What is it about ?
Psychoactive substances are products which have an influence on the brain, and therefore also on the emotions, the senses and the state of consciousness. These are alcohol, illegal drugs and drugs used only for recreational purposes. They can have a stimulating effect (caffeine, amphetamines, cocaine, crack, ecstasy, …), a calming effect (alcohol, heroin, GHB, sleeping pills, sedatives, …) and modify the state of consciousness (hallucinogenic drugs such as cannabis, LSD, …).
It is possible to become addicted to these substances, and their use can be fatal. It is not uncommon for a user of psychoactive substances to be dependent on several products at the same time.
Alcohol poisoning causes as many deaths as all drug poisoning combined. Alcohol increases the risk of serious damage or bleeding in the brain. A dose of 6 g of alcohol per kg of body weight is fatal for an adult.
A heroin overdose is usually the result of intravenous administration. For a regular user, the risk of dying from an overdose is about 1 in 100.
As often, symptoms worsen with mixed poisoning (for example, alcohol mixed with another psychoactive substance), making it difficult to make a correct diagnosis and initiate treatment. appropriate.
How to recognize it?
The following signals can evoke the abuse of psychoactive substances, but they are very varied: weight loss, change in appetite, pallor, signs of fatigue, pupils very narrow or – conversely – very dilated, general disinterest in old hobbies, family and friends, poor school results or poor performance at work, severe mood swings, financial difficulties, avoidance behavior, …
Each group of substances also has its “typical” characteristics:
- for stimulants, it is an agitation sometimes accompanied by delusions and / or hallucinations (psychotic state) with a loss of control over reality. Cocaine can cause serious heart rhythm disturbances; the risk of seizures is higher with cocaine than with other stimulants. Ecstasy (XTC) carries a particular risk of severe dehydration and high body temperature (hyperthermia).
- sedatives such as alcohol, sleeping pills (benzodiazepines), GHB, … have a profound tranquilizing effect and induce sleep (sedative effect). They are often accompanied by confusion. Loss of consciousness can occur.
- heroin and other euphoric drugs cause severe narrowing of the pupils. The effect may resemble that of alcohol poisoning. Loss of consciousness is possible. Breathing difficulties are a particular risk.
How is the diagnosis made?
When suspecting abuse of psychoactive substances, the doctor will pay attention to the victim’s level of consciousness. Measuring blood pressure, pulse and temperature as well as observing the size of the pupils gives him an indication of the type of intoxication.
Serious complications (heart problems, brain hemorrhage, fever, difficulty in breathing) can occur with a large number of psychoactive substances. It is the combination of the different signs and symptoms that puts the doctor on the track of the substances consumed.
Some substances can be detected by means of a breath test (such as a breathalyzer), a blood test or a urine test.
It is sometimes not easy to make a quick and precise diagnosis. For example, a person’s clinical assessment may indicate a state of ‘heavy drunkenness’ while the concentration of alcohol in the blood underestimates the severity of the situation. Conversely, alcohol poisoning can give a positive result to the breathalyzer, even in the absence of alcohol in the blood.
What can you do ?
If you are having trouble switching off certain substances and their use negatively affects your daily activities, seek help. You can do this free of charge and anonymously (see below, section ‘Find out more?’).
In the event of an overdose, withdrawal symptoms, or an accident, drug users usually need urgent help. Loss of consciousness related to possible substance abuse is always an emergency. Contact the emergency services.
People who inject drugs intravenously can be infected with viruses that are transmitted through the blood, such as hepatitis C, hepatitis B and AIDS (HIV).
What can your doctor do?
Alcohol poisoning
A gastric lavage only makes sense if it is done immediately after ingestion. Faced with a breathalyzer showing a rate greater than 3 per thousand, with the absence of a verbal reaction to the stimulation or with a state suggesting the consumption of other substances, the victim is closely monitored in a hospital. His state of consciousness is monitored there, as well as his sugar level (blood sugar), signs of infection, body temperature, etc.
A child who is unconscious or suffering from heart problems or breathing problems must always be admitted to a specialized care unit.
The victim can only be discharged from the hospital when he or she is able to take care of herself or benefits from the support of another person with normal functional capacities.
The signs and treatment of carburettor fluid or antifreeze (isopropanol) poisoning are the same as for alcohol poisoning.
Heroin poisoning
In the event of serious breathing problems, respiratory support is provided by means of a mask or intubation. Naloxone, which is an antidote for heroin and other drugs in the same class (opiates), is given by infusion or injection under the skin or into the muscle. The victim is then followed for at least 2 hours in order to be able to quickly detect a relapse or adverse effects.
Poisoning by stimulants
We try to neutralize the effect of stimulants by administering sedatives (diazepam or lorazepam). In case of loss of consciousness, chest pain, or suspected heart rhythm disturbances, an electrocardiogram (ECG) is usually done. If the blood pressure is (very) high, hypotensive drugs (such as labetalol) are given. In the presence of heart problems, appropriate drug therapy is given.
Poisoning by other substances
Windshield washer fluid (from methanol) or antifreeze (from ethylene glycol) can cause symptoms such as confusion, vomiting, hyperventilation, dilated pupils, convulsions, too little sugar in the blood (hypoglycemia) and kidney problems. In this case, alcohol (ethanol) is administered as quickly as possible and an immediate hospitalization is organized. Methanol is already lethal at a dose of 30 ml, or the equivalent of 2 tablespoons.
Want to know more?
- Alcohol ingestion in young children – Center Antipoisons
- Be careful with the combination of alcohol and medication – poison center
- Binge drinking is dangerous for young people – Center Antipoisons
Are you looking for more specialized help?
- Alcohol aid – Le Pélican & Le center ALFA
- AA – Alcoholics Anonymous
- Infor-Drogues – Another listen
- Mental Health Services – The Social Guide
- Poison Control Center 070 245 245
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