Substance abuse intoxication, acute

Analysis of substances of abuse involves different fields of application including diagnosis of acute/ lethal intoxication, differentiation between chronic and occasional substance abuse (as it may imply different legal consequences for the substance abuser), enforcement of drug traffic safety (driving under influence), and the identification of the source of origin of illicit drugs. 

Exposure to toxicants can vary, producing what is known as acute or chronic poisoning. Poisoning can also be classified according to the intent of use. Poisoning can either be suicidal (non-accidental) or accidental in nature. Recreational poisoning, such as substance abuse, can be a source of harmful intoxication and, in some cases, can lead to addiction and withdrawal symptoms. Intentional harm is observed when there is criminal doping with sedative-hypnotic medicines, often associated with robberies. 

Substance or Drug Class Drug Abuse Potential Acute Intoxication Withdrawal Symptoms Additional Consequences of Use ... 

Ethanol is a widely used and often abused chemical substance. Consequently the measurement of ethanol is one of the more frequently performed tests in the toxicology laboratory. Although less frequently encountered, it is important to include methanol, isopropanol, and acetone (a metabolite of isopropanol) in a test battery for alcohols for proper evaluation of the acutely intoxicated patient. 

Today, if anaesthesia is excluded, acute poisoning with solvents and other volatile substances usually follows deliberate inhalation of vapour in order to become intoxicated [volatile substance abuse (VSA)]. Patients who ingest solvents or solvent-containing products either by accident or... 

Toxic Effects of Acute Overdoses Acute poisoning with tricyclic antidepressants or MAO inhibitors is potentially hfe-threatening. Fatalities are much less common since modern antidepressants have widely replaced these drugs however, suicide rates have not declined consistently as clinical usage of modern antidepressants has increased. Deaths have been reported with acute doses of 2 g of imipramine, and severe intoxication can be expected at doses >1 g, or about a week s supply. If a patient is severely depressed, potentially suicidal, impulsive, or has a history of substance abuse, prescribing a relatively safe antidepressant agent with close clinical follow-up is appropriate. If a potentially lethal agent is prescribed, it is best dispensed in small, sublethal quantities, with the risk that sustained adherence to recommended treatment may be compromised. 

Nursing implementation may focus on managing the patient s acute intoxication and withdrawal and then monitoring the effectiveness of therapy to treat the patient s substance abuse problem. 

The intoxicating effects of opioids appear to be due to their action as agonists on mu (p) receptors of the opioid neurotransmitter system. Competitive p opioid antagonists such as naloxone and naltrexone acutely reverse many of the adverse effects of opioids. To date we do not have specific antagonists for most other abused substances, so rapid pharmacologic reversal of intoxication is usually not possible. 

Anxiety is characterized by fear and apprehension that may or may not be associated with a cieariy identifiabie stimuius. Anxiety is a common reaction to significant life stress, is seen in conjunction with almost every psychiatric disorder, and is a common component of numerous organic disorders as well (e.g., hyperthyroidism, hypoglycemia, pheochromocytoma, complex partial seizures, pulmonary disorders, acute myocardial infarction, caffeine intoxication, various substances of abuse). Anxiety is almost invariably accompanied by physical symptoms such as the following ... 

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