hypoglycemia or hypoglycaemia is the medical term for a pathologic state produced by a lower than normal level of Glucose ( sugar) in the blood Insulin is a Hormone with intensive effects on both metabolism and several other body systems (eg vascular compliance g. , metabolic acidosis in aspirin, liver failure due to paracetamol)
• Non-specific symptoms due to central nervous system irritation (e. In Medicine, metabolic acidosis is a process which if unchecked leads to acidemia (i Aspirin, or acetylsalicylic acid (ASA (əˌsɛtɨlsælɨˌsɪlɨk ˈæsɨd is a Salicylate drug, often used as an Analgesic to relieve Liver failure is the inability of the Liver to perform its normal synthetic and metabolic function as part of normal physiology Paracetamol ( INN) (ˌpærəˈsiːtəmɒl -ˈsɛtə- or acetaminophen ( USAN) is a widely-used Analgesic and Antipyretic Medication In Vertebrates the central nervous system ( CNS) is the part of the Nervous system which is enclosed in the Meninges. g. , confusion, vertigo, nausea, vomiting, delirium, seizures)

Diagnosis

Diagnosis of an overdosed patient is generally straightforward if the drug is known. Confusion, of a Pathological degree usually refers to loss of orientation (ability to place oneself correctly in the world by time location and personal identity and Vertigo (from the Latin vertere, to turn and the suffix -igo, a condition i Nausea ( Latin: Nausea, Greek:, " Sea-sickness " also called wamble) is the sensation of unease and discomfort Vomiting (also called throwing up, emesis) is the forceful expulsion of the contents of one's Stomach through the Mouth and sometimes the Delirium is an acute and relatively sudden (developing over hours to days decline in attention-focus perception and Cognition. An epileptic seizure is caused by excessive and/or hypersynchronous electrical Neuronal activity and is usually self-limiting However, it can be very difficult if the patient cannot (or refuses to) state what drug they have overdosed on. At times, certain symptoms and signs exhibited by the patient, or blood tests, can reveal the drug in question. Even without knowing the drug, most patients can be treated with general supportive measures.

In some instances, antidotes may be administered if there is sufficient indication that the patient has overdosed on a particular type of medication. An antidote or counterdose is a substance which can counteract a form of Poisoning. Naloxone in opioids and flumazenil in benzodiazepines, are specific receptor antagonists and they reverse completely the effect of the poisoning drug. Naloxone is a drug used to counter the effects of Opioid overdose, for example Heroin or Morphine overdose An opioid is a chemical Substance that has a Morphine -like action in the body Flumazenil (also known as flumazepil, code name Ro 15-1788, trade names Anexate, Lanexat, Mazicon, Romazicon The benzodiazepines (pronounced, often abbreviated to "benzos") are a class of Psychoactive drugs with varying Hypnotic A receptor antagonist is a type of receptor ligand or Drug that does not provoke a biological response itself upon binding to a receptor, but blocks

First aid

Depressants

First aid can prevent a death from overdose of depressants, as it may take several hours for someone to die in these cases. The common drugs in this category include opiates (ie. heroin, morphine and methadone), alcohol, and certain prescription drugs (such as Benzodiazepines). The benzodiazepines (pronounced, often abbreviated to "benzos") are a class of Psychoactive drugs with varying Hypnotic Signs of overdose are those of a depressed central nervous system — slow, infrequent or shallow breathing, blue lips or fingernails, cold or pale skin, slow or faint pulse, snoring or gurgling noises, and the inability to be aroused from nodding off (unresponsiveness).

• The first step is to stay calm and try to get a response from the person by pinching the back of their arm, calling their name, or rubbing your knuckles against their chest.
• If there is no response, check to make sure their airway is not blocked and see if they are breathing.
• If insufficient breathing or a weak or non-existent pulse, commence cardiopulmonary resuscitation. ^[4]Modern CPR methods suggest a lack of normal breathing only (i. e. no pulse check necessary), because detecting a faint pulse can be difficult for a layperson. However, if these signs are present, roll the person in question on his/her side into the recovery position. The recovery position or more technically known as the lateral recumbent position is a First aid technique recommended for assisting people who are unconscious
• Call an ambulance. Ideally, someone should call an ambulance immediately while another person evaluates the patient and performs CPR if necessary.

Stimulants

People can overdose on stimulants, such as amphetamines, and cocaine, with symptoms such as rapid heartbeat, muscle cramps, seizures, paranoia, psychosis, confusion, loss of control of movement, vomiting, lack of consciousness, and possibly cardiac arrest. Amphetamine psychosis is a form of Psychosis which can result from Amphetamine or Methamphetamine use A cardiac arrest, also known as cardiorespiratory arrest, cardiopulmonary arrest or circulatory arrest, is the abrupt cessation of normal circulation of It can result in an often fatal condition known as excited delirium. Excited delirium is a controversial term used to explain deaths of individuals in police custody in which the person being arrested detained or restrained is highly agitated and may Delirium is an acute and relatively sudden (developing over hours to days decline in attention-focus perception and Cognition.

First aid in these cases involves staying with the person and helping them to remain calm. Move them to a quiet area, and where possible, apply a wet cloth to their neck or forehead. If unconscious, place them in the recovery position and call an ambulance. The recovery position or more technically known as the lateral recumbent position is a First aid technique recommended for assisting people who are unconscious ^[4]

Prevention

• Refrain from mixing depressant drugs like alcohol, barbiturates, benzodiazepines, and opiates together. ^[5]
• Start with small amounts, in order to estimate the potency of a drug.
• Be careful when taking a drug after a period of abstinence, as your tolerance may be drastically lowered.
• If you have a pharmaceutical chemical, make sure it is not expired. Toxicity can increase drastically.

Causes

Common types of drugs that are overdosed on:

• Barbiturates
  • Seconal
  • Nembutal
• Benzodiazepines
  • Temazepam
  • Triazolam
• Narcotics
  • Morphine
  • Heroin
• Stimulants
  • Methamphetamine
  • Cocaine
• Ethyl Alcohol
  • Alcoholic beverages
• Prescription drugs
  • Drug "cocktails", or a combination of numerous drugs

Statistics

While they do not give separate figures for drug overdoses and other kinds of accidental poisoning, the National Center for Health Statistics report that 19,250 out of 30,000 people died of accidental poisoning in the U. A psychoactive drug or psychotropic substance is a Chemical substance that acts primarily upon the Central nervous system where it alters Brain Barbiturates are drugs that act as central nervous system Depressants and by virtue of this they produce a wide spectrum of effects from mild Sedation Secobarbital (marketed by Eli Lilly and Company under the brand name Seconal) is a Barbiturate derivative drug Pentobarbital is a short-acting Barbiturate that is available as both a Free acid and a Sodium salt, the former of which is only slightly soluble in water The benzodiazepines (pronounced, often abbreviated to "benzos") are a class of Psychoactive drugs with varying Hypnotic Temazepam (marketed under brand names Restoril, Euhypnos, Normison, Remestan, Tenox and Norkotral) is an intermediate-acting Triazolam (marketed under brand names Halcion, Novodorm, Songar) is a Benzodiazepine derivative drug The term narcotic (ναρκωτικός is believed to have been coined by the Greek physician Galen to refer to agents that benumb or deaden causing loss Medical uses Morphine can be used as an analgesic in hospital settings to relieve pain in Myocardial infarction pain in Heroin ( INN: diacetylmorphine, BAN: diamorphine) is a semi-synthetic opioid synthesized from Morphine, a derivative Stimulant drugs are Drugs that temporarily increase alertness and awareness Cocaine ( benzoylmethyl ecgonine) is a Crystalline Tropane Alkaloid that is obtained from the leaves of the Coca plant A prescription drug is a licensed medicine that is regulated by legislation to require a prescription before it can be obtained National Center for Health Statistics ( NCHS) is part of the Centers for Disease Control and Prevention (CDC which is part of the United States Department of S. in the year 2004. ^[6]

See also

• List of deaths by accidental drug overdose
• Combined Drug Intoxication
• Suicide

References

External links

• Fact sheets on illicit drugs, overdose prevention, detox and harm reduction strategies.

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