intoxications

Cocaine is a very addictive drug that is made from leaves of the coca plant found in South America. It is mostly available as an illegal drug that some people use to get high. In rare cases, it is also used as a prescription drug for for anesthesia during certain surgeries.

As a street (illegal) drug, cocaine is usually a fine, white, crystal powder. Street dealers sometimes mix it with cornstarch, talcum powder, or flour to make it look like they have more cocaine. That way they can make more money. They may also mix it with other illegal drugs. Another form of the drug is crack cocaine. Crack cocaine has been heated to make it into a rock crystal.

People snort cocaine powder through the nose or rub it into their gums. Others dissolve the powder and inject it into the bloodstream. Some people inject a combination of cocaine and heroin, called a "speedball." Crack cocaine is smoked.

Cocaine is a stimulant that can make people feel like they have more energy and are extra alert. But it can also make people feel restless, irritable, anxious, and paranoid. Large amounts of cocaine can lead to bizarre, unpredictable, and violent behavior.

Cocaine's effects appear almost immediately and disappear within a few minutes to an hour. How long the effects last and how intense they are will depend on how the person used it.

In some cases, cocaine can cause very serious health problems such as a heart attack, stroke, or coma.

People who use cocaine over the long term may develop health problems. Which problems they have will depend on how they used the cocaine:

• Snorting it can lead to a loss of sense of smell, nosebleeds, nasal damage, and trouble swallowing.
• Smoking it can cause a cough, asthma, trouble breathing, and a higher risk of infections like pneumonia.
• Injecting it with a needle can lead to skin or soft tissue infections, as well as scarring. It can cause collapsed veins. When a vein collapses, the blood cannot flow through it. Injecting cocaine also puts a person at higher risk of getting diseases such as HIV and hepatitis C.

Other long-term effects of cocaine use may include malnutrition and movement disorders, including Parkinson's disease.

Repeated use of cocaine can lead to tolerance. This means users need more and more of the drug to have the same effect. At higher doses over time, the body becomes dependent on cocaine. If someone who is dependent on cocaine stops using it, they will have withdrawal symptoms. These symptoms can include:

• Depression
• Restlessness
• Fatigue
• Increased appetite
• Bad dreams and insomnia
• Slowed thinking

Repeated use of cocaine can also lead to cocaine use disorder, also called addiction. This is more than physical dependence. It's a chronic (long-lasting) brain disorder. When someone has it, they continue to use cocaine even though it causes problems in their life. Some examples include health problems and not being able to meet responsibilities at work, school, or home. Getting and using cocaine becomes their main purpose in life.

It's possible to overdose on cocaine. This happens when a person uses so much cocaine that it causes a life-threatening reaction or death. Some people use cocaine along with other drugs or alcohol. This can increase the risk of an overdose.

A cocaine overdose can cause health problems such as:

• Stroke
• Seizures
• irregular heartbeat (arrhythmia)
• Heart attack

There is no specific medicine to treat an overdose. Health care providers will focus on treating the specific health problems caused by the overdose.

The treatments for cocaine use disorder are different types of behavioral therapies. There are no medicines which can treat it.

NIH: National Institute on Drug Abuse

Delirium is a mental state in which you are confused, disoriented, and not able to think or remember clearly. It usually starts suddenly. It is often temporary and treatable.

There are three types of delirium:

• Hypoactive, when you are not active and seem sleepy, tired, or depressed
• Hyperactive, when you are restless or agitated
• Mixed, when you change back and forth between being hypoactive and hyperactive

There are many different problems that can cause delirium. Some of the more common causes include:

• Advanced cancer.
• Alcohol or drugs, either from intoxication or withdrawal. This includes a serious type of alcohol withdrawal syndrome called delirium tremens. It usually happens to people who stop drinking after years of alcohol use disorder (AUD).
• Dehydration and electrolyte imbalances.
• Dementia.
• Hospitalization, especially in intensive care.
• Infections, such as urinary tract infections, pneumonia, and the flu.
• Medicines. This could be a side effect of a medicine, such as sedatives or opioids. Or it could be from withdrawal after stopping a medicine.
• Metabolic disorders.
• Organ failure, such as kidney or liver failure.
• Poisoning.
• Serious illnesses.
• Severe pain.
• Sleep deprivation.
• Surgeries, including reactions to anesthesia.

Certain factors put you at risk for delirium, including:

• Being in a hospital or nursing home
• Having dementia
• Having a serious illness or more than one illness
• Having an infection
• Older age
• Having surgery
• Taking medicines that affect the mind or behavior
• Taking high doses of pain medicines, such as opioids

The symptoms of delirium usually start suddenly, over a few hours or a few days. They often come and go. The most common symptoms include:

• Changes in alertness (usually more alert in the morning, less at night)
• Changing levels of consciousness
• Confusion
• Disorganized thinking, talking in a way that doesn't make sense
• Disrupted sleep patterns, sleepiness
• Emotional changes: anger, agitation, depression, irritability, overexcitement
• Hallucinations and delusions
• Memory problems, especially with short-term memory
• Trouble concentrating

Your health care provider may use many tools to make a diagnosis:

• A medical history, which includes asking about your symptoms
• Physical and neurological exams
• Mental status testing, which checks for problems with your thinking and alertness
• Lab and diagnostic imaging tests

Delirium and dementia have similar symptoms, so it can be hard to tell them apart. You can also have both at the same time. The differences between them are that:

• Delirium starts suddenly and can cause hallucinations. It is mainly a problem with attention and staying alert. The symptoms may get better or worse and can last for hours or weeks.
• Dementia develops slowly and does not cause hallucinations. It usually starts with memory loss. The symptoms don't change often, like they can with delirium. Dementia almost never gets better.

Treatment of delirium focuses on the causes and symptoms of delirium. The first step is to identify the cause. Often, treating the cause will lead to a full recovery. The recovery may take some time - weeks or sometimes even months. In the meantime, there may be treatments to manage the symptoms, such as:

• Controlling the environment, which includes making sure that the room is quiet and well-lit, having clocks or calendars in view, and having family members around
• Medicines, including those that control aggression or agitation and pain relievers if there is pain
• If needed, making sure that the person has a hearing aid, glasses, or other devices for communication

Treating the conditions that can cause delirium may reduce the risk of getting it. Hospitals can help lower the risk of delirium by avoiding sedatives and making sure that hospital rooms are kept quiet, calm, and well-lit. It can also help to have family members around and to have the same staff members treat the person each day (if possible).

Drugs are chemical substances that can change how your body and mind work. They include prescription medicines, over-the-counter medicines, alcohol, tobacco, and illegal drugs.

Drug use, or misuse, includes:

• Using illegal substances, such as
• Anabolic steroids
• Club drugs
• Cocaine
• Heroin
• Inhalants
• Marijuana
• Methamphetamines
• Misusing prescription medicines, including opioids. This means taking the medicines in a different way than the health care provider prescribed. This includes
• Taking a medicine that was prescribed for someone else
• Taking a larger dose than you are supposed to
• Using the medicine in a different way than you are supposed to. For example, instead of swallowing your tablets, you might crush and then snort or inject them.
• Using the medicine for another purpose, such as getting high
• Misusing over-the-counter medicines, including using them for another purpose and using them in a different way than you are supposed to

Drug use is dangerous. It can harm your brain and body, sometimes permanently. It can hurt the people around you, including friends, families, kids, and unborn babies. Drug use can also lead to addiction.

Drug addiction is a chronic brain disease. It causes a person to take drugs repeatedly, despite the harm they cause. Repeated drug use can change the brain and lead to addiction.

The brain changes from addiction can be lasting, so drug addiction is considered a "relapsing" disease. This means that people in recovery are at risk for taking drugs again, even after years of not taking them.

Not everyone who uses drugs becomes addicted. Everyone's bodies and brains are different, so their reactions to drugs can also be different. Some people may become addicted quickly, or it may happen over time. Other people never become addicted. Whether or not someone becomes addicted depends on many factors. They include genetic, environmental, and developmental factors.

Various risk factors can make you more likely to become addicted to drugs, including:

• Your biology. People can react to drugs differently. Some people like the feeling the first time they try a drug and want more. Others hate how it feels and never try it again.
• Mental health problems. People who have untreated mental health problems, such as depression, anxiety, or attention deficit/hyperactivity disorder (ADHD) are more likely to become addicted. This can happen because drug use and mental health problems affect the same parts of the brain. Also, people with these problems may use drugs to try to feel better.
• Trouble at home. If your home is an unhappy place or was when you were growing up, you might be more likely to have a drug problem.
• Trouble in school, at work, or with making friends. You might use drugs to get your mind off these problems.
• Hanging around other people who use drugs. They might encourage you to try drugs.
• Starting drug use when you're young. When kids use drugs, it affects how their bodies and brains finish growing. This increases your chances of becoming addicted when you're an adult.

Signs that someone has a drug problem include:

• Changing friends a lot
• Spending a lot of time alone
• Losing interest in favorite things
• Not taking care of themselves - for example, not taking showers, changing clothes, or brushing their teeth
• Being really tired and sad
• Eating more or eating less than usual
• Being very energetic, talking fast, or saying things that don't make sense
• Being in a bad mood
• Quickly changing between feeling bad and feeling good
• Sleeping at strange hours
• Missing important appointments
• Having problems at work or at school
• Having problems in personal or family relationships

Treatments for drug addiction include counseling, medicines, or both. Research shows that combining medicines with counseling gives most people the best chance of success.

The counseling may be individual, family, and/or group therapy. It can help you:

• Understand why you got addicted
• See how drugs changed your behavior
• Learn how to deal with your problems so you won't go back to using drugs
• Learn to avoid places, people, and situations where you might be tempted to use drugs

Medicines can help with the symptoms of withdrawal. For addiction to certain drugs, there are also medicines that can help you re-establish normal brain function and decrease your cravings.

If you have a mental disorder along with an addiction, it is known as a dual diagnosis. It is important to treat both problems. This will increase your chance of success.

If you have a severe addiction, you may need hospital-based or residential treatment. Residential treatment programs combine housing and treatment services.

Drug use and addiction are preventable. Prevention programs involving families, schools, communities, and the media may prevent or reduce drug use and addiction. These programs include education and outreach to help people understand the risks of drug use.

NIH: National Institute on Drug Abuse

Heroin is an illegal, very addictive opioid drug. It's made from morphine, which comes from the seedpod of opium poppy plants. These plants grow in Southeast and Southwest Asia, Mexico, and Colombia. Heroin can be a white or brown powder, or a black sticky substance known as black tar heroin.

People inject, sniff, snort, or smoke heroin. Some people mix heroin with crack cocaine, which is called "speedballing." All these ways of taking heroin send it to the brain very quickly, which makes it highly addictive.

People who use heroin report feeling a "rush" (a surge of pleasure). And then they may feel other effects, such as a warm flushing of the skin, dry mouth, and a heavy feeling in the arms and legs. They may also have severe itching, nausea, and vomiting. After these first effects, they will usually be drowsy for several hours, and their breathing will slow down.

People who use heroin over the long term may develop many different health problems. These problems could include liver, kidney, and lung disease, mental disorders, and abscesses.

People who inject the drug also risk getting infectious diseases such as HIV, hepatitis, and bacterial infections of the skin, bloodstream, and heart (endocarditis). They can also get collapsed veins. When a vein collapses, the blood cannot flow through it.

Repeated use of heroin can lead to tolerance. This means users need more and more of the drug to have the same effect. At higher doses over time, the body becomes dependent on heroin. If someone who is dependent on heroin stops using it, they have withdrawal symptoms. These symptoms can include restlessness, muscle and bone pain, diarrhea, vomiting, and cold flashes with goose bumps.

Repeated use of heroin often leads to heroin use disorder, sometimes called addiction. This is more than physical dependence. It's a chronic (long-lasting) brain disorder. When someone has it, they continue to use heroin even though it causes problems in their life. Some examples include health problems and not being able to meet responsibilities at work, school, or home. Getting and using heroin becomes their main purpose in life.

It's possible to overdose on heroin. This happens when a person uses so much heroin that it causes a life-threatening reaction or death. All heroin users are at risk of an overdose because they never know the actual strength of the drug they are taking or what may have been added to it. And people often use heroin along with other drugs or alcohol. This can increase the risk of an overdose.

When people overdose on heroin, their heart rate and breathing slow down. Their breathing may slow do so much that not enough oxygen reaches the brain. This condition is called hypoxia. Hypoxia can lead to a coma, permanent brain damage, or death.

A medicine called naloxone can treat a heroin (or other opioid) overdose if it is given in time. It works by blocking the effects of the opioid on the body. Sometimes more than one dose of the medicine is needed.

There are two forms of naloxone that anyone can use without medical training: nasal spray and injectable. People at risk of an overdose are encouraged to carry naloxone with them. They can buy naloxone at a pharmacy.

Treatments for heroin use disorder include medicines to treat withdrawal symptoms, medicine to block the effects of opioids, and behavioral treatments. Often, a combination of medicine and behavioral treatment works best. People getting treatment for heroin use disorder should work with their health care providers to come up with a treatment plan that fits their needs.

NIH: National Institute on Drug Abuse

Marijuana is a green, brown, or gray mix of dried, crumbled parts from the marijuana plant. The plant contains chemicals which act on your brain and can change your mood or consciousness.

There are many different ways that people use marijuana, including:

• Rolling it up and smoking it like a cigarette or cigar
• Smoking it in a pipe
• Mixing it in food and eating it
• Brewing it as a tea
• Smoking oils from the plant ("dabbing")
• Using electronic vaporizers ("vaping")

Marijuana can cause both short-term and long-term effects.

Short term:

While you are high, you may experience:

• Altered senses, such as seeing brighter colors
• Altered sense of time, such as minutes seeming like hours
• Changes in mood
• Problems with body movement
• Trouble with thinking, problem-solving, and memory
• Increased appetite

Long term:

In the long term, marijuana can cause health problems, such as:

• Problems with brain development. People who started using marijuana as teenagers may have trouble with thinking, memory, and learning.
• Coughing and breathing problems, if you smoke marijuana frequently
• Problems with child development during and after pregnancy, if a woman smokes marijuana while pregnant

It is possible to overdose on marijuana, if you take a very high dose. Symptoms of an overdose include anxiety, panic, and a rapid heartbeat. In rare cases, an overdose can cause paranoia and hallucinations. There are no reports of people dying from using just marijuana.

After using marijuana for a while, it is possible to get addicted to it. You are more likely to become addicted if you use marijuana every day or you started using it when you were a teenager. If you are addicted, you will have a strong need to take the drug. You may also need to smoke more and more of it to get the same high. When you try to quit, you may have mild withdrawal symptoms such as:

• Irritability
• Trouble sleeping
• Decreased appetite
• Anxiety
• Cravings

The marijuana plant has chemicals that can help with some health problems. More states are making it legal to use the plant as medicine for certain medical conditions. But there isn't enough research to show that the whole plant works to treat or cure these conditions. The U.S. Food and Drug Administration (FDA) has not approved the marijuana plant as a medicine. Marijuana is still illegal at the national level.

However, there have been scientific studies of cannabinoids, the chemicals in marijuana. The two main cannabinoids that are of medical interest are THC and CBD. The FDA has approved two drugs that contain THC. These drugs treat nausea caused by chemotherapy and increase appetite in patients who have severe weight loss from AIDS. There is also a liquid drug that contains CBD. It treats two forms of severe childhood epilepsy. Scientists are doing more research with marijuana and its ingredients to treat many diseases and conditions.

NIH: National Institute on Drug Abuse

Opioids, sometimes called narcotics, are a type of drug. They include strong prescription pain relievers such as oxycodone, hydrocodone, fentanyl, and tramadol. The illegal drug heroin is also an opioid. Some opioids are made from the opium plant, and others are synthetic (man-made).

A health care provider may give you a prescription opioid to reduce pain after you have had a major injury or surgery. You may get them if you have severe pain from health conditions like cancer. Some providers prescribe them for chronic pain.

Opioids can cause side effects such as drowsiness, mental fog, nausea, and constipation. They may also cause slowed breathing, which can lead to overdose deaths. If someone has signs of an overdose, call 911. These signs may include:

• Very small pupils of the eyes
• Falling asleep or loss of consciousness
• Slow, shallow breathing
• Choking or gurgling sounds
• Vomiting
• Limp body
• Pale, blue, or cold skin
• Faint heartbeat
• Purple lips and fingernails

When using opioids, there is also a risk of opioid use disorder (OUD).

Opioid use disorder (OUD) means that you have a problematic pattern of using opioids. The pattern causes a lot of distress and impairment (meaning that it causes problems in and interferes with your daily life). Instead of OUD, sometimes people use the terms "opioid dependence" and "opioid addiction." Dependence means feeling withdrawal symptoms when not taking the drug. Addiction is a chronic brain disease that causes a person to compulsively seek out drugs, even though they cause harm.

The risk of OUD is higher if you misuse the medicines. Misuse can include taking more than your prescribed dose or taking it more often, using it to get high, or taking someone else's opioids.

Opioid use disorder and overdoses are serious public health problems in the United States. As more people misuse opioids, more women are misusing opioids during pregnancy. This can lead to health risks for the mother and baby. The baby may be born with neonatal abstinence syndrome (NAS). NAS is a group of withdrawal symptoms that a baby has after being exposed to drugs during pregnancy.

Another problem with increased opioid misuse is that it can also lead to more heroin use. There are some people who switch from prescription opioids to heroin because heroin may be cheaper and easier to get.

There are effective medicines to treat OUD. Using medicines to treat OUD is called medications for opioid use disorder (MOUD). MOUD can help you stop using the drug, get through withdrawal, and cope with cravings. It is often combined with behavioral therapy and counseling. Having support from family and friends can also help.

There is also a medicine called naloxone which can treat opioid overdoses. It can reverse the effects of the overdose and prevent death if it is given quickly.

To prevent problems with prescription opioids, be sure to follow your doctor's instructions when taking them. Do not share your medicines with anyone else. Contact your doctor if you have any concerns about taking the medicines.

NIH: National Institute on Drug Abuse

If you take a medicine in a way that is different from what the doctor prescribed, it is called prescription drug misuse. It could be:

• Taking a medicine that was prescribed for someone else
• Taking a larger dose than you are supposed to
• Taking the medicine in a different way than you are supposed to. This might be crushing tablets and then snorting or injecting them.
• Using the medicine for another purpose, such as getting high

Misusing some prescription drugs can lead to addiction. These include opioids, sedatives, tranquilizers, and stimulants.

Every medicine has some risk of side effects. Doctors take this into account when prescribing medicines. People who misuse these drugs may not understand the risks. The medicines may not be safe for them, especially at higher doses or when taken with other medicines.

NIH: National Institute on Drug Abuse