A male in late 50 s was found unconscious in a Delhi hotel. He had been to a late night party yesterday and came back a little drunk. Hotel helped him to his room.
Knock Knock - no reply till next day evening when he was to supposed to check out in the afternoon.
Police were informed and he was found unconscious.
Vomiting episodes - a little blood in the bathroom - otherwise all well.
No signs of struggle - no theft - no one in the room.
He was taken in an Ambulance to the hospital.
Placed on ventilator - blood test was positive for drugs.
Drug Abuse & Dependency
Drugs are abused because they cause strong feelings of euphoria and alter the perceptions. It is usually taken to mean the use of an illicit drug or the excessive or nonmedical use of licit drug. The drug abuse also donates the deliberate use of chemicals that are generally not considered drugs by the lay public but may be harmful to the user. A primary motivation for drug abuse appears to be the anticipated feeling of the pleasure derived from the CNS effects of the drugs. However, repetitive exposure induces widespread adaptive changes in the brain. As a result of this drug use may become compulsive which is the hallmark of addiction.
Every addictive drug causes its own characteristic spectrum of acute effects, but all of them have in common one effect the strong feelings of euphoria and reward. With continuous use, addictive drugs induce adaptive changes such as tolerance which is the escalation of the drug to maintain an effect. Once the drug of abuse is not available, signs of withdrawal become apparent.
A combination of such signs referred to as the withdrawal syndrome, defines dependence. The body becomes totally dependent on the availability of the drug. The drug addiction is characterized by a high motivation to obtain and use a drug despite negative consequence. If drug is not available, person craves for its need and wants in anyhow. This is the withdrawal effect which leads to further use of drug and dependence.
Withdrawal Effect of Drugs
Physiological dependence occurs with continuous use of any drug. The most important signs of withdrawal derive from excessive CNS stimulation and include nausea, vomiting, tremors, anxiety, delirium, sweating, yawing, rhinorrhea, muscle jerks, hyperpnoea and hallucinations.
Drugs of Abuse: Some of the important drugs of abuse are
Due to some diseases like chronic pain, depressions, anxiety, sleep disorders or number of other disease lead to chronic use of drugs and their dependence. Some people take drug in order to get pleasure and become addicted to them.
Behavioral Effects Due to Drug Abuse and Dependence
The drug addiction leads to many immoral acts and deterioration of person personality. Such a person become unaware of what is right and what is wrong. He becomes abusive and forgets the moral values. He does crimes even. He can kill anyone just to fulfill his drugs needs. He lost everything for this fulfillment of drug addiction.
Treatment: The pharmacological intervention may aim to eliminate this addiction along with withdrawal effects. Some of the drugs use against this addiction are naltrexone, baclofen and rimonabant. Dependence can be reduced with the support of behavioral interventions.
We transport at least 2 patients every month who are drug dependent and the transportation comes with its own set of clinical problems which needs to be addressed when we are transporting such patients. Also involved is the police formalities which needs to be taken care of before the actual transportation of the patient is done.
More information on patient transportation in India - Delhi - www.vibha.info.