First Aid for Drug Overdose

© American Institute of Preventive Medicine

Drug overdoses can be accidental or on purpose. The amount of a certain drug needed to cause an overdose varies with the type of drug and the person taking it. Overdoses from prescription or over-the-counter (OTC) medicines, "street" drugs, and/or alcohol can be life-threatening. Know, too, that mixing certain medications or "street" drugs with alcohol can also kill.

Physical symptoms of a drug overdose vary with the type of drug(s) taken. They include:

Abnormal breathing Slurred speech Lack of coordination Slow or rapid pulse Low or elevated body temperature Enlarged or small eye pupils Reddish face Heavy sweating Drowsiness Delusions and/or hallucinations Unconsciousness which may lead to coma

Parents need to watch for signs of illegal drug and alcohol use in their children. Morning hangovers, the odor of alcohol, and red streaks in the whites of the eyes are obvious signs of alcohol use. Items such as pipes, rolling papers, eye droppers and butane lighters may be the first telling clues that someone is abusing drugs. Another clue is behavior changes such as:

Lack of appetite Insomnia Hostility Mental confusion Depression Mood swings Secretive behavior Social isolation Deep sleep Hallucinations

Prevention

Accidental prescription and over-the-counter medication overdoses may be prevented by asking your doctor or pharmacist:

What is the medication and why is it being prescribed? How and when should the medication be taken and for how long? (Follow the instructions exactly as given.) Can the medication be taken with other medicines or alcohol or should it not be? Are there are any foods to avoid while taking this medication? What are the possible side effects? What are the symptoms of an overdose and what should be done if it occurs? Should any activities be avoided such as sitting in the sun, operating heavy machinery, driving? Should the medicine still be taken if there is a pre-existing medical condition?

Medication overdoses can be avoided:

Never take a medicine prescribed for someone else. Never give or take medication in the dark. Before each dose, always read the label on the bottle to be

certain it is the correct medication. Always tell the doctor of any previous side effects or adverse reactions to medication as well as new and

unusual symptoms that occur after taking the medicine. Always store medications in bottles with child-proof lids and place those bottles on high shelves, out of a

child's reach, or in locked cabinets. Take the prescribed dose, not more. Keep medications in their original containers.

Illicit drug use among children should be discouraged:

Set a good example for your children by not using drugs yourself. Teach your child to say "NO" to drugs and alcohol. Explain the dangers of drug use, including the risk of

AIDS. Get to know your children's friends and their parents. Know where your children are and who they are with. Listen to your children and help them to express their feelings and fears. Encourage your children to engage in healthy activities such as sports, scouting, community- based youth

programs and volunteer work. Learn to recognize the signs of drug and alcohol abuse.

Questions to Ask

Is the person not breathing and has no pulse?

Perform CPR and Get Emergency Care.

Is the person not breathing, but has a pulse?

Perform Rescue Breathing and Get Emergency Care. (See "Airway and Breathing" under CPR.)

Is the person unconscious?

Get Emergency Care and give first aid before emergency care. Lie the victim down on his or her left side and check airway, breathing and pulse often before emergency care. Do CPR or Rescue Breathing (see "Airway and Breathing") as needed.

Does the person have any of these signs? Hallucinating Confusion Convulsions

Breathing slow and shallow and/or slurring their words

Do you suspect the person has taken an overdose of drugs?

Get Emergency Care and call Poison Control Center.

Tell the Poison Control Center:

The name of the medication or drug, if known. The amount of the drug taken, if known. For example,

the number of pills or amount of liquid you suspect was swallowed.

When the medication or drug was taken. The person's age, gender and weight. How the person is feeling and reacting. Any medical problems the person has.

Follow the Poison Control Center's instructions:

If poison control tells you to induce vomiting: o Approach the victim calmly and carefully. o Give the person syrup of ipecac as instructed.

General guidelines are: o One tablespoon to children 1 to 6 years and

two tablespoons to those older than 6 years

followed by a large glass of water or milk. o Walk the person around to help the ipecac

work faster and to keep him or her awake. o Give syrup of ipecac again in 20 minutes if the

person has not yet vomited. o Touch the back of the person's throat with a

finger or spoon, if syrup of ipecac is not available.

o After vomiting begins, continue giving clear fluids until the vomited material is clear.

o When the vomiting has stopped, give nothing by mouth for 2 hours to give the stomach a chance to rest.

Note: If after taking two doses of syrup of ipecac the person has not vomited, seek emergency care.

Is the person's personality suddenly hostile, violent and aggressive?

NOTE: Use caution. Protect yourself. Do not turn your back to the victim or move suddenly in front of him or her. If you can, see that the victim does not harm you, himself or herself. Remember, the victim is under the influence of a drug. Call the police to assist you if you cannot handle the situation. Leave and find a safe place to stay until the police arrive.

Have you or someone else accidentally taken more than the prescribed dose of a prescription or over-the-counter medicine?

Call Doctor. If doctor is not available, call Poison Control Center. Follow instructions given.

DRUG OVERDOSE 

Drugs are usually medicinal substances that come in a variety of forms: pills, capsules, powders, liquids, aerosols and pastes. They are chemical concoctions or refined natural products that are used for specific purposes ranging from relieving headaches to stopping the heart. Most are supplied under control, either by doctors’ prescriptions, or by government-controlled sale. Some however, are illegal and pose a danger to users.

   Drugs are generally classified as either:

Prescription drugs require a doctor’s authority to purchase them. They are drugs to which the relevant government authority has given a ‘Schedule Number’, indicating the toxicity or cautionary usage of the

substance.

Most prescription drugs are at least ‘Schedule 4’, and range up to ‘Schedule 8’ which are dangerous narcotic-based drugs. The associated (usually typewritten) label, indicating that a pharmacist has dispensed them readily identifies prescription drugs. Some common examples are; ‘Valium’, ‘Normison’, and ‘Anginine’.

         Non-prescription drugs are those

which may be purchased without prescription. They consist of headache compounds, cough elixirs, and similar mild medications, and can be purchased at virtually any chemist or retail outlet. Common examples are; ‘Panadol’, ‘Aspro’, ‘Vick’s Cough Syrup’, alcohol, and nicotine (cigarettes).

Illicit drugs are drugs that are imported, grown or manufactured illegally. All illicit drugs are dangerous and usually imply a degree of dependence, or in some cases, addiction. Examples are: heroin, cocaine, amphetamines, ‘ecstasy’, marijuana, and LSD.

All drugs, even non-prescription drugs, are dangerous when taken as an overdose. Many people have suffered severe renal and kidney impairment from ingesting an overdose of what they considered to be an innocuous drug. As an example, Paracetamol (‘Panadol’, ‘Panadeine’) is an excellent analgesic if taken as directed, but is particularly dangerous, even fatal, if taken as an overdose.

Using another person’s medication is also a very dangerous practice. Elderly people are at risk of accidental overdose due to memory lapses, and unsupervised children are also at potential risk.

  SIGNS AND SYMPTOMS

evidence of empty containers, suicide notes, etc

altered level of consciousness slurred speech depressed respirations slow pulse, or alternatively, rapid,

weak pulse irrational behaviour ‘pin-point’ pupils (narcotics) injection (‘track’) marks on arms,

behind knees, thighs, and groin unconsciousness

respiratory/cardiac arrest        CARE AND TREATMENT

treat as for poisoning urgent ambulance transport psychological support

resuscitation as required      

be aware of Hepatitis and HIV

The first aid provider should be aware that care and treatment may not be restricted to the chemical effects of drugs, but psychological disturbances and trauma are also associated with drug abuse and overdose.

Certain amphetamines and cocaine cause delusions and behavioural problems, which can lead to self-inflicted injury or inadvertent serious trauma.

Overdosing on alcohol (drunkenness) is also an example of potentially injurious behaviour.

        

Useful ResourcesAustralian Drug Information Network