Substances of abuse – Prescription medication, illegal drugs, alcohol continue to be a complicated public health challenge. Through the years, many substances have lead to poisoning and even death.

As drug trends continue to evolve, experts at the Florida Poison Information Center – Tampa are always available to provide timely medical advice to help facilitate effective diagnosis and treatment of overdoses even in case of unknown substances.

Please call 1-800-222-1222 for free confidential assistance.

Current Trends

Adulterated Spice, Cocaine and Heroin, prescription medications (counterfeits)

Electronic cigarettes (E-cigs) - vapor cigarettes, liquid nicotine (e-liquid, e-juice), JUUL

Pill Disposal

The federal Drug Enforcement Agency (DEA) coordinates National Prescription Drug Take Back Day events to provide a safe and convenient way to dispose unwanted medications. For more information about these events, please click here.

You can also call 1-800-882-9539 for more information.

Many counties offer permanent disposal sites – Prescription Drop-Off Box, please check with your local Sheriff or Police Department for the location nearest you.

Suicide

Suicide (whether a thought or an actual attempt) is considered an emergency and timely help is necessary. Please call the National Suicide Prevention Hotline 1-800-273-TALK (8255) for free confidential support 24/7.

Suicide Lifeline

1-800-273-TALK (8255)

Inhalant Abuse

Scenarios: A 16-year-old boy is found dead after inhaling fumes from an aerosol air freshener. A teen dies from sniffing nitrous oxide. A group of Central Florida pre-teens recently became ill after obtaining freon from a school air conditioning unit.

Products:

Children as young as 10 years old have abused:

  • spot removers
  • glue
  • disposable lighters
  • hair spray
  • paint thinners
  • whipped cream
  • polish removers
  • typewriter correction fluids
  • nitrous oxide
  • deodorants & air fresheners
  • gasoline

How do inhalants affect the body?

After inhaling the product for a short time, inhalants may create a feeling of excitation followed by drowsiness, headache, dizziness or respiratory irritation. Long-term abuse causes brain/kidney/liver damage. In some cases, instant death occurs because the heart begins beating erratically (ventricular fibrillation), resulting in “sudden sniffing death.”

Signs of regular use include:

  • paint or stains on the face or clothes
  • red or runny eyes or nose
  • spots or sores around the nose or mouth
  • chemical breath odor
  • anxiety, irritability, excitability

Awareness and prevention:

Parents can observe their children for the signs of abuse and changes in their child’s routines and behavior. Studies have shown that a high percentage of children have abused inhalants, but a low percentage of parents think children actually abuse these substances. Efforts such as family discussions, education and prompt treatment will help. For more information, visit www.inhalants.org.

Oxycontin

OxyContin, Oxycodone, Hillbilly Heroin, Oxy’s, Poor Man’s Heroin

What is OxyContin?
OxyContin refers to the continuous-release version of Oxycodone, a prescription narcotic for relief of severe pain. When the pills are taken by mouth, they provide pain relief for up to 12 hours.

How does OxyContin affect the body?
When pain pills are taken by a person who does not have chronic pain, the results are nausea, extreme drowsiness, constipation, dizziness, sweating and weakness. When a strong dose is taken, a person can have cold & clammy skin, slow heartbeat, constricted pupils, muscle weakness, lethargy, coma and shallow breathing. Long-term use of OxyContin is addictive.

How is it abused?
People seeking an alternative to heroin often try OxyContin. They chew the time-release tablets for a quicker high. Some crush the tablet to snort or inject it. Classified as a Schedule II drug, prescriptions are often obtained fraudulently, then sold for up to $180 per tablet. In many robberies of pharmacies and residences, only the Oxycontin is stolen.

How widespread is Oxycontin abuse?
In only 4 years since it hit the market (1996-2000), Emergency Room visits due to OxyContin abuse have doubled and deaths have quadrupled. The majority of abusers are age 35 and older. For more information, visit www.dea.gov.

How is an OxyContin overdose treated in the hospital?
Any person that cannot be awakened should be taken to the hospital. Do not let the person “sleep it off.” It is treated like any narcotic overdose, with a reversing agent and by supporting body functions possibly with the use of a ventilator (breathing machine).

Ecstasy

Ecstasy (MDMA, Adam, XTC, X)

What is Ecstasy?
A hallucinogenic amphetamine made in street labs. It comes in pill form in many colors & designs.

Who uses Ecstasy and why?
As a mind-altering hallucinogen with a speed effect, it’s taken to provide energy in dance clubs or to combat the effects of drugs such as downers or depressants.

What are some signs of Ecstasy use?
Users chew gum or suck on pacifiers to relieve tension in jaw muscles. High body temperatures cause users to remove layers of clothing and consume lots of water. Irritability and agitation may lead to the taking of alcohol or downers for a calming effect.

What are the dangers?
The normal dose is close to the toxic dose. When a person gets a strong tablet, they can experience fever, hallucinations, agitation, high blood pressure, irregular heartbeat, fast heartbeat, stroke, upset stomach, jaw clenching, muscle spasms, seizures (convulsions), sweating and dilated pupils. Deaths are usually due to complications from fevers up to 108° or seizures. For more information, visit www.dea.gov.

How is it treated in the hospital?
Support of breathing may involve use of a breathing machine (ventilator). Medications may be needed to control blood pressure, fast heart rates, agitation or convulsions. IV fluids and cooling measures help treat high fevers.

GHB

GHB – Gamma HydroxybutyrateXyrem, BD (Butadeniol), GBL (Gamma butyrolactone), GVL (Gamma valerolactone)

What is it?
GHB has been used in medical investigations, as a nutritional supplement and a street drug. It has been marketed as an over-the-counter sleep or weight-control aid. Bodybuilders claim that it stimulates release of a natural growth hormone and enhances muscle growth. It has been marketed illegally under various names: Gamma Hydroxybutric Acid, Sodium Oxybate, Oxybutyrate, Gamma-Oh, 4-Hydroxybutyrate, Gamma Hydrate, Somsanit, Blue Nitro and Somatomax PM. An investigational form, Xyrem, is prescribed for treatment of sleep disorders.

What problems does it cause?
The use of GHB as a legitimate drug and nutritional supplement was discontinued due to unsafe side effects such as convulsions and heavy sedation. Its sale and use was banned in Florida and California in 1990. The effects of this drug are unpredictable. Within 15 minutes after swallowing GHB, users may experience:

  • drowsiness, dizziness, shallow breathing, coma
  • amnesia, euphoria, headache
  • vomiting, loss of bowel/bladder control
  • slow heart rate, low blood pressure

With regular use, people become addicted. Discontinuing GHB after regular use can result in withdrawal, causing anxiety, shaking, paranoia, hallucinations, fever, fast heart rate and abnormal eye movements for weeks.

Why is it so dangerous?
When alcohol or other depressants are mixed with GHB, extreme sedation and death have occurred. Non-commercial GHB is manufactured on the street and can contain dangerous additives. The toxic dose is very close to the “party” dose, so even amounts as small as 1/4 teaspoon can be dangerous.

How is it treated in the hospital?
Patients exposed to GHB require symptomatic supportive care in a health care facility for monitoring of breathing, lethargy and possible seizures. There is no specific antidote for GHB, but screening for other types of sedatives can be helpful. Call the Florida Poison Information Center at 1-800-222-1222 for treatment details.

Coricidin

Dextromethorphan (DXM), Coricidin (CCC, Triple C’s) & Robitussin

Who abuses DXM and why?
The latest substance abuse trend involves taking over-the-counter cold remedies containing dextromethorphan. These are abused by teens and pre-teens because they can be purchased without a prescription in drugstores. This practice is often mistaken for a suicidal overdose because many pills are swallowed to achieve the desired effects. Teens hope to feel excitement and euphoria, but often encounter drowsiness, dizziness, vomiting, hallucinations, fast heartbeat, high blood pressure, convulsions, coma or death.

What are some signs of DXM use?
The person may have signs similar to alcohol intoxication: difficulty walking, vomiting, confusion and drowsiness. They may be out of touch with reality, exhibiting unnatural postures and feel extremely frightened. Depending on which added ingredients are in the product, the abuser may also have dilated pupils and feel hot, dry and flushed.

What are the dangers?
Added ingredients add potential problems, including high fevers or liver failure. The Coricidin can cause heart or nervous system damage. Long-term abuse can cause mental illness (psychosis), erectile dysfunction, frequent urination, chronic high blood pressure, muscle contortions and rapid back-and-forth eye movements (nystagmus).

How is it treated in the hospital?
Treatment may include many medications (to calm agitation, lower the blood pressure, slow the heartbeat, counteract coma, reduce muscle contortions, control convulsions), IV fluids, cooling measures or breathing machines. Call Florida Poison Information Center at 1-800-222-1222 for emergency advice or questions.

Wild Mushrooms

There are two types of mushrooms growing in the wild: the edible ones and the toxic ones. It often takes a mycologist (mushroom expert) to tell them apart. Many people have accidentally been poisoned after they thought certain identification tips were fool-proof. Any person or pet that swallows part of a wild mushroom should be treated in a medical facility BEFORE signs of illness occur.

mushrooms
Poisonous mushrooms can cause one or more of the following problems depending which type is eaten:
  • Fever
  • Hallucinations
  • Wheezing
  • Lung congestion
  • Inability to urinate
  • Hallucinations
  • Watery diarrhea
  • Seizures
  • Liver failure
  • Kidney failure
  • Bloody vomiting
  • Severe thirst
  • Muscle aches
  • Coma
  • Chest pain

Angel's Trumpet

These plants are the size of a bush or tree and produce large pastel-colored flowers that point down. The strength, or the amount of poison in each plant, varies according to its growing conditions. For instance well-cared-for plants may be more toxic than neglected ones or vice versa. Teens eat the flowers or boil the seeds to make tea.

angel-trumpet
Signs of poisoning include:
  • Dilated pupils
  • Confusion
  • Dry, warm skin
  • Inability to urinate
  • Drowsiness
  • Fast heartbeat
  • Severe thirst
  • Constipation
  • Anxiety

Methamphetamine

Crystal methamphetamine use is associated with numerous serious physical problems. The drug is a stimulant similar to cocaine, but much more addictive and dangerous. It can cause rapid heart rate, increased blood pressure, and damage to the brain cells. Regular use of the drug can result in inflammation of the heart lining. Overdoses can cause hyperthermia (elevated body temperature), convulsions, and death.

Individuals who use crystal methamphetamine also may have episodes of violent behavior, paranoia, anxiety, confusion, and insomnia. The drug can produce psychotic symptoms that last for months or years after an individual has stopped using the drug.

“Meth labs” are a neighborhood hazard: often booby-trapped and contain ingredients that explode and burn easily. Many people may be unaware that they’re living near a meth lab.

Here are some things to look for:

  • Unusual, strong odors (like cat urine, ether, ammonia, acetone or other chemicals).
  • Residences with windows blacked out.
  • Renters who pay their landlords in cash.
  • Lots of traffic – people coming and going at unusual times. There may be little traffic during the day, but at night the activity increases dramatically.
  • Excessive trash including large amounts of items such as: antifreeze containers, lantern fuel cans, red chemically stained coffee filters, drain cleaner and duct tape.
  • Unusual amounts of clear glass containers being brought into the home.

For more info:
https://www.drugabuse.gov/publications/drugfacts/methamphetamine.

Roofies

What are roofies?
Flunitrazepam is an approved prescription medication manufactured by Roche Laboratories under the trade name Rohypnol. It is a benzodiazepine, the same class of drug as diazepam (Valium), but it is much more potent.

How does a roofie affect the body?
It acts like a Valium (a depressant), causing relaxation and drowsiness. It is particularly dangerous when combined with alcohol and other depressants because it results in lethargy, coma or difficulty breathing. Medical professionals can screen and treat a roofie overdose just like a Valium overdose.

Who uses roofies?
Roofies has been called the Date Rape drug because it sedates victims and leaves them with a temporary amnesia. Roofies are also used to come down off stimulant drugs like cocaine or to enhance the effect of depressants like heroin.

Where do roofies come from?
While problems have been attributed to Rohypnol abuse in other countries where it is legal, South Florida appears to be the USA point of origin. At least twenty thousand tablets have been seized by the D.E.A. in Miami in one year alone. The illegally diverted Rohypnol is apparently of Colombian origin. Rohypnol has been classified as a Schedule III drug due to the abuse potential and is not approved for use in the United States.

For more information, visit https://www.dea.gov/.

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Spice or K-2: Synthetic Marijuana

Spice or K-2: Synthetic Marijuana

What is synthetic (man-made) marijuana?
“Spice” or “K-2” are just two names for products sold as incense. Other product names are Genie, Yucatan Fire, King Krypto, Mr. Nice Guy, K-3, Red Magic, Blueberry Medication and Super Skunk. The incense is sprayed with one or more chemicals which may include:

  • JWH-015, -018, -019, -073, -200, -398
  • HU-210, -211
  • CP 47, 497

Why do people smoke synthetic marijuana?
Instead of burning the incense as a fragrance, some people smoke it as a drug for a marijuana-like high. Its popularity was due to its former legal status and the fact that the chemicals do not test positive on a THC drug test.

Is it illegal to buy or possess?
In the USA as of March 2011, most of the most common ingredients are illegal to buy, sell or posses. It is scheduled as a Class I drug with penalties similar to marijuana possession. When one ingredient becomes illegal, sellers import another synthetic product s with different chemical ingredient to get around the law. It’s sold online and in some convenience stores, but just because it’s sold over-the –counter does NOT make it safe.

Are a lot of people using synthetic marijuana?
Poison Information Centers receive calls from people who become ill on Spice. Poison center data:
In 2010, there were 2,906 cases in the USA and 252 in Florida. 1,2
In 2011, there were 6,995 cases in the USA and 498 in Florida. 1,2
Jan- June 2012, there were 3,372 USA cases and 375 in Florida.

Are there any dangers to smoking this incense?
Many who have smoked the incense say it’s not the mellow high that they expected. The most common problems identified in hospital cases include agitation, fast heartbeat, vomiting and seizures. The long-term effects are not known, but people have reported psychiatric disturbances for two weeks after Spice use.

For answers or advice after exposure to a drug, call FL Poison Information Center free hotline 24/7 at 1-800-222-1222.

1. https://aapcc.org/
2. FL Poison Information Center

Prescription Pills

How Many People in Florida Die from Prescription Medication Abuse?

7 Floridians die every day from prescription medication abuse – 5 times as many deaths as from all illegal drugs. Since 2008, more Floridians died every day from medication poisoning than from car crashes.

Bath Salts

What’s in Bath Salts?
“Bath Salts” is the most common term referring to a set of synthetic drugs also sold as “Plant Food.” Labeled “not for human consumption,” the active ingredient may be one of several synthetic drugs similar to natural cathinone psychostimulants found in the khat plant:

Methylenedioxypyrovalerone (MDPV)
Fluoromethcathinone
Methylenedioxymethcathinone (methylone)
Methoxymethcathinone
Methylmethcathinone (Mephedrone)
Dimethlyamylamine (DMAA)
Diphenylmethylpiperidine (2DPMP)

The crystals or capsules may contain the anesthetic lidocaine. Bath salts are known by various brand names: Ivory Wave, Vanilla Sky, Zoom2, Pixie Dust, Sextacy, Ocean Burst, Purple Rain, Hurricane Charlie and many more.

Why do people inhale and ingest bath salts?
The products were rumored to be legal substitutes for amphetamine or cocaine. Until recently, the ingredients were legal and could be purchased at smoke shops or convenience stores. Florida’s Attorney General enacted an emergency rule in January 26, 2011, classifying some chemicals as Schedule 1 drugs so that possession is illegal in Florida. After the ruling, usage has decreased.

What happens to people who snort or smoke bath salts?
The nervous system is stimulated; creating a burst of energy along with high blood pressure, fast heart rate, increased alertness, anxiety and muscle cramps. There are frightening delusions, hallucinations, psychosis and paranoia. There are multiple accounts of people thinking that monsters, policemen or helicopters are chasing them. This has resulted in combativeness, assaults and suicide attempts. Deaths potentially related to effect of these products are reported.

For more information, please visit:

American Association of Poison Control Centers - https://aapcc.org/

National Institute of Drug Abuse - Drug Facts: Bath Salts

https://www.drugabuse.gov/publications/drugfacts/synthetic-cathinones-bath-salts