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Poisoning
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Over-the-counter and prescribed medications are common causes of both intentional and unintentional poisonings. Recreational drug use can result in significant intoxication, with alcohol and opioid poisonings in particular being responsible for many deaths across the world. It is important to bear in mind that drugs may have been administered to someone, perhaps in ‘spiked’ drinks, without their knowledge and this includes sedating drugs, such as benzodiazepines. Less commonly, patients may be accidentally exposed either at home or in the workplace to toxins such as carbon monoxide, heavy metals and organophosphates.
Preconception Care
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
Numerous recreational drug exposures have adverse pregnancy effects (see Chap. 23 in Maternal-Fetal Evidence Based Guidelines). This list is extensive and includes, but is not limited to, common recreational drugs such as alcohol, cannabinoids, cocaine, heroin, and methamphetamines. Patients with substance use disorder are disproportionately overrepresented among patients with unplanned pregnancies, and thus discussing birth control methods and approaches to a planned pregnancy is important.
Drugs and health
Published in Sally Robinson, Priorities for Health Promotion and Public Health, 2021
Recreational drugs are substances taken for pleasure or leisure, perhaps as part of someone’s lifestyle, without medical supervision. They come from raw plants, e.g. cannabis, magic mushroomsrefined plants, e.g. heroin from opium poppies, cocaine from coca plantssynthetic, e.g. amphetamine-type stimulants, new psychoactive substancesDrugs may be made of natural or synthetic compounds, sometimes both. Natural plant compounds continue to provide information for the development of new drugs.
The association of amfetamines and cathinones with acute coronary syndrome – a systematic review
Published in Clinical Toxicology, 2023
F. M. J. Gresnigt, E. S. Smits, C. den Haan, R. K. Riezebos, E. J. F. Franssen, D. W. de Lange
According to the World Drug Report, cocaine was used by 0.4%, and amfetamine-type stimulants (amfetamine, metamfetamine and 3,4-methylenedioxymetamfetamine) were used by 0.9% of the world population aged 15–64 in 2018 [11]. Recreational drugs are associated with an ongoing rise in recreational drug use disorders and drug-related deaths [11]. The use of cocaine, a sympathomimetic recreational drug, is a known risk factor for cardiovascular disease-inducing acute coronary syndrome. It increases oxygen demand through tachycardia and hypertension and causes endothelial dysfunction and platelet aggregation while simultaneously decreasing oxygen delivery due to coronary vasospasm [1,6,8,12–14]. In addition, long-term cocaine use will induce and accelerate atherosclerosis [8]. Since sympathomimetic effects contribute to the increased risk of cocaine-associated acute coronary syndrome, it has been suggested that other sympathomimetic recreational drugs, like amfetamines and cathinones, also increase the risk of acute coronary syndrome [2–5].
Emergency department visits due to new psychoactive substances and other illicit drugs in Taiwan: preliminary results of the Taiwan Emergency Department Drug Abuse Surveillance (TEDAS) project
Published in Clinical Toxicology, 2022
Chih-Chuan Lin, Te-I Weng, Chip-Jin Ng, Chia-Pang Shih, Jui Hsu, Yuan-Chun Liao, Chen-Chang Yang, Cheng-Chung Fang
The TEDAS project was established to monitor acute toxicity owing to the recreational use of drugs in EDs in Taiwan since 2019. After acquiring oral consent from patients or their family members, emergency physicians ordered a pre-specified urine toxicological screening (including 110 compounds listed in the Supplementary table). Patients aged below 12 years were not included in this study. Patients were enrolled if they self-reported recreational drug use, or manifested clinical presentations consistent with acute toxicity of recreational drug abuse such as unexplained consciousness change, acute delirium/hallucination, violent behavior, suicide attempt/non-suicidal self-harm, or other symptomatology that fulfilled the inclusion criteria. All urine samples were collected and de-identified at participating EDs and refrigerated without additives until they were sent to one of the two TEDAS laboratories for analysis. Clinical and laboratory data were anonymized and only linked to the case by the staff who performed the de-identification during urine sample collection. Urine samples were submitted in a particular form that enabled the recording of patient’s clinical characteristics, and the analysis was free of charge. The study was approved by the Ethics Committee of Chang Gung Memorial Hospital (approval no: 202000500B0, date of approval: 2020/03/31).
Co–administering cannabis with tobacco and persistent tobacco smoking after 4½ years in young adults who use stimulants: A prospective population–based study
Published in Journal of Psychoactive Drugs, 2022
Abdullah Ahmed Alghamdi, Coral Gartner, Jake Najman, Andrew Smirnov
It is important to examine the behavior of co-administration cannabis and tobacco for groups in which this behavior is common. Young adults who regularly engage in recreational use of illegal drugs such as ecstasy and methamphetamine are more likely than other young adults to use a range of other drugs, including cannabis and tobacco (Australian Institute of Health and Welfare 2020; Fraser, Gartner, and Hall 2014; Smirnov et al. 2013). In Australia and elsewhere, cannabis is the most commonly used recreational drug, followed by ecstasy and methamphetamine (Australian Institute of Health and Welfare 2020;. Office for National Statistics 2019). Data from the Australian Institute of Health and Welfare (2020) indicate that regular use of cannabis and tobacco is common among young adults who use ecstasy or methamphetamine. Consequently, young adults who use ecstasy or methamphetamine are likely to be a suitable group for examining intensive patterns of cannabis and tobacco smoking, including the co-administration of these drugs. In addition, the concurrent use of multiple drugs, including illicit stimulants, among people who use cannabis, may also influence patterns of cannabis and tobacco smoking (Wang et al. 2014).