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In the past, a drug overdose was a somewhat rare occurrence. An occasional news report of a celebrity drug overdose death or a neighborhood rumor about a local overdose might emerge, but these incidents were not common. How dramatically things can change in a decade or two. Now our nation grapples with an epidemic of overdose deaths, claiming tens of thousands of lives per year. In 2017, over 70,000 Americans died due to a drug overdose, according to the Centers for Disease Control. Whether it is an intentional or accidental drug overdose, the result is the same–lives altered or lost.
By far the highest rates of accidental drug overdoses involve opioids, but in 80% of overdose deaths two or more substances were ingested. Losing track of dosing, taking the pills on an empty stomach, combining medications, or drinking alcohol along with prescription meds—all of these can result in an overdose.
Of course, not drug overdoses are accidental. While 87% are accidental drug overdoses, the remaining 13% were caused by intentional misuse. Some individuals purposely abuse multiple drugs, literally playing Russian roulette with their lives. Suicide attempts are another source of intentional drug overdoses, with 7% of overdoses deaths attributed to suicide.
Individuals who are discovered before the toxicity reaches a fatal level can be successfully treated. Emergency interventions provided in a timely manner make the difference between life and death. Now many first responders are trained to administer naloxone, an antidote to reverse the effects of an opioid overdose, which has had a profound impact on saving lives that otherwise would have succumbed.
The most perilous drug to hit the street in the last few years is fentanyl. Fentanyl is a synthetic opioid that is about 50 times more potent than heroin. This drug has been flooding into the U.S. via Mexico and China, embedded into heroin as well as in pills purchased illicitly on the street or online. Most individuals are not aware that the substance they purchased contains the deadly fentanyl, and may quickly overdose as a result.
Ironically, many of the opioid overdose deaths occurred in individuals who had been clean and sober for a substantial period, and then relapsed. This happens because the brain has adjusted to the absence of the opioid during the period of sobriety. When the individual relapses they use the same dosage as when they were active in the addiction, overpowering the brain and central nervous system, and resulting in a fatality.
What Are the Signs of an Overdose?
The symptoms of a drug overdose will vary depending on the class of drug, and the severity of the symptoms may differ among individuals based on biology, general health, age, and whether there was more than one substance involved. Symptoms might include:
Benzodiazepines and other depressants:
- Slowed or slurred speech
- Difficulty walking or standing
- Cognitive impairment
- Blurred vision
- Very low blood pressure
Opioids or heroin:
- Low blood pressure
- Clammy, grey or bluish skin
- Slowed heart rate
- Slowed respiratory rate
- Pinpoint pupils
- Loss of consciousness
- Chest pain
- Heart arrhythmia
- Labored breathing
- Irregular heartbeat
Treatment for Accidental Overdose
If an overdose is suspected, a call for immediate assistance is essential. The first responder will ask about what drug or drugs might have been taken and in what dosages, and what time the drug was ingested. Any information provided can help the first responder administer life-saving procedures.
Once the drug of abuse has been identified, blood tests can help monitor how rapidly the drug is clearing the body, and whether any damage to the liver or kidneys has resulted. Immediate care is imperative, as the toxins can do more damage as time passes.
Emergency measures will possibly include:
- Assessment of the airway to see if the trachea is blocked. If so, intubation will be required, which involves inserting a tube through the mouth and into the trachea to assist breathing.
- Vital signs assessed
- Blood and urine samples collected
- Vomiting is induced to eliminate unabsorbed substance of abuse
- Gastric lavage may be utilized, which washes out the stomach. The contents of the stomach are suctioned out through a tube.
- Diuretics or laxatives may be used to further flush any absorbed substance from the body.
- Activated charcoal may be given to help absorb the substance
- Intravenous fluids may be administered to help with dehydration as well as to further flush the drug from the body. Electrolytes, such as sodium, bicarbonate, or potassium may be administered through the IV line.
- In some cases where kidney damage has resulted, hemodialysis is performed. This procedure involves blood being circulated out of the body and into a dialysis machine before being reintroduced into the body.
- In the event of a narcotic poisoning, the antidote naloxone can be used to reverse the respiratory distress caused by the overdose.
In addition to the emergency interventions, psychiatric evaluation will be conducted if it is determined that the overdose was intentional. Regardless of if it was an intentional or accidental overdose, a follow up visit to the individual’s physician will be needed.
Addiction Recovery After an Overdose
Individuals who have experienced a drug overdose are in need of addiction treatment interventions. Whether they are dealing with a recent drug problem or an entrenched chemical dependency, the fact that they have had an overdose is a warning sign that their substance use disorder is serious.
Addiction treatment is available in either outpatient or inpatient formats. In most cases, insurance plans will cover at least a portion of the expenses related to treatment and rehabilitation. Plan coverage and personal resources will often dictate whether the individual will receive outpatient or inpatient care.
Outpatient rehab is available in three levels of intensity: basic outpatient therapy, intensive outpatient programs (IOP) and partial hospitalization programs (PHP). The number of weekly hours dedicated to addiction treatment is based on the level of intensity of the outpatient program. Individuals will be able to live at home while they are receiving treatment, and can usually still work at least part-time. Most outpatient rehab programs last 3-6 months in duration.
The inpatient treatment option is a residential program that provides the highest standard of care. Inpatient rehab offers continuous support within a structured setting, and with multiple therapeutic activities offered daily. The benefit of an inpatient program is being able to focus entirely on recovery without the stressors or distractions of daily life. There are many different types of rehabs available, specializing in various niches, such as luxury rehab, faith-based rehab, pet-friendly rehab, couples rehab, holistic rehab, and more. It is important to select a rehab program that best aligns with personal preferences and philosophies.
Treatment for a Substance Use Disorder
Both outpatient and inpatient rehabs aim to provide the building blocks to a new, healthy life in sobriety. Most programs are multi-modal, meaning they offer a variety of treatment elements that sync to help the individual in recovery make fundamental changes in their thought patterns and behavioral responses.
Addiction treatment includes:
Detox and withdrawal. At the outset of the recovery journey, the individual may have to first undergo the detox process. This involves the period of time after cessation of drug use when the body expels the substance. Detox and withdrawal can take 5-14 days depending on the substance of abuse and the length of the addiction history. Detox and withdrawal management involves continuous oversight, with medications provided to minimize discomfort.
Evidence-based psychotherapy. Some types of psychotherapy are especially effective in treating substance use disorders. These include cognitive behavioral therapy, dialectical behavior therapy, contingency management, and motivational enhancement therapy. Psychotherapy assists the recovery process in two ways. First, it can help identify any underlying emotional issues that are contributory, and second, therapy can help guide the individual in changing their dysfunctional thought/behavior patterns.
Peer group therapy. Group therapy is a popular aspect of rehab, as it involves meeting with peers to share feelings and frustrations, as well as to learn better communication skills. Group therapy helps bond individuals in treatment, helping to created a strong source of social support.
Education. Psychosocial education covers a broad range of topics related to recovery. New coping skills are taught, and relapse prevention plans are created. In some programs, job seeking skills and other life skills are taught to prepare the individual for their entry back into the workforce after treatment.
Medication-assisted treatment. Some individuals, particularly those with long-term opioid or alcohol addictions, will benefit from support in recovery. Drugs such as buprenorphine and naltrexone can help sustain recovery by reducing the effects of the drug, thereby reducing cravings and relapse risk.
Dual diagnosis treatment. About 25% of individuals with a substance use disorder also have a co-occurring mental health disorder. Psychiatric assistance is available for these individuals while they are being treated for the substance use disorder.
Holistic therapies. Learning how to regulate stress is an essential coping skill in recovery. Most rehabs now introduce individuals to various holistic activities, such as yoga and meditation, that can help them reduce stress and invoke relaxation.
Recreational therapy. Exercise is a natural coping skill, as physical activity produces endorphins, which help to improve mood, and serotonin, which helps reduce anxiety. Rehabs offer a range of outdoor activities to enable individuals the opportunity to get exercise while in treatment.
Capo by the Sea Provides Dual Diagnosis Treatment in Orange County
Capo by the Sea is a premier addiction and dual diagnosis recovery program located in Southern California. The clinical team at Capo by the Sea is trained to guide individuals who have experienced an accidental drug overdose back to healthy functioning through a life of sobriety and wellness. For more information about the program, please contact our team today at [phone_number].