Overdose and acute intoxication prevention and management

Very high doses of stimulant drugs consumed in a short amount of time can trigger acute respiratory distress, chest pain, palpitations or myocardial infarctions. In extreme cases this can result in cardiac arrest.

The first signs of stimulant drugs intoxication are hyperactivity, rapid speech and dilated pupils. In the case of polydrug use, overdose can be the result of the combination of stimulants with other drugs including opioid or sedative drugs.

The treatment of stimulant drugs intoxication is symptomatic and requires regular monitoring of blood pressure, pulse rate, respiratory rate and temperature.

Serotonergic syndrome is caused by an excess of serotonin in the central nervous system associated with the use of ATS. It can result in uncontrollable muscle spasms, tremor, seizures, psychosis, high blood pressure, high body temperature >40C (hyperthermia) and release of myoglobin from muscles and blood clotting in vessels (disseminated intravascular coagulation), which may lead to severe diseases and potentially death.

People who use stimulant drugs need to be informed on how to reduce the risks of acute intoxications. For people on PrEP, ART or hepatitis treatment, information should be provided on the interactions and possible risks of cocaine and ATS use to serum levels.

People who use stimulant drugs should be trained to recognize overdoses, provide first aid, including cardiopulmonary resuscitation (CPR) and call immediately for emergency professional assistance if they witness an overdose.

Source: HIV Prevention, Treatment, Care and Support for People Who Use Stimulant Drugs (TECHNICAL GUIDE).