Assuntos
Estimulantes do Sistema Nervoso Central/intoxicação , Overdose de Drogas/etiologia , Hipnóticos e Sedativos/administração & dosagem , Dimesilato de Lisdexanfetamina/intoxicação , Tentativa de Suicídio , Adolescente , Relação Dose-Resposta a Droga , Overdose de Drogas/tratamento farmacológico , Feminino , Humanos , Resultado do TratamentoRESUMO
AIM: To assess the effect of involuntary drug treatment (IDT) on non-fatal overdose among people who inject drugs (PWID). DESIGN: Longitudinal study. SETTING: Tijuana, Mexico. PARTICIPANTS: Baseline sample of 671 PWID included 258 (38.4%) women and 413 (61.6%) men. MEASUREMENTS: Primary independent variables were reported recent (i.e. past 6 months) non-fatal overdose event (dependent variable) and IDT. Substance use the day of the non-fatal overdose was also examined. FINDINGS: From 2011 to 2017, 213 participants (31.7%) reported a recent non-fatal overdose and 103 (15.4%) reported recent IDT. Heroin, in combination with methamphetamine and tranquilizers, were the drugs most reported at the day of the event. IDT significantly increased the odds of reporting a non-fatal overdose event [adjusted odds ratio (aOR) = 1.76; 95% confidence interval (CI) = 1.04-2.96]. Odds of non-fatal overdose also increased independently for each additional injection per day (aOR = 1.05; 95% CI = 1.02-1.08), recent tranquilizer use (aOR = 1.92; 95% CI = 1.41-2.61) and using hit doctors (aOR = 1.68; 95% CI = 1.29-2.18) and decreased with age (aOR = 0.97 per year, 95% CI = 0.95-0.99). CONCLUSIONS: Recent involuntary drug treatment in Mexico is a risk factor for non-fatal drug overdose.
Assuntos
Overdose de Drogas/epidemiologia , Tratamento Involuntário/estatística & dados numéricos , Abuso de Substâncias por Via Intravenosa/terapia , Adulto , Estimulantes do Sistema Nervoso Central/intoxicação , Feminino , Heroína/intoxicação , Humanos , Estudos Longitudinais , Masculino , Metanfetamina/intoxicação , México/epidemiologia , Entorpecentes/intoxicação , Fatores de Risco , Tranquilizantes/intoxicaçãoRESUMO
Stimulant medications are used in the treatment of attention deficit hyperactivity disorder and serious cardiac complications can occur when these medications are abused. We present a 15-year-old adolescent girl who was found to have a Takotsubo cardiomyopathy after acute amphetamine/dextroamphetamine ingestion.
Assuntos
Estimulantes do Sistema Nervoso Central/intoxicação , Dextroanfetamina/intoxicação , Imagem Cinética por Ressonância Magnética/métodos , Cardiomiopatia de Takotsubo/induzido quimicamente , Cardiomiopatia de Takotsubo/diagnóstico por imagem , Adolescente , Eletrocardiografia/métodos , Feminino , Humanos , Prognóstico , Recuperação de Função Fisiológica , Medição de Risco , Tentativa de Suicídio , Cardiomiopatia de Takotsubo/terapia , Resultado do TratamentoRESUMO
BACKGROUND: Experimental studies in animal models and case reports in humans have described the hepatotoxic potential of cocaine. However, there are few data regarding the clinical and laboratory characteristics of patients admitted for cocaine intoxication, particularly regarding the status of the liver enzymes. GOAL: To investigate the significance of alanine aminotransferase (ALT) levels in individuals hospitalized for acute cocaine intoxication. METHODS: Retrospective study with standardized chart review that included patients admitted between January 2003 and December 2010. Bivariate analyses were used to investigate factors associated with ALT above the upper tertile according to gender. Cases of marked ALT elevation were described in detail. RESULTS: Ninety-three patients were included (79% men, mean age of 27.73±9.97 y). ALT above the upper tertile was associated with higher aspartate aminotransferase (AST), creatine phosphokinase, creatinine, and international normalized ratio. Higher levels of ALT were also related to acute renal failure and death. Five subjects had severe ALT elevation during follow-up and all had evidence of hepatocellular dysfunction (jaundice, prolonged prothrombin time with or without hepatic encephalopathy), rhabdomyolysis, and acute renal failure. AST/ALT ratio <2 was present in 2 subjects with severe ALT elevation at admission, but AST/ALT ratio >2 was observed in 3 cases with evidence of progression to acute liver injury. CONCLUSIONS: In acute cocaine intoxication, higher ALT levels were associated with evidence of muscle damage, progression to acute renal failure, and death. Severe liver damage was observed in 5% of the sample and was associated with rhabdomyolysis and renal failure in all cases.
Assuntos
Alanina Transaminase/sangue , Estimulantes do Sistema Nervoso Central/intoxicação , Doença Hepática Induzida por Substâncias e Drogas/diagnóstico , Ensaios Enzimáticos Clínicos , Transtornos Relacionados ao Uso de Cocaína/diagnóstico , Cocaína/intoxicação , Admissão do Paciente , Injúria Renal Aguda/induzido quimicamente , Adolescente , Adulto , Biomarcadores/sangue , Doença Hepática Induzida por Substâncias e Drogas/sangue , Doença Hepática Induzida por Substâncias e Drogas/etiologia , Doença Hepática Induzida por Substâncias e Drogas/mortalidade , Transtornos Relacionados ao Uso de Cocaína/sangue , Transtornos Relacionados ao Uso de Cocaína/complicações , Transtornos Relacionados ao Uso de Cocaína/mortalidade , Estudos Transversais , Progressão da Doença , Feminino , Humanos , Masculino , Valor Preditivo dos Testes , Estudos Retrospectivos , Rabdomiólise/induzido quimicamente , Fatores de Risco , Regulação para Cima , Adulto JovemRESUMO
OBJECTIVE: To describe bath salts and synthetic tetrahydrocannabinol (THC) exposures in the US from 2009 to 2012, hypothesizing a yearly increase. STUDY DESIGN: All exposures reported to American Association of Poison Control Centers between January 1, 2009, and April 30, 2012, were extracted from the National Poison Data System using generic and product codes. RESULTS: Bath salts and synthetic THC exposures totaled 7467 and 11,561, respectively. Bath salts exposures were 0 in 2009, 298 in 2010, and 6062 in 2011. Synthetic THC exposures were 14 in 2009, 2821 in 2010, and 6255 in 2011. First-tertile bath salts exposures were lower in 2012 (n = 1007) than in 2011 (n = 2027), and synthetic THC exposures were higher in 2012 (n = 2389) than in 2011 (n = 1888). Most exposures occurred in the midwest and southeast regions (64.8% of bath salts and 58% of synthetic THC exposures). Male subjects comprised 69% (n = 5153) of bath salts users and 74% (n = 8505) of synthetic THC users. Exposure to bath salts were highest in subjects 20-29 years of age (n = 2943), and exposure to synthetic THC was highest for subjects 13-19 years of age (n = 5349). Intentional abuse and inhalation were most common reason for and mode of exposure, respectively. CONCLUSIONS: Bath salts and synthetic THC abuse increased from 2009 to 2011. Synthetic THC emerged first and has more reported exposures than bath salts. In 2012, bath salts abuse declined and synthetic marijuana abuse increased. Young men intentionally abusing the drug via inhalation make up the majority of users.