Things we need to know about INTOXICATION

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Intoxication can refer to:

    Substance intoxication:
        Alcohol intoxication
        Toxidrome
        Effects of cannabis
        Cocaine intoxication
        Caffeine#Caffeine intoxication
        Stimulant#Effects
        Water intoxication
        Drug overdose

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Substance intoxication is a type of substance-induced disorder which is potentially maladaptive and impairing, but reversible, and associated with recent use.

If the symptoms are severe, the term "substance intoxication delirium" may be used. Generic slang terms include: getting high or being stoned or blazed (all usually in reference to cannabis), with many more specific slang terms for each particular type of intoxicant. Alcohol intoxication is even graded in intensity, from buzzed, to tipsy, all the way up to hammered, smashed, wasted and a number of other similar terms. Slight intoxication of a familiar substance is usually referred to as being buzzed.

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Alcohol intoxication (also known as drunkenness or inebriation) is a physiological state induced by the consumption of alcohol.

Intoxication is the consequence of alcohol entering the bloodstream faster than it can be metabolized by the liver. Some effects of alcohol intoxication are central to alcohol's desirability as a beverage and its history as the world's most widespread recreational drug.

Common symptoms of alcohol intoxication include slurred speech, euphoria, impaired balance, loss of muscle coordination (ataxia), flushed face, dehydration, vomiting, reddened eyes, reduced inhibitions, and erratic behavior. Sufficiently high levels of blood-borne alcohol will cause coma and death from the depressive effects of alcohol upon the central nervous system.

"Acute alcohol poisoning" is a related medical term used to indicate a dangerously high concentration of alcohol in the blood, high enough to induce coma or respiratory depression. It is considered a medical emergency. The term is mostly used by health care providers. Toxicologists use the term “alcohol intoxication” to discriminate between alcohol and other toxins.

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A toxidrome (a portmanteau of toxic and syndrome) is a syndrome caused by a dangerous level of toxins in the body. The term was coined in 1970 by Mofenson and Greensher. It is often the consequence of a drug overdose. Common symptoms include dizziness, disorientation, nausea, vomiting, and oscillopsia. A toxidrome may indicate a medical emergency requiring treatment at a poison control center. Aside from poisoning, a systemic infection may also lead to a toxidrome. "Classic" toxidromes are presented below, but they are often variable or obscured by the co-ingestion of multiple drugs.

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The effects of cannabis are caused by chemical compounds in cannabis, including cannabinoids such as tetrahydrocannabinol (THC). Cannabis has both psychological and physiological effects on the human body. Five European countries, Canada, and twenty US states have legalized medical cannabis if prescribed for nausea, pain or the alleviation of symptoms surrounding chronic illness.

In large enough doses, THC can induce auditory and visual hallucination. Acute effects while under the influence can include both euphoria and anxiety. Concerns have been raised about the potential for long-term cannabis consumption to increase risk for schizophrenia, depersonalization disorder, bipolar disorders, and major depression, however studies are inconclusive and the ultimate conclusions on these factors are disputed. The evidence of long-term effects on memory is preliminary and hindered by confounding factors. For thousands of years people have believed that cannabis has religious and spiritual effects.

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Sedative Intoxication

A sedative or tranquilizer (or tranquilliser, see American and British English spelling differences) is a substance that induces sedation by reducing irritability or excitement.

At higher doses it may result in slurred speech, staggering gait, poor judgment, and slow, uncertain reflexes. Doses of sedatives such as benzodiazepines, when used as a hypnotic to induce sleep, tend to be higher than amounts used to relieve anxiety, whereas only low doses are needed to provide a peaceful and calming sedative effect.

Sedatives can be misused to produce an overly-calming effect (alcohol being the classic and most common sedating drug). In the event of an overdose or if combined with another sedative, many of these drugs can cause unconsciousness (see hypnotic) and even death.

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Hypnotic Intoxication

Hypnotic (also called soporific) drugs are a class of psychoactives whose primary function is to induce sleep and to be used in the treatment of insomnia, and in surgical anesthesia. When used in anesthesia to produce and maintain unconsciousness, "sleep" is metaphorical as there are no regular sleep stages or cyclical natural states; patients rarely recover from anesthesia feeling refreshed and with renewed energy. Because drugs in this class generally produce dose-dependent effects, ranging from anxiolysis to production of unconsciousness, they are often referred to collectively as sedative-hypnotic drugs. Hypnotic drugs are regularly prescribed for insomnia and other sleep disorders, with over 95% of insomnia patients being prescribed hypnotics in some countries. Many hypnotic drugs are habit-forming and, due to a large number of factors known to disturb the human sleep pattern, a physician may instead recommend alternative sleeping patterns, sleep hygiene, and exercise, before prescribing medication for sleep. Hypnotic medication when prescribed should be used for the shortest period of time possible.

The benzodiazepine and nonbenzodiazepine hypnotic medications also have a number of side effects such as daytime fatigue, and cognitive impairments. In children, prescribing hypnotics is not yet acceptable unless if used to treat night terrors or somnambulism. Elderly people are more sensitive to these side effects and a meta analysis found that the risks generally outweigh any marginal benefits of hypnotics in the elderly. A review of the literature regarding benzodiazepine hypnotic and Z drugs concluded that these drugs caused an unjustifiable risk to the individual and to public health, and lack evidence of long-term effectiveness due to tolerance. The risks include dependence, accidents, and other adverse effects. Gradual discontinuation of hypnotics leads to improved health without worsening of sleep. Preferably they should be prescribed for only a few days at the lowest effective dose, and avoided altogether wherever possible in the elderly.

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Cocaine intoxication refers to the immediate effects of cocaine on the body. Although cocaine intoxication and cocaine dependence can be present in the same individual, they present with different sets of symptoms.

Cocaine increases alertness, feelings of well-being and euphoria, energy and motor activity, feelings of competence and sexuality. Common side effects include anxiety, increased temperature, paranoia, restlessness, and tooth grinding. With prolonged use, often accompanied by lack of sleep, the drug can cause itching, tachycardia, hallucinations, and paranoid delusions. Possible lethal side effects include rapid heartbeat, tremors, convulsions, markedly increased core temperature, heart attack, stroke and heart failure.

Depression with suicidal ideation may develop in very heavy users. Finally, a loss of vesicular monoamine transporters, neurofilament proteins, and other morphological changes appear to indicate a long-term damage to dopamine neurons. Chronic intranasal usage can degrade the cartilage separating the nostrils (the septum nasi), which can eventually lead to its complete disappearance.

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Caffeine Intoxication

Caffeine is a bitter, white crystalline xanthine alkaloid and a stimulant drug. Caffeine is found in varying quantities in the seeds, leaves, and fruit of some plants, where it acts as a natural pesticide that paralyzes and kills certain insects feeding on the plants, as well as enhancing the reward memory of pollinators. It is most commonly consumed by humans in infusions extracted from the seed of the coffee plant and the leaves of the tea bush, as well as from various foods and drinks containing products derived from the kola nut. Other sources include yerba maté, guarana berries, guayusa, and the yaupon holly.

In humans, caffeine acts as a central nervous system stimulant, temporarily warding off drowsiness and restoring alertness. It is the world's most widely consumed psychoactive drug, but unlike many other psychoactive substances, it is legal and unregulated in nearly all parts of the world. Beverages containing caffeine, such as coffee, tea, soft drinks, and energy drinks, enjoy great popularity. In North America, 90% of adults consume caffeine daily.

Part of the reason caffeine is classified by the Food and Drug Administration as GRAS (generally recognized as safe) is that toxic doses (over 1 gram for an average adult) are much higher than typically used doses (less than 500 milligrams). Ordinary consumption can have low health risks, even when carried on for years – there may be a modest protective effect against some diseases, including Parkinson's disease, and certain types of cancer. Some people experience sleep disruption if they consume caffeine, especially during the evening hours, but others show little disturbance and the effect of caffeine on sleep is highly variable.

Evidence of a risk to pregnancy is equivocal, but some authorities have concluded that prudent advice is for pregnant women to limit consumption to the equivalent of two cups of coffee per day or less. The American Congress of Obstetricians and Gynecologists (ACOG) concluded in 2010 that caffeine consumption is safe up to 200 mg per day in pregnant women. Caffeine has pressor and mild diuretic effects when administered to people who are not used to it, but regular users develop a tolerance to this effect, and studies have generally failed to support the common notion that ordinary consumption contributes significantly to dehydration. With heavy use, tolerance develops rapidly to autonomic effects such as elevated heart rate and muscle twitching, but not to the cognitive or arousal effects of caffeine. The degree to which caffeine can produce clinically significant dependency and addiction remains a subject of controversy in the medical literature.

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hallucinogen intoxication

Physical

LSD can cause pupil dilation, reduced or increased appetite, and wakefulness. Other physical reactions to LSD are highly variable and nonspecific, some of which may be secondary to the psychological effects of LSD. Among the reported symptoms are numbness, weakness, nausea, hypothermia or hyperthermia, elevated blood sugar, goose bumps, heart rate increase, jaw clenching, perspiration, saliva production, mucus production, sleeplessness, hyperreflexia, and tremors. Some users, including Albert Hofmann, report a strong metallic taste for the duration of the effects.

LSD is not considered addictive by the medical community. Rapid tolerance build-up prevents regular use, and cross-tolerance has been demonstrated between LSD, mescaline and psilocybin. This tolerance diminishes after a few days after cessation of use and is probably caused by downregulation of 5-HT2A receptors in the brain.

Psychological

LSD's psychological effects (colloquially called a "trip") vary greatly from person to person, depending on factors such as previous experiences, state of mind and environment, as well as dose strength. They also vary from one trip to another, and even as time passes during a single trip. An LSD trip can have long-term psychoemotional effects; some users cite the LSD experience as causing significant changes in their personality and life perspective[citation needed]. Widely different effects emerge based on what Timothy Leary called set and setting; the "set" being the general mindset of the user, and the "setting" being the physical and social environment in which the drug's effects are experienced.

Some psychological effects may include an experience of radiant colors, objects and surfaces appearing to ripple or "breathe", colored patterns behind the closed eyelids (eidetic imagery), an altered sense of time (time seems to be stretching, repeating itself, changing speed or stopping), crawling geometric patterns overlaying walls and other objects, morphing objects, a sense that one's thoughts are spiraling into themselves, loss of a sense of identity or the ego (known as "ego death"), and other powerful psycho-physical reactions. Many users experience a dissolution between themselves and the "outside world". This unitive quality may play a role in the spiritual and religious aspects of LSD. The drug sometimes leads to disintegration or restructuring of the user's historical personality and creates a mental state that some users report allows them to have more choice regarding the nature of their own personality.

If the user is in a hostile or otherwise unsettling environment, or is not mentally prepared for the powerful distortions in perception and thought that the drug causes, effects are more likely to be unpleasant than if he or she is in a comfortable environment and has a relaxed, balanced and open mindset.
Sensory

LSD causes an altered sensory experience of senses, emotions, memories, time, and awareness for 6 to 14 hours, depending on dosage and tolerance. Generally beginning within thirty to ninety minutes after ingestion, the user may experience anything from subtle changes in perception to overwhelming cognitive shifts. Changes in auditory and visual perception are typical. Visual effects include the illusion of movement of static surfaces ("walls breathing"), after image-like trails of moving objects ("tracers"), the appearance of moving colored geometric patterns (especially with closed eyes), an intensification of colors and brightness ("sparkling"), new textures on objects, blurred vision, and shape suggestibility. Users commonly report that the inanimate world appears to animate in an unexplainable way; for instance, objects that are static in three dimensions can seem to be moving relative to one or more additional spatial dimensions. Many of the basic visual effects resemble the phosphenes seen after applying pressure to the eye and have also been studied under the name "form constants". The auditory effects of LSD may include echo-like distortions of sounds, changes in ability to discern concurrent auditory stimuli, and a general intensification of the experience of music. Higher doses often cause intense and fundamental distortions of sensory perception such as synaesthesia, the experience of additional spatial or temporal dimensions, and temporary dissociation.

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Water intoxication, also known as water poisoning or dilutional hyponatremia, is a potentially fatal disturbance in brain functions that results when the normal balance of electrolytes in the body is pushed outside safe limits by over-hydration.

Under normal circumstances, accidentally consuming too much water is exceptionally rare. Nearly all deaths related to water intoxication in normal individuals have resulted either from water drinking contests in which individuals attempt to consume large amounts of water, or long bouts of intensive exercise during which electrolytes are not properly replenished, yet huge amounts of fluid are still consumed. Moreover, water cure, a method of torture in which the victim is forced to consume excessive amounts of water, can cause water intoxication.

Water, just like any other substance, can be considered a poison when over-consumed in a specific period of time. Water intoxication mostly occurs when water is being consumed in a high quantity without giving the body the proper nutrients it needs to be healthy.

Excess of body water may also be a result of a medical condition or improper treatment; see "hyponatremia" for some examples. Water is considered the least toxic chemical compound, with a LD50 of 90 g/kg or more in rats.

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Drug Intoxication

The term drug overdose (or simply overdose or OD) describes the ingestion or application of a drug or other substance in quantities greater than are recommended or generally practiced. An overdose may result in a toxic state or death.

The word "overdose" implies that there is a common safe dosage and usage for the drug; therefore, the term is commonly only applied to drugs, not poisons, though even certain poisons are harmless at a low enough dosage.

Drug overdoses are sometimes caused intentionally to commit suicide or as self-harm, but many drug overdoses are accidental, the result of intentional or unintentional misuse of medication. Intentional misuse leading to overdose can include using prescribed or unprescribed drugs in excessive quantities in an attempt to produce euphoria.

Usage of illicit drugs of unexpected purity, in large quantities, or after a period of drug abstinence can also induce overdose. Cocaine users who inject intravenously can easily overdose accidentally, as the margin between a pleasurable drug sensation and an overdose is small.

Unintentional misuse can include errors in dosage caused by failure to read or understand product labels. Accidental overdoses may also be the result of over-prescription, failure to recognize a drug's active ingredient, or unwitting ingestion by children. A common unintentional overdose in young children involves multi-vitamins containing iron. Iron is a component of the hemoglobin molecule in blood, used to transport oxygen to living cells. When taken in small amounts, iron allows the body to replenish hemoglobin, but in large amounts it causes severe pH imbalances in the body. If this overdose is not treated with chelation therapy, it can lead to death or permanent coma.

The term 'overdose' is often misused as a descriptor for adverse drug reactions or negative drug interactions due to mixing multiple drugs simultaneously.

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Inhalant Intoxication

Inhalant users inhale vapors or aerosol propellant gases using plastic bags held over the mouth or by breathing from an open container of solvents, such as gasoline or paint thinner. Nitrous oxide gases from whipped cream aerosol cans, aerosol hairspray or non-stick frying spray are sprayed into plastic bags. When inhaling non-stick cooking spray or other aerosol products, some users may filter the aerosolized particles out with a rag. Some gases, such as propane and butane gases, are inhaled directly from the canister. Once these solvents or gases are inhaled, the extensive capillary surface of the lungs rapidly absorb the solvent or gas, and blood levels peak rapidly. The intoxication effects occur so quickly that the effects of inhalation can resemble the intensity of effects produced by intravenous injection of other psychoactive drugs.

The effects of Solvent intoxication can vary widely depending on the dose and what type of solvent or gas is inhaled. A person who has inhaled a small amount of rubber cement or paint thinner vapor may be impaired in a manner resembling alcohol inebriation. A person who has inhaled a larger quantity of solvents or gases, or a stronger chemical, may experience stronger effects such as distortion in perceptions of time and space, hallucinations, and emotional disturbances.

In the short term, many users experience headache, nausea and vomiting, slurred speech, loss of motor coordination, and wheezing. A characteristic "glue sniffer's rash" around the nose and mouth is sometimes seen after prolonged use. An odor of paint or solvents on clothes, skin, and breath is sometimes a sign of inhalant abuse, and paint or solvent residues can sometimes emerge in sweat.
Computer-cleaning dusters are dangerous to inhale, because the gases expand and cool rapidly upon being sprayed.

According to NIH, even a single session of inhalant abuse "can disrupt heart rhythms and lower oxygen levels," which can lead to death. "Regular abuse can result in serious harm to the brain, heart, kidneys and liver."