Substance AbuseOverdose

Substance Abuse Terms• Substance Abuse• Addiction• Tolerance• Withdrawal• Drug Overdose

Commonly Abused Drugs• Alcohol• Cocaine• Narcotics• Amphetamines• Hallucinogens• Benzodiazepines• Barbiturates• Marijuana

Name the Drug:Whippets

Name the Drug:Angel Dust

Name the Drug:Downers

Name the Drug:Nose Candy

Booger Sugar

Name the Drug:Cookie

Name the Drug:Speed

Name the Drug:Smack

Name the Drug:Mary Jane

Name the Drug:

Name the Drug:

Name the Drug

Name the Drug

Name the Drug

Name the Addict

Name the Addict

Name the Addict

Alcohol- Types• Beer• Whiskey• Gin• Vodka• Wine• Tequila

Alcohol- Signs and Symptoms

• CNS Depression• Slurred speech• Disordered thought• Impaired judgement• Diuresis• Stumbling gait• Stupor• Coma

Alcohol- Management• ABC’s• Respiratory support• Oxygenate• IV• Thiamine• ECG• Blood glucose• D50 if hypoglycemic

Barbituates• Thiopental• Phenobarbital• Primidone

Barbituates- Street Names• Downers, Barbs, Blue Devils, Red Devils, Yellow Jackets,

Yellows, Nembutal, Tuinals, Seconal, and Amytal

Barbituates- Signs and Symptoms

• Lethargy• Incoordination• Slurred speech• Nystagmus• Coma• Hypotension• Respiratory depression

Barbituates- Treatment• ABC’s• Respiratory support• Oxygenate• IV• ECG• Contact poison control- may give bicarbonate 1-800-222-1222• Campus papa johns 224-1222• Killearn 893-1222

Cocaine• Coke, Snow, Nose Candy, Flake, Blow, Big C, Lady, White, and Snowbirds,

Powder, China

Cocaine

• Crack• Rock

Cocaine- Signs and Symptoms

• Euphoria• Hyperactivity• Dilated pupils• Psychosis• Twitching• Anxiety• Hypertension• Tachycardia• Dysrhythmias• Seizures• Chest pain

Cocaine- Treatment• ABC’s• Respiratory support• Oxygenate• IV• ECG• Treat life threatening dysrhythmias• Seizure precautions: Diazepam 5-10 mg IV• DO NOT GIVE BETA BLOCKERS

Narcotics• Heroin

Smack, Horse, Mud, Brown sugar, Junk, Black tar, and Big H• Morphine

Pectoral syrup• Opium

Paregoric, Dover's Powder, Parepectolin• Codeine

Empirin compound with codeine, Tylenol with codeine,Codeine in cough medicine

• MeperidinePethidine, Demerol, Mepergan

• Analog of Fentanyl (Narcotic)Synthetic heroin, China white

• Analog of Meperidine (Narcotic)MPTP (New heroin), MPPP, synthetic heroin

Narcotics• Heroin• Codeine• Meperidine• Morphine• Hydromorphone• Pentazocine• Darvon• Darvocet• Methadone

Narcotics- Signs and Symptoms

• CNS depression• Constricted pupils• Respiratory depression• Hypotension• Bradycardia• Pulmonary edema• Coma • Death

Narcotics- Treatment• ABC’s• Respiratory support• Oxygenate• IV• ECG• Narcan

Marijuana• Pot, Reefer, Grass, Weed, Dope, Ganja, Mary Jane, or Sinsemilla, Urb,

Marijuana• Euphoria• Dry mouth• Dilated pupils• Altered sensation

Marijuana- Treatment• ABCs• Reassure the patient• Speak in a quiet voice• ECG monitor

Amphetamines• Speed, Uppers, Ups, Black beauties, Pep pills, Co-pilots, Bumblebees,

Hearts, Benzedrine, Dexedrine, Footballs, and Biphetamine

Amphetamines• Benzedrine• Dexadrine• Ritalin

Amphetamines- Signs and Symptoms

• Exhilaration• Hyperactivity• Dilated pupils• Hypertension• Psychosis• Tremors• Seizures

Amphetamines- Treatment• ABC’s• Respiratory support• Oxygenate• IV• ECG• Seizure precautions: Diazepam 5-10 mg

Meth Lab Awareness• Chemicals associated

with Meth Labs:– Acetone– Fertilizer– Bleach– Drain cleaner– Methanol/alcohol– Iodine– Matches– Muriatic acid– Salt– Organic ether

• Trichloroethane (gun cleaner)

• Isopropyl alcohol• Battery acid• Coleman fuel• Peroxide• Lithium batteries• Cold medicine

Meth Lab Awareness• Equipment for Meth

Labs:– Blenders– Chemistry glassware– Cheesecloth– Hot plates– Garden spray jugs– pH test strips– Rubber gloves– Turkey baster wands– Camp stove

• Coffee filters• Duct tape• Funnels• Gas cans• Propane tanks• Strainers

Hallucinogens• Mescaline and Peyote

Mesc, Buttons, and Cactus• Psilocybin (Shrooms)

Magic Mushrooms, 'shrooms• Lysergic acid diethylamide

Acid, Microdot, White lightning, Blue heaven, and Sugar Cubes• Analog of Amphetamines or Methamphetamines

MDMA (Ecstasy, XTC, Adam, Essence), MDM, STP, PMA, 2, 5-DMA, TMA, DOM, DOB, EVE

• PhencyclidinePCP, Hog, Angel Dust, Loveboat, Lovely

• Analog of Phencyclidine (PCP)PCPy, PCE

PCP• Hallucinogen• Angel dust, killer weed, supergrass, crystal cyclone, hog, elephant

tranquilizer, embalming fluid, horse tranquilizer, monkey dust, rocket fuel, goon, surfer, scuffle

• Stored in body fat

Hallucinogens- Signs and Symptoms

• Psychosis• Nausea• Dilated pupils• Rambling speech• Headache• Dizziness• Suggestibility• Distortion of sensory perceptions

Hallucinogens- Treatment

• ABCs• Reassure the patient• “Talk down” the “high” patient• Protect the patient from injury• Provide a dark, quiet environment• Peak in a soft, quiet voice• Seizure precautions

Benzodiazepines• Valium• Librium• Xanax• Halcion• Restoril• Dalmane• Centrax• Ativan• Serax

Benzos- Signs and Symptoms

• AMS• Slurred speech• Dysrhythmias• Coma

Benzos- Treatment• ABCs• Respiratory support• Oxygenate• Activated charcoal• IV• ECG• Romazicon 1-10 mg

Common Drugs of Abuse• Drugs Used for Sexual Purposes– Ecstasy (MDMA)

• Signs and symptoms include anxiety, nausea, tachycardia, and hypertension, followed by relaxation and euphoria

• Provide supportive care– Rohypnol (“Date Rape Drug”)

• Potent benzodiazepine, illegal in the U.S.• Treat as a benzodiazepine overdose and sexual assault victim

Alcohol Abuse• Physiologic Effects– CNS depressant– Alcoholism

• Susceptible to methanol or ethylene glycol ingestion– Peripheral vasodilation, diuresis

• General Alcoholic Profile– Drinks early in the day, alone, or secretly– Binges, blackouts, GI problems, “green tongue syndrome,”

chronic flushing of face and palms– Cigarette burns, tremulousness, and odor of alcohol

• Consequences of Chronic Alcohol Ingestion– Poor nutrition– Alcohol hepatitis– Liver cirrhosis, pancreatitis– Sensory loss in hands/feet– Loss of balance and coordination– Upper GI hemorrhage– Hypoglycemia– Falls (fractures and subdural

hematoma)

Alcohol Abuse

Alcohol Abuse• Withdrawal Syndrome– Delirium Tremens (DTs)– Signs and Symptoms

• Coarse tremor of hands, tongue, eyelids• Nausea, vomiting, general weakness, anxiety• Tachycardia, sweating, hypertension, hallucinations, irritability or

depressed mood, poor sleep• Increased sympathetic tone, orthostatic hypotension

Alcohol Abuse• Withdrawal Syndrome– Treatment

• Establish and maintain the airway• Determine if other drugs are involved• Establish IV access

– Lactated Ringer’s or normal saline• Consider medications

– 25g D50W if hypoglycemic– 100mg thiamine IV or IM

• Transport, maintaining a sympathetic attitude, and reassure the patient

Emergency Care• Establish / maintain

airway• Administer oxygen• Position the patient• Maintain body

temperature• Check BgL• Restrain if necessary

• Talk-down technique:– Be calm– Establish rapport before

entering personal space– Give simple and

concrete statements (don’t feed hallucinations)

Withdrawal• Tolerance• Dependence

• Stage 1: Nausea, insomnia, sweating, and tremors• Stage 2: All the above + hallucinations• Stage 3: Seizures• Stage 4: Delirium tremens or DTs

– Can last 1 – 3 days

DT’s• Confusion• Loss of memory• Tremors• Restlessness and irritability• High fever• Dilated pupils• Profuse sweating• Elevated BP• Tachycardia• N/V/D• Hallucinations

Name the Celebrity and Overdose

Alcohol

Heroin and Diazepam

Profofol and Benzodiazepines

Narcotics and Benzos

Heroin

Barbituates

Chloral hydrate and Benzos

Heroin

Heroin

Heroin, cocaine

alcohol, benzos