A drug overdose is defined as “taking an excessive amount of a drug or drugs”.
What is a drug overdose?
A drug overdose is defined as “taking an excessive amount of a drug or drugs”. This may lead to toxic effects on the body. The majority of people who have taken an overdose will survive with supportive measures, though occasionally drug overdoses may cause death. A drug overdose may be unintentional or deliberate. Drugs may include recreational drugs such as heroin, cocaine and amphetamines; over the counter drugs such as aspirin and panadol; or prescription medication such as anti-depressants and sleeping tablets.
Body systems affected
Each and every drug may affect different body systems including the lungs, heart, brain, liver and kidneys. Most commonly the patient presents with an alteration in neurological (level of consciousness), cardiovascular (heart) and respiratory (breathing) functions. Some drugs affect one body system whilst other drugs may affect several. It is not uncommon for people to take more than one drug at a time, again affecting many body systems.
Symptoms of a drug overdose
- Awake but unable to talk
- Erratic Behaviour
- Passing out
- Limp body
- Pale face
- Throwing up
- Choking or gurgling sounds
- Slow or erratic heart beat
- Absent Heart beat
- Slow shallow breathing
- Absent Breathinng
- Extreme temperature
What Happens in Intensive Care?
When a person is admitted with a drug overdose the most important aspect of patient care is to maintain the patient’s airway, breathing and blood pressure. This may require full support using an endotracheal tube (breathing tube) and ventilator (the breathing machine). Close monitoring of vital signs (heart rate, blood pressure, oxygen saturation) will be done using a bedside monitor. The patient will have an intravenous cannula and receive IV fluids.
Other treatments may be required but this is dependent on the type of drug taken. When the patient is unable to communicate, the medical staff may ask the family / friends if they know what drug was taken, how much and how long ago and if the patient has vomited since. This information is extremely important in determining what specific treatments are required. It is essential that you be honest about what drugs were taken, even if they are illegal, so that we can treat the patient appropriately and in a timely manner.
Specific treatments may include activated charcoal, haemodialysis (the kidney machine) and specific antidotes. Activated charcoal is sometimes given to prevent absorption of swallowed drugs. It also increases the clearance of drugs from the blood through the gut. Haemodialysis and other forms of dialysis can sometimes be used to remove drugs from the body. However, most drugs are not removed by dialysis, and then removal depends on the body’s natural methods for drug removal by the kidneys and/or the liver.. There are a few antidotes available for certain drugs and these may be used if appropriate
Sometimes a combination of these treatments may be required. Treatments are very dependent on what drug or drugs have been taken, the amount of drug taken and when it was taken.
Investigations may include taking blood, urine and stomach contents for analysis to determine what drugs have been taken. Blood tests may be ongoing to determine whether drug levels in the blood are increasing or decreasing. A chest x-ray will be done to determine if the tubes are in the correct position and to assess the lungs. An ECG or series of ECGs may be done if the heart has been affected.
How long will the patient remain in Intensive Care?
The patient will remain in the intensive care unit until they have been cleared medically. The intensivist on duty and / or toxicologist will determine this. Before the patient is allowed to leave the hospital a member of the psychiatry team must also review them especially if the overdose was deliberate. For patients with drug and or alcohol dependency a member of the drug and alcohol team may also see them.
Drug Overdose Version 1 (Author Melissa LintottCNS) First published online August 2006
The information contained on this page is general in nature and therefore cannot reflect individual patient variation. In addition it reflects Australian intensive care practice which may differ from other countries. It is meant as a back up to specific information which will be discussed with you by the Doctors and Nurses caring for your loved one. ICCMU attests to the accuracy of the information contained here BUT takes no responsibility for how it may apply to an individual patient. Please refer to the full disclaimer.