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Writer's pictureJosé Lurker

Overdose

There's nothing funny about an overdose. Perhaps only one thing is worth noting. Addicts and alcoholics often talk to each other, with a certain pride, about their overdoses, whether informally, in mutual aid group meetings or in hospitalizations: "I almost died". But overdose is always a worrying phenomenon. Although most of the time it occurs in drug addicts who have already had some experience of addiction, it also occurs in first-time sailors, and can be fatal in these cases. It's always something that needs to be looked at very carefully: it's an alarm signal.

Do all drugs cause overdose?

No. The drugs most frequently implicated in overdoses are opioids, cocaine (particularly if inhaled or injected into a vein - interestingly crack is less likely to cause overdoses), alcohol, barbiturates (yes, prescription drugs can cause overdoses) and amphetamines ( MMDA is an amphetamine). Among synthetic drugs, ecstasy is implicated in serious clinical consequences (due to dehydration and hypertemia) and ketamine, as it is a potent anesthetic, should be viewed with caution, although fatalities with this drug are not common. Marijuana, nicotine, benzodiazepines and hallucinogens has a low potential to cause an overdose.

Overdoses are always the same

In terms of severity, there is no doubt that all overdoses share one aspect: they are all a manifestation of the severity of dependence. Perhaps the most relevant question at the moment is the opioid epidemic that has taken on dramatic dimensions in the USA. In addition to a long history of heroin abuse, the upward curve of opioid use in the US has become more evident in the 21st century, initiated by the legal (medical) prescription of opioid analgesics. Since then, the abuse of these drugs outside the prescription environment has become increasingly common. Fentanyl, much more potent than heroin or morphine, began to be produced clandestinely and in this way, with more erratic dosage, purity and potency. And many fatal overdoses have resulted from this.

How do overdoses manifest?

It depends on the substance ingested. There is no dose that is fatal. The person who uses the drug, according to their characteristics, is decisive for the occurrence of an overdose. The length of time using the substance, tolerance, gender, the presence of obesity, the concomitant use of other drugs, all of these factors can positively or negatively influence the risk of overdose. In general, overdose with opioids and alcohol, depressants of the central nervous system, lead to reduced level of consciousness, coma and respiratory depression. Alcoholics may experience hypothermia. Amphetamines cause serious cardiac and neurological damage, and overdose can occur mainly due to cardiac causes, such as arrhythmias. Cocaine has several manifestations of overdose - acute myocardial infarction (reported to be the main cause of heart attack in young people), stroke, convulsions and rhabdomyolysis, an acute muscle injury, with myocyte necrosis, which can progress to renal failure acute and need for dialysis (which may sometimes not be reversed, with the need for permanent dialysis). I have already approached a coma with alcohol and I have had several overdoses with cocaine, curiously always manifesting with rhabdomyolysis. On 3 occasions I needed to be hospitalized, twice in the ICU, for vigorous hydration and cardiac monitoring. It's not an experience I wish on anyone. But drug addiction is something so insane and cruel that even this type of experience didn't stop me from continuing to use the drug.


(PS: this is a personal statement and should not be used as a reference source).



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