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A Drug Overdose is the accidental or intentional intake of any drug in dosage higher than the prescribed quantity.

What is Drug Overdose?

  • A drug or medication is used or prescribed for treating a specific health condition(s) or to reduce/control a specific symptom(s). It may be in the form of an oral tablet or liquid, injection, drops, inhaling vapor, or topical application
  • A Drug Overdose is the accidental or intentional intake of any drug in dosage higher than the prescribed quantity. Depending on the severity of the condition, a Drug Overdose can result in debilitating symptoms or even death
  • The condition is diagnosed based upon the clinical history, combination of signs and symptoms, and additional tests (that may include, in some cases, radiological studies and laboratory tests)

Drug Overdose may be also referred to as Medication Overdose.

What are the Causes of Drug Overdose?

  • Drug Overdose is caused by the intake of any drug in dosage that is higher than recommended. The drug may be swallowed, inhaled, injected, or applied 
  • This intake could be accidental, or in some cases intentional, to bring self-harm
  • Some of the most commonly involved medication types in Drug Overdose include sedative hypnotics, painkillers (such as opioids and paracetamol/acetaminophen), multivitamins, tricyclic antidepressants (TCAs), and inhalants

Note: The drug can interact with other prescribed or non-prescribed medications in the body. Such interactions may enhance the therapeutic effects of the drug or other medications being taken, resulting in undesired side effects (such as an overdose).

What are the Signs and Symptoms of Drug Overdose?

The signs and symptoms of Drug Overdose depends on the specific drug type or class of drug involved, and the mode of ingestion (i.e., swallowed, injected, etc.). It can vary from one individual to another and may be mild in some and severe in others. Several systems of the body, such as the digestive system, nervous system, vascular system, respiratory system, urinary system, skin and ENT may be affected.

The common signs and symptoms of a Drug Overdose may include:

  • Headache
  • Nausea and vomiting
  • Diarrhea
  • Stomach pain
  • Drowsiness
  • Chest pain
  • Reduced breathing rate and other respiratory issues
  • Increased or decreased blood pressure (hypertension or hypotension respectively)
  • Rapid or slow heartbeat rate; irregular pulse rate
  • Increased or decreased body temperature (hyperthermia or hypothermia respectively)
  • Numbness and tingling sensation
  • Lack of muscle coordination; muscle spasms
  • Ringing in the ears (tinnitus)
  • Vision abnormalities such as blurred vision or vision loss
  • Dilated pupils
  • Urination difficulties
  • Skin rashes; skin color may change to blue (lips and fingernails) or red (flushed face and body)
  • Altered mental state
  • Extreme agitation or anxiety
  • Decreased alertness level
  • Seizures
  • Unconsciousness
  • Coma

How is First Aid administered for Drug Overdose?

First Aid tips for Drug Overdose:

  • If the individual with Drug Overdose is in a coma, or is experiencing life-threatening symptoms, call 911 (or your local emergency help number) immediately
  • Call the Poison Control Center at 1-800-222-1222 (or your local poison control center) for further instructions
  • Provide them with information such as dosage, type of drug taken, strength and time of ingestion of medication, age, weight and general health status of affected individual
  • Confirm that the airways are protected; also, ensure breathing and the presence of pulse
  • If the individual is unconscious, place them on their side and tilt the head, to prevent them from choking on their vomit (if it occurs)
  • If the individual is unable to breathe or is not breathing, check the pulse and then begin CPR (cardiopulmonary resuscitation) with chest compressions if you are trained to do so
  • Unless instructed by a healthcare professional, DO NOT induce vomiting in the affected individual
  • If skin or eye exposure has occurred, then wash the skin/eye thoroughly with copious amounts of water (for about 15 minutes)
  • Stay with the affected individual until medical help arrives
  • Avoid any home remedies, which may only worsen the condition
  • Take individual to emergency room (ER) for further treatment
  • Always try to take the medication strip/bottle/container to the ER

The emergency medical health professional might take any or all the following steps towards treating the condition, after identifying the medication ingested:

  • Conduct blood and urine tests, obtain an electrocardiogram (ECG), and undertake imaging scans, as needed
  • Gastric lavage for elimination of drug from the stomach
  • Administer an antidote to counter the effects of the ingested drug
  • Administration of activated charcoal to avoid absorption of the drug in the body
  • Administer laxatives for elimination of the drug from body
  • Medically manage serious symptoms such as seizures, low blood pressure, irregular heart rate, and gastrointestinal bleeding
  • Provide breathing support; relieve respiratory distress with an artificial respirator
  • Administer fluids by an intravenous drip line
  • Wash skin/eyes repeatedly and thoroughly (irrigation), to eliminate the compound

Who should administer First Aid for Drug Overdose?

First aid for Drug Overdose is administered by healthcare professionals.

  • The individual who overdosed, or someone near, should call 911 for emergency assistance (or the local emergency number)
  • They should also call the poison control center at 1-800-222-1222 (or the local poison control center) and follow instructions

What is the Prognosis of Drug Overdose?

The prognosis of Drug Overdose is dependent on the type and amount of drug consumed, time between overdose and treatment, severity of the symptoms, as well as general health status of the patient.

  • In case of a mild overdose, the adequate management of symptoms can lead to a good prognosis. In moderate cases of an overdose, the patient may be still able to recover following early appropriate treatment
  • In case of a severe overdose, the patient might be unconscious with life-threatening symptoms and complications. In such cases, an immediate aggressive treatment of the patient may be necessary for improving the outcomes
  • Deaths can occur from severe Drug Overdoses. This may be due to respiratory failure, severe internal bleeding, multiple organ failure, irreversible brain damage, and/or delayed medical treatment

In general, overdoses are common situations in the emergency departments. A majority of the cases are often not fatal when appropriate treatment is given.

How can Drug Overdose be Prevented?

Drug Overdose can be prevented by:

  • Taking the right dose of medication at recommended times
  • Avoiding drugs that might interact with prescribed drug
  • Talking to your health-care provider if recommended doses do not provide adequate relief
  • DO NOT continue to take medications beyond the prescribed dose duration before checking with and obtaining permission of the consulting physician
  • Refraining from self-medication
  • Avoiding alcohol while taking any medication
  • DO NOT recommend or share medications you are taking with others who may have similar or near similar health conditions
  • Exercising caution while taking multiple drugs
  • Parental education to prevent overdose situations in children
  • Keeping medications out of reach of children in child-proof containers
  • For older individuals and those who tend to be forgetful, medications should be stored in single dose containers with time labels, to avoid multiple dosage
  • Monitor intake of drugs, especially in patients who have depression or harbor suicidal thoughts and behavior

It is important to give your healthcare provider a complete list of prescription and non-prescription medications that are being currently taken. This will help them in assessing the possible drug interactions within various medications and help avoid/prevent accidental or unintentional toxic drug effects.

What are certain Crucial Steps to be followed?

  • Call 911 (or your local emergency number) for emergency assistance, if symptoms are life-threatening
  • Call Poison Control Center at 1-800-222-1222 (or the local poison control center) and follow the recommend steps
  • It would be helpful if the following information is readily available:
    • Type, dosage and time of administration of medication
    • Age and weight of the individual
    • And, the overall health status of the individual

What are some Useful Resources for Additional Information?

National Capital Poison Center (USA)
3201 New Mexico Ave, Suite 310 Washington, DC 20016
Administrative Line: (202) 362-3867
Emergency Line: 1 (800) 222-1222
Fax: (202) 362-8377
Email: pc@poison.org
Website: http://www.poison.org

American Association of Poison Control Centers (USA)
515 King St., Suite 510, Alexandria, VA 22314
Phone: (703) 894-1858
Email: info@aapcc.org
Website: http://www.aapcc.org

National Poisons Centre (New Zealand)
Dunedin School of Medicine, University of Otago
PO Box 913 Dunedin 9054, New Zealand
Phone: 0800 POISON (0800 764 766)
Website: http://www.poisons.co.nz

NSW Poisons Information Centre (Australia)
Hawkesbury Rd & Hainsworth Street, Westmead NSW 2145, Australia
Phone: +61 13 11 26
Email: nswpoisons@chw.edu.au
Website: https://www.poisonsinfo.nsw.gov.au

British Columbia Drug and Poison Information Centre (Canada)
Room 0063, BC Centre for Disease Control
655 West 12th Avenue
Vancouver, BC V5Z 4R4 Canada
Phone: (604) 682-5050
Toll-Free: 1 (800) 567-8911
Fax: (604) 707-2807
Website: http://www.capcc.ca

Poisons Information Centre (South Africa)
Room 411, Institute of Child Health
Red Cross Children's Hospital
Klipfontein Road, Rondebosch, 7700, Cape Town South Africa
Phone: +27 21 658 5308
Fax: +27 21  650 4492
Email: poisonsinformation@uct.ac.za
Website: https://www.afritox.co.za

National Poisons Information Service (United Kingdom)
City Hospital Dudley Rd, Birmingham United Kingdom B187QH
Phone: +44 844 892 0111
Fax: +44 121 507 55 88
Email: mail@npis.org
Website: http://www.npis.org

References and Information Sources used for the Article:

https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates (accessed on 07/20/2017)

http://drugabuse.com/library/drug-overdose/ (accessed on 07/20/2017)

http://www.emedicinehealth.com/drug_overdose/article_em.htm (accessed on 07/20/2017)

https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm253338.htm (accessed on 07/20/2017)

https://americanaddictioncenters.org/overdose (accessed on 12/10/2021)

https://en.wikipedia.org/wiki/Drug_overdose (accessed on 12/10/2021)

Helpful Peer-Reviewed Medical Articles:

Centers for Disease Control and Prevention (CDC. (2012). CDC grand rounds: prescription drug overdoses-a US epidemic. MMWR. Morbidity and mortality weekly report, 61(1), 10.

Paulozzi, L. J., Kilbourne, E. M., & Desai, H. A. (2011). Prescription drug monitoring programs and death rates from drug overdose. Pain Medicine, 12(5), 747-754.

Johnson, H., Paulozzi, L., Porucznik, C., Mack, K., & Herter, B. (2014). Decline in drug overdose deaths after state policy changes—Florida, 2010–2012. MMWR Morb Mortal Wkly Rep, 63(26), 569-574.

Rudd, R. A. (2016). Increases in drug and opioid-involved overdose deaths—United States, 2010–2015. MMWR. Morbidity and mortality weekly report, 65.

Cutajar, M. C., Mullen, P. E., Ogloff, J. R., Thomas, S. D., Wells, D. L., & Spataro, J. (2010). Suicide and fatal drug overdose in child sexual abuse victims: a historical cohort study. The Medical Journal of Australia, 192(4), 184-187.

Haegerich, T. M., Paulozzi, L. J., Manns, B. J., & Jones, C. M. (2014). What we know, and don’t know, about the impact of state policy and systems-level interventions on prescription drug overdose. Drug and alcohol dependence, 145, 34-47.

Martins, S. S., Sampson, L., Cerdá, M., & Galea, S. (2015). Worldwide prevalence and trends in unintentional drug overdose: a systematic review of the literature. Journal Information, 105(11).

Centers for Disease Control and Prevention. (2014). Prescription drug overdose in the United States: Fact sheet. Availa le at: http://www. cdc. gov/homeandrecreationalsafety/overdose/facts. htmlAccessed: May, 15.