SAS Urban Survival Handbook (128 page)

OVERDOSE SYMPTOMS

Depending on the amount and type of drug/substance involved, one or more of the following symptoms may occur:

• ■ Vomiting
  
• ■ Difficulty breathing
  
• ■ Sweating
  
• ■ Hallucination
  
• ■ Dilation or contraction of the pupils
  
• ■ Unconsciousness
  
• ■ Coma
  

ACTION
This is a general guide for all types of drug/substance overdose:

• ■ Seek urgent medical attention/CALL AN AMBULANCE if the victim is unconscious or having breathing difficulty. This is a life-threatening situation.
  
• ■ Collect a sample of vomit and any evidence —syringe, pill, bottle or container—near the victim, which may help with medical diagnosis.
  
• ■ If the victim is unconscious but breathing, check for any obstructions in the mouth and throat and place in the recovery position (see
  Save a life!
  ).
  
• ■ If the victim stops breathing, you must begin artificial respiration immediately (see
  Save a life!
  ).
  
• ■ Monitor the pulse. If the victim’s heart stops beating (and ONLY if it does) apply cardiac compression (see
  Save a life!
  ).
  
• ■ Stay with the victim and keep him/her calm. Make sure no more drugs/substances or alcohol are taken. Keep the victim away from bright lights and loud noise which may intensify the problem. Prevent any accidents. A ‘violent’ person may have to be physically restrained to prevent self-injury. Be as gentle as possible.
  
• ■ If solvents/gases have been used, remove the source and open doors and windows. Take care to avoid the risk of fire, especially if flammable substances have been used.
  
• ■ With milder drugs such as amyl nitrate and cannabis, it may only be necessary to wait for the effects to wear off provided that no other drugs have been used as well.
  
• ■ NEVER induce vomiting, unless the victim has DEFINITELY taken tranquillizers or barbiturates very recently. The only safe way to do so, is to insert your fingers GENTLY into the mouth towards the throat until the victim’s ‘vomit reflex’ takes over. NEVER do this with the victim on his/her back. If the victim is semi-conscious or unconscious, there is a severe risk of choking, or of fluid entering the lungs. Always call an ambulance FIRST—don’t waste time!
  
• ■ NEVER try to keep the victim awake by walking him/her around or by giving black coffee to drink. This will only speed the effects of the drug.
  

AMPHETAMINES

Swallowed in tablet or capsule form. Amphetamine sulphate powder is sniffed, swallowed, dissolved or injected. Traditionally known as ‘pep’ pills or ‘speed’.

OVERDOSE SYMPTOMS
The user will be restless and irrational, with outbursts of delusions and hysterical behaviour, even fits. There will be rapid breathing/pulse rate, twitching and increased body temperature.

AMYL NITRATE

Originally available only as glass ampoules containing a clear liquid. The vapours are inhaled. It is more common as ‘poppers’ in small, usually brown, glass bottles. Smells like dry-cleaning fluid.

OVERDOSE SYMPTOMS
Excessive doses will cause a severe headache and flushed skin, staggering and incoherence. The victim may collapse and have difficulty breathing.

BARBITURATES

Capsules and tablets of barbiturates are swallowed, often with alcohol, which can prove fatal. Pentothal, though not common, is injected. Barbiturates are ‘downers’.

OVERDOSE SYMPTOMS
The victim may be drowsy, semiconscious or comatose. If Pentothal is injected breathing may stop, especially after a large dose.

COCAINE

A fine white powder that may be sniffed (‘snorting’), dissolved in water and injected (‘mainlining’), mixed with tobacco and smoked (‘freebasing’) or chewed in the form of coca leaves. Most available cocaine can be presumed to be impure. It is often combined with amphetamine sulphate (‘speed’), which is cheaper. Particularly unscrupulous ‘dealers’ may extend the drug with almost ANY white powder, sometimes with disastrous consequences.

OVERDOSE SYMPTOMS
Cocaine overdose causes hysteria, delusions, physical tremors and fits. There may be an increase in the pulse, body temperature and breathing rate. The user could suddenly collapse from anaphylactic shock.

CANNABIS

Smoked in ‘joints’ or pipes, on its own or mixed with tobacco. It may also be added to cake mixtures and eaten. The effects of the drug are rarely dangerous. When taken to great excess, may impair judgement for several days. The main risk is that the drug may be contaminated with poisonous plant matter or insecticides.

OVERDOSE SYMPTOMS
Drowsiness, disorientation and mild hallucinations. In many cases, the user will fall asleep before toxic levels are reached.

SOLVENTS/GASES

Freely available in the form of lighter fuel, glues, dry-cleaning agents, petrol, nail varnishes and removers, all of which give off an intoxicating vapour. Glue or liquid is poured into a paper bag or onto a cloth and inhaled. The gases halon (used in some fire extinguishers) and butane (used for lighter fuel) are also abused.

OVERDOSE SYMPTOMS
Solvents/gases often lead to coma. Breathing may stop, particularly if the victim falls forward into the bag or cloth and continues to inhale the fumes. Extreme exertion after prolonged use may put the heart at risk. Halon affects the nervous system and leads to convulsions and even death.

HEROIN/MORPHINE

Both are usually smoked, but can also be swallowed or injected directly into a vein (‘mainlining’) once dissolved in water. Both are highly addictive.

OVERDOSE SYMPTOMS
Vomiting, coma and contracted pupils. Breathing may stop.

METHADONE

A synthetic drug resembling morphine. In liquid or tablet form, it is usually swallowed. Otherwise, methadone may be injected into a vein. Widely used in drug clinics to reduce the heavy dependence and cravings felt by heroin or morphine addicts. Methadone is not, however, without side effects.

OVERDOSE SYMPTOMS
The same as for heroin/morphine.

OPIUM

Raw opium is smoked in a pipe or swallowed. Refined opium is swallowed, smoked, injected, or heated and the fumes inhaled.

OVERDOSE SYMPTOMS
Similar to heroin/ morphine, but with less likelihood of breathing difficulties or coma.

LSD

Most hallucinogens, including LSD (lysergic acid diethylamide) and magic mushrooms, are swallowed. LSD is also known as ‘acid’.

OVERDOSE SYMPTOMS
Overdoses are rare, but accidents may occur through a ‘bad trip’ where the user experiences illusory terrors and tries to escape them. Occasionally the user may become violent, especially if very frightened.

TRANQUILLIZERS

Some tranquillizers, like Librium and Valium, are mild, whereas others like Largactil may have a profound sedative effect and can induce drowsiness even in normal doses. They are swallowed or occasionally injected.

OVERDOSE SYMPTOMS
Dangerous if taken with alcohol—can result in coma. Coma is less likely if tranquillizers are used on their own. Most tranquillizers used for prolonged periods (six weeks or more) are addictive or may lead to dependence. Even when prescribed by a doctor, they should only be used for short periods.

ALCOHOL DEPENDENCE

Habitual and compulsive heavy drinking commonly leads to hypertension, heart disease, liver disorders and brain disorders. Alcohol over-use is also closely linked to numerous social problems—traffic /industrial accidents, physical assault, marital breakdown, domestic violence and child abuse. Alcohol IS a poison—if the drinker collapses or becomes unconscious, there is a possibility of alcohol poisoning.

SYMPTOMS
Heavy drinking. In more serious cases, nausea, vomiting, shaking in the morning, lapses of memory, abdominal pain, facial redness, unsteadiness, confusion and irregular pulse. A habitual drinker may hide bottles, become aggressive or grandiose, be drunk for long periods of time, neglect his/her appearance or food intake, constantly promise to give up and have uncontrollable personality changes such as anger, violence and selfishness. After a heavy drinking session, the sufferer may be in a stupefied state. There is a severe danger that the drinker may fall into a coma and stop breathing.

WARNING Never assume that a person who looks drunk IS drunk. Other conditions such as diabetes mellitus and some drugs can produce similar apparent effects. Always check for the smell of alcohol.

ACTION
In the event of collapse or unconsciousness, seek urgent medical attention. If breathing stops while you are waiting, give artificial respiration. Do NOT induce vomiting. Loosen tight clothing, check that the mouth is clear. Place casualty in the recovery position to keep air-way open (see
Save a life!
).

REMEMBER
Treatment to help compulsive drinkers give up drinking altogether involves detoxification to help them get over withdrawal symptoms, which may include—in extreme cases—hallucinations (delirium tremens), severe shaking and convulsions. Longterm counselling and support may be needed to help them rebuild their lives. People who think they have an alcohol problem should contact their doctor or a help group such as Alcoholics Anonymous as soon as possible.

TOBACCO SMOKING

Nicotine, a constituent of tobacco, contains several cancer-causing (carcinogenic) substances. There is a direct link between the amount smoked and the likelihood of cancer of the lung, mouth, lips, throat, kidney, pancreas and bladder. The majority of people with head and neck cancers have a history of heavy alcohol use and smoking.

Another harmful effect of smoking is coronary heart disease, which kills more middle-aged men in industrial societies than any other disease. Smokers are about three times more likely to contract the disease than nonsmokers. Smoking also damages the arteries of the legs and brain and can lead to strokes. A number of other diseases have been linked with tobacco smoking.

WARNING Smoking and pregnancy: Smoking is extremely harmful during pregnancy—the foetus is likely to be smaller with less chance of survival. After birth, children of smokers are more likely to develop asthma and other respiratory diseases.

A woman who smokes during pregnancy increases her child’s risk of getting cancer. Other risks include spontaneous abortion, stillbirth and premature birth, as well as a baby of impaired growth and increased susceptibility to infection.

PASSIVE SMOKING
People who live, work or spend a lot of time in the company of smokers are at risk of contracting smoking-related illnesses. Passive smokers often suffer the immediate discomforts of coughing, wheezing and watery eyes. Evidence shows that the children of smokers take in the equivalent of 80 cigarettes each year and are more likely to smoke when they are older. It is also thought that those who live with smokers have an increased risk of developing lung cancer.

STOPPING SMOKING
If you want to stop smoking, the first and most important thing to do is to decide that you definitely will give up. Cutting down is usually only temporary. Acupuncture, hypnosis and chewing gum containing nicotine may help. Many people do not like the idea of gaining weight if they stop smoking. This is NOT a foregone conclusion, although it may occur temporarily because smoking increases the metabolic rate (the rate at which the body uses up food). Those who give up tend to eat more at first—sweets and ‘comfort’ foods may satisfy ‘cravings’. However, it is far safer to be slightly overweight than to smoke. Smoking is an addiction and a smoker wishing to give up may need help and support from family, friends, or a help group.

COFFEE & TEA

Some people may be surprised to find these common beverages classed as dangerous substances. But both contain tannin and caffeine, which have adverse effects on the body. Both can become addictive.

Coffee contains caffeine in larger amounts than tea or cola drinks. Caffeine is a stimulant drug, which affects all the organs and tissues of the body. In the short term, caffeine combats drowsiness and fatigue and can help the drinker to concentrate. In larger quantities (more than five cups per day) it may cause overstimulation, anxiety, irritability and restlessness. If you are suffering from or being treated for any anxiety-related condition, the effects may be dangerous.

Research shows that people who drink coffee throughout the week (at work, perhaps) often suffer withdrawal symptoms, such as irritability, headaches and fatigue, at the weekends if they go without a cup of coffee for just a few hours. Caffeine overdose causes muscle twitching, heart palpitations and abdominal pain.

As with other drugs, users tend to build up a level of tolerance and have to drink more before they are able to feel the effects. Caffeine can improve short-term athletic performance and is therefore banned in high doses during sports competitions.

Tea also contains caffeine, but in smaller doses than in coffee. More importantly, it contains tannin which was once used for medicinal purposes but has now been found to cause liver damage and constipation in large doses. Tannin is also suspected of having links with mouth cancer.