Be wary of accidentally overdosing on drugs

It’s Saturday night. After a long night of partying, your
friend throws up and passes out. Will he or she: (1) wake up
tomorrow afternoon with a blinding headache, snarling adorably at
the world; or (2) choke, stop breathing, and fall into a coma?

By now most of us can recite the dangers associated with
intoxicated behavior ““ like date rape, suicidal depression,
paranoia attacks, invincibility and fighting with large groups of
thick-necked men.

If you plan on doing more than a little experimenting with drugs
and alcohol, learn its long-term effects and get help for substance
abuse and dependence. Most importantly, know that accidental
overdoses can easily happen.

Overdose occurs after you take the drug, but before it hits your
organs. The amount needed to overdose varies by individual, health
status, drug preparation and purity, administration (smoked, shot
up, snorted, drunk), speed of ingestion, and other substances used
simultaneously. Heroin with cocaine is one such lethal
combination.

Also, beware of mixing substances with regular medications,
including painkillers (like Tylenol), birth control pills and
antidepressants. They travel to the same organs ““ especially
the liver and the brain ““ and can collide with fatal
consequences or at least make your birth control pills
ineffective.

In possible overdose of sedatives ““ and, to a lesser
degree, alcohol and opiates ““ maintain the airway, keep the
person awake and responsive. Keep the person upright or on his
side, and don’t try anything that will slow getting to the
hospital.

Too much alcohol can bring about slowed breathing and seizures.
After that comes shock and in severe cases, coma and even
death.

But to vomit, you don’t have to be completely gone.
Alcohol suppresses the gag reflex, causing you to inhale the
vomitus (which is highly acidic thanks to gastric juices), causing
lung inflammation in response to the acidity and irritation. This
can lead to pneumonia and respiratory crisis. Led Zeppelin’s
John Bonham and many others have gone this way. So try not to lie
flat on your back when the alcohol starts to make you feel really
sick and sleepy.

Sedatives (nerve pills, tranks, downers), including
benzodiazepines (Valium, Halcion, Ativan and Xanax) and
barbiturates (red devils, goof balls, yellow jackets, Christmas
trees) can easily lead to accidental overdose when mixed with
alcohol. They are also very potent agents of overdose when used by
themselves. Your breathing slows, consciousness wanes, blood
pressure drops, and you may even go into shock.

Opioids, such as heroin, opium, codeine and morphine, are also
high risks for overdose because large quantities of these drugs can
be shot up into your body all at once. Signs of overdose include
slowed breathing, tiny pupils, skin flushing and difficulty
breathing, which can be followed by coma or even death.

Overdosing on amphetamines such as crystal meth, crank and
speed, can make you more hyperactive and paranoid. These substances
raise your blood pressure, increasing the risk for a heart
attack.

An overdose of cocaine and crack can induce seizures, heart
attacks, strokes and shock. Cocaine-induced psychosis often gives
the feeling of bugs crawling under your skin.

Withdrawal from these substances can produce serious or fatal
convulsive seizures, along with psychosis, delirium and other signs
of your body going haywire, so get treatment. Celebrity victims of
withdrawal include Marilyn Monroe and Jimi Hendrix, to name a
few.

Conversely, marijuana and hashish is not a great reason for
bothering the emergency room staff. The “high” needs no
treatment unless it comes with a bad trip and psychotic symptoms
(hallucinations, paranoia, delusions, etc.). The benign withdrawal
makes you cranky and generally under the weather, with temporary
cognitive dulling (dumbing down).

But one warning: Jimson Weed is often mistaken for marijuana and
can cause an overdose emergency with seizures. Look for hot, dry
skin, blurry vision, dry mouth and confusion.

Liu is a third-year medical student at the UCLA David Geffen
School of Medicine. “Your Health” is a weekly column
written by a rotating group of UCLA medical students. E-mail
questions and column topics to [email protected].