Drug overdose
Drug overdose | |
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Other names | Overdose, OD, Hotshot, Wasted, Intoxication, Gassed, Medicinal Poisoning |
A photograph showing a person who had overdosed | |
Specialty | Toxicology |
Symptoms | Vary depending on the drug and the amount used |
Complications |
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Causes |
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Risk factors | |
Differential diagnosis |
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Treatment |
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A drug overdose (overdose or OD) is the ingestion or application of a drug or other substance in quantities much greater than are recommended.[2][3] Typically it is used for cases when a risk to health will potentially result.[2] An overdose may result in a toxic state or death.[3]
Classification
The word "overdose" implies that there is a common safe dosage and usage for the drug; therefore, the term is commonly applied only to drugs, not poisons, even though many poisons as well are harmless at a low enough dosage. Drug overdose is sometimes used as a means to commit suicide, as the result of intentional or unintentional misuse of medication. Intentional misuse leading to overdose can include using prescribed or non-prescribed drugs in excessive quantities in an attempt to produce euphoria.
Usage of
The term 'overdose' is often misused as a descriptor for adverse drug reactions or negative drug interactions due to mixing multiple drugs simultaneously.
Signs and symptoms
Symptoms | Blood pressure |
Heart rate | Respiratory rate |
Temperature | Pupils |
Bowel sounds |
Diaphoresis
|
---|---|---|---|---|---|---|---|
Anticholinergic | ~ [clarification needed] |
up | ~ | up | dilated | down | down |
Cholinergic | ~ | ~ | unchanged | unchanged | constricted | up | up |
Opioid | down | down | down | down | constricted | down | down |
Sympathomimetic |
up | up | up | up | dilated | up | up |
Sedative-hypnotic | down | down | down | down | ~ | down | down |
Signs and symptoms of an overdose vary depending on the drug or exposure to toxins. The symptoms can often be divided into differing toxidromes. This can help one determine what class of drug or toxin is causing the difficulties.
Symptoms of
Causes
The drugs or toxins that are most frequently involved in overdose and death (grouped by ICD-10):
- Acute alcohol intoxication(F10)
- Ethyl alcohol
- Methanol poisoning
- Ethylene glycol poisoning
- Opioid overdose (F11)
- Among sedative-hypnotics (F13)
- Barbiturate overdose (T42.3)
- Benzodiazepine overdose (T42.4)
- Uncategorized sedative-hypnotics (T42.6)
- Ethchlorvynol (Placidyl)
- GHB
- Glutethimide (Doriden)
- Methaqualone
- Ketamine (T41.2)
- Among stimulants (F14-F15)
- Cocaine overdose(T40.5)
- Amphetamine overdose (T43.6)
- Methamphetamine overdose (T43.6)
- Among tobacco (F17)
- Nicotine poisoning (T65.2)
- Among poly drug use(F19)
- Drug "cocktails" (speedballs)
- Medications
- Aspirin poisoning(T39.0)
- Paracetamol poisoning (Alone or mixed with oxycodone)
- Paracetamol toxicity(T39.1)
- Tricyclic antidepressant overdose (T43.0)
- Vitamin poisoning
- Pesticide poisoning (T60)
- Inhalants
- Lithium toxicity
Added flavoring
Masking undesired taste may impair judgement of the
Diagnosis
The substance that has been taken may often be determined by asking the person. However, if they will not, or cannot, due to an altered level of consciousness, provide this information, a search of the home or questioning of friends and family may be helpful.
Examination for
Prevention
The distribution of
Supervised injection sites (also known as overdose prevention centers) have been used to help prevent drug overdoses by offering opioid reversal medications such as naloxone, medical assistance and treatment options. They also provide clean needles to help prevent the spread of diseases like HIV/AIDS and hepatitis.[19][20][21][22]
Management
Stabilization of the person's airway, breathing, and circulation (
Antidotes
Specific
Epidemiology and statistics
The examples and perspective in this section may not represent a worldwide view of the subject. (December 2022) |
The UN gives a figure of 300,000 deaths per year in the world through drug overdose.
1,015,060 US residents died from drug overdoses from 1968 to 2019. 22 people out of every 100,000 died from drug overdoses in 2019 in the US.[26] From 1999 to Feb 2019 in the United States, more than 770,000 people have died from drug overdoses.[27]
In the US around 107,500 people died in the 12-month period ending August 31, 2022, at a rate of 294 deaths per day.[28] 70,630 people died from drug overdoses in 2019.[29] The U.S. drug overdose death rate has gone from 2.5 per 100,000 people in 1968 to 21.5 per 100,000 in 2019.[26]
The National Center for Health Statistics reports that 19,250 people died of accidental poisoning in the U.S. in the year 2004 (eight deaths per 100,000 population).[30]
In 2008 testimony before a Senate subcommittee, Leonard J. Paulozzi,[31] a medical epidemiologist at the Centers for Disease Control and Prevention said that in 2005 more than 22,000 American people died due to overdoses, and the number is growing rapidly. Paulozzi also testified that all available evidence suggests unintentional overdose deaths are related to the increasing use of prescription drugs, especially opioid painkillers.[32] However, the vast majority of overdoses are also attributable to alcohol. It is very rare for a victim of an overdose to have consumed just one drug. Most overdoses occur when drugs are ingested in combination with alcohol.[33]
Drug overdose was the leading cause of injury death in 2013. Among people 25 to 64 years old, drug overdose caused more deaths than motor vehicle traffic crashes. There were 43,982 drug overdose deaths in the United States in 2013. Of these, 22,767 (51.8%) were related to prescription drugs.[34]
The 22,767 deaths relating to prescription drug overdose in 2013, 16,235 (71.3%) involved opioid painkillers, and 6,973 (30.6%) involved
-
U.S. yearly overdose deaths from all drugs.[29]
-
U.S. yearly overdose deaths involvingbenzodiazepines.[29]
-
U.S. overdose deaths involving allopioids. Deaths per 100,000 population.[36]
-
U.S. yearly deaths involving prescription opioids. Non-methadone synthetics is a category dominated by illegally acquired fentanyl, and has been excluded.[29]
-
US yearly overdose deaths, and the drugs involved. Among the 70,200 deaths in 2017, the sharpest increase occurred among deaths related to fentanyl and fentanyl analogs (synthetic opioids) with 28,466 deaths.[29]
See also
- 27 Club
- Adulterants
- Brandon Vedas
- Drug checking
- Drug interactions
- Hepatotoxicity
- List of deaths from drug overdose and intoxication
- List of pop musicians who died of drug overdose
- Responsible drug use
- Suicide methods § Drug overdose
- Water intoxication
References
- ^ Fentanyl. Image 4 of 17. US DEA (Drug Enforcement Administration). See archive with caption: "photo illustration of 2 milligrams of fentanyl, a lethal dose in most people".
- ^ a b Definitions Archived February 27, 2011, at the Wayback Machine Retrieved on September 20, 2014.
- ^ a b "Stairway to Recovery: Glossary of Terms" Archived July 9, 2011, at the Wayback Machine. Retrieved on March 19, 2021
- ^ NCHS Data Visualization Gallery—Drug Poisoning Mortality. From National Center for Health Statistics. Open the dashboard dropdown menu and pick "U.S. Trends". From the menus on the right pick all races, all ages, and both sexes. Run your cursor over the graph to see the data.
- ^ Study on fatal overdose Archived January 19, 2012, at the Wayback Machine in New-York City 1990-2000, visited May 11, 2008,
- ^ "What to do with leftover medicines". Medicines Talk, Winter 2005. Available at "What to do with left-over medicines: National Prescribing Service Ltd NPS". Archived from the original on October 24, 2009. Retrieved January 6, 2010.
- ISBN 0-8385-3148-2.
- ^ Chandler, Stephanie. "Symptoms of an opiate overdose". Live Strong. Archived from the original on April 18, 2012. Retrieved May 17, 2012.
- ^ "T.I. Arrest -- Sippin' on Sizzurp?". TMZ. September 2, 2010. Retrieved August 19, 2019.
- ^ Melissa Leon (March 17, 2013). "Lil Wayne Hospitalization: What the Hell Is Sizzurp?". The Daily Beast.
- ^ Tamara Palmer (2005). Country Fried Soul: Adventures in Dirty South Hip-hop. Outline Press Limited. p. 188.
- ^ "Column—Fatal Drug-Drug Interaction As a Differential Consideration in Apparent Suicides" Archived February 23, 2008, at the Wayback Machine.
- S2CID 31367375.
- ^ "Community-Based Opioid Overdose Prevention Programs Providing Naloxone—United States, 2010". Centers for Disease Control and Prevention. December 2010. Archived from the original on September 9, 2017.
- PMID 21668761.
- SSRN 1437163. Archived (PDF) from the original on January 27, 2023 – via Boonshoft School of Medicine.
- PMID 17146712.
- ^ Lavoie D. (April 2012). "Naloxone: Drug-Overdose Antidote Is Put In Addicts' Hands". Huffington Post. Archived from the original on May 18, 2012.
- ^ Oladipo, Gloria (November 30, 2021). "New York to open supervised injection sites in bid to curb overdose deaths". The Guardian. Retrieved December 1, 2021.
- ^ Kim, Lisa (November 30, 2021). "NYC Close To Opening Supervised Injection Sites To Prevent Overdoses, After Years Of Setbacks, Report Says". Forbes. Retrieved December 1, 2021.
- ^ "What's The Evidence That Supervised Drug Injection Sites Save Lives?". NPR. September 7, 2018. Retrieved December 1, 2021.
- PMID 29138158.
- ISBN 978-0-19-856837-7.
- ^ PMID 20956228.
- US Drug Enforcement Administration. Archivedfrom the original on November 15, 2023. Retrieved November 15, 2023.
- ^ a b Data is from these saved tables from CDC Wonder at the Centers for Disease Control and Prevention, National Center for Health Statistics. The tables have totals, rates, and US populations per year.
- 1968-1978 data: Compressed Mortality File 1968-1978. CDC WONDER Online Database, compiled from Compressed Mortality File CMF 1968-1988, Series 20, No. 2A, 2000. Accessed at http://wonder.cdc.gov/cmf-icd8.html on March 13, 2021, 5:04:32 PM.
- 1979-1998 data: Compressed Mortality File 1979-1998. CDC WONDER On-line Database, compiled from Compressed Mortality File CMF 1968-1988, Series 20, No. 2A, 2000 and CMF 1989-1998, Series 20, No. 2E, 2003. Accessed at http://wonder.cdc.gov/cmf-icd9.html on March 13, 2021, 5:19:27 PM.
- 1999-2019 data: Multiple Cause of Death 1999-2019. CDC WONDER Online Database, released in 2020. Data are from the Multiple Cause of Death Files, 1999-2019, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/mcd-icd10.html on March 13, 2021, 5:05:13 PM.
- ^ STATCAST—Week of September 9, 2019. NCHS Releases New Monthly Provisional Estimates on Drug Overdose Deaths. National Center for Health Statistics.
- ^ Products - Vital Statistics Rapid Release - Provisional Drug Overdose Data. Centers for Disease Control and Prevention. Hover cursor over the end of the graph in Figure 1A to get the latest number. Scroll down the page and click on the dropdown data table called "Data Table for Figure 1a. 12 Month-ending Provisional Counts of Drug Overdose Deaths". The number used is the "predicted value" for the 12 month period that is ending at the end of that month. That number changes as more info comes in. If there are problems use a different browser.
- ^ a b c d e f g Overdose Death Rates. And Archived 2015-11-28 at the Wayback Machine. By National Institute on Drug Abuse.
- ^ Referral Page—FASTSTATS—Accidents or Unintentional Injuries Archived July 15, 2017, at the Wayback Machine Retrieved on September 20, 2014.
- ^ CDC Expert, Leonard J. Paulozzi, MD, MPH Archived February 20, 2014, at the Wayback Machine Retrieved on September 20, 2014.
- ^ CDC Washington Testimony March 5, 2008 Archived July 15, 2017, at the Wayback Machine Retrieved on September 20, 2014.
- ^ "The Persistent, Dangerous Myth of Heroin Overdose" Archived March 23, 2015, at the Wayback Machine.
- ^ "Understanding the Epidemic | Drug Overdose | CDC Injury Center" Archived September 9, 2017, at the Wayback Machine.
- ^ "Prescription Opioid Overdose Data | Drug Overdose | CDC Injury Center" Archived January 18, 2017, at the Wayback Machine.
- ^ Opioid Data Analysis and Resources. Drug Overdose. CDC Injury Center. Centers for Disease Control and Prevention. Click on "Rising Rates" tab for a graph. See data table below the graph.
Further reading
- Nelson, Lewis H.; Flomenbaum, Neal; Goldfrank, Lewis R.; Hoffman, Robert Louis; Howland, Mary Deems; Neal A. Lewin (2015). Goldfrank's toxicologic emergencies. New York: McGraw-Hill, Medical Pub. Division. ISBN 978-0-07-143763-9.
- Olson, Kent C. (2004). Poisoning & drug overdose. New York: Lange Medical Mooks/McGraw-Hill. ISBN 0-8385-8172-2.