By M.D. Peter G. Bourne
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Extra resources for Acute Drug Abuse Emergencies. A Treatment Manual
T h e same signs, h o w e v e r , m a y be manifestations of o t h e r disease states or poisonings. While i n t r a v e n o u s narcotics addicts are usually recognized b y charac teristic " t r a c k s " and t h e addict utilizing t h e s u b c u t a n e o u s r o u t e iden tified b y p o c k m a r k s or " q u i n i n e b u m s " from skin-popping, t h e p a t i e n t with a m e t h a d o n e overdose m a y or m a y n o t be an addict a n d , even if he is, m a y or m a y n o t show t h e usual c u t a n e o u s manifestations of long-term narcotics use.
T h e s e are d e m e r o l and p r o p o x y p h e n e . N a l o x o n e m a y be of help in this situation, b u t t h e seizures themselves m a y require t r e a t m e n t with intravenous Dilantin (dose: 600—800 mg given over t h e course of 4 5 m i n ) . 8. STREET LORE ANTIDOTES Addict street lore suggests t h a t ice or milk are h e r o i n a n t i d o t e s . T h u s , t h e finding of either ice or milk, particularly applied t o t h e s c r o t u m , in a c o m a t o s e y o u n g p a t i e n t , is highly suggestive of an o p i a t e etiology.
There is c u r r e n t evidence t h a t m e t h a d o n e diversion has been limited b y these a p p r o a c h e s b u t m e t h a d o n e is still available, particularly in certain geographical areas. IL E l e m e n t s of t h e Medical History Generally, t h e victim of m e t h a d o n e poisoning is either (a) a hard core heroin addict w h o has o b t a i n e d m e t h a d o n e illicitly and used it instead of heroin t o o b t a i n e u p h o r i c effects; (b) a drug e x p e r i m e n t e r w h o will take any drug or m i x t u r e w h e t h e r or n o t h e k n o w s w h a t it is or d o e s , and w h o might never have t a k e n a n a r c o t i c drug before; or (c) a n o n d r u g user, child or a d u l t , w h o i n a d v e r t e n t l y swallows a m e t h a d o n e p r e p a r a t i o n belonging t o a p a t i e n t in t r e a t m e n t .
Acute Drug Abuse Emergencies. A Treatment Manual by M.D. Peter G. Bourne