Drogenintoxikationen

Background. Toxicity resulting from the abuse of drugs or alcohol is a frequent indication for primary care by emergency physicians in Germany. Alcohol intoxication . Excessive consumption of alcoholic beverages and caffeinated alcoholic drinks is increasingly observed among adolescents and accounts for a significant number of visits to emergency departments. While treatment of alcohol intoxication remains symptomatic, overdoses with methanol or ethylene glycol often require specific administration of alcohol dehydrogenase inhibitors or haemodialysis. Opiate and opioid intoxication . Treatment of opiate-And opioid-related toxicity is mainly symptomatic, while the use of specific antidote treatment with naloxone should be reserved for a specific patient population. Cocaine . Cocaine consumption may result in central nervous, sympathomimetic and cardiovascular toxicity with the risk of hypertensive crisis, malignant hyperthermia or arrhythmia as well as acute coronary syndrome. Treatment consists of aggressive administration of benzodiazepines for agitation, alpha-blockers for hypertension and, in selected cases, hypertonic sodium bicarbonate or lidocaine for ventricular arrhythmia. Designer drugs. The use of designer drugs known as "legal highs" as well as the consumption of "spice", acting as cannabinoid receptor agonists, is increasingly observed; the mainstay of treatment consists of benzodiazepine administration. Herbal drugs. Misuse of hallucinogenic plants such as jimson weed or deadly nightshade can cause acute anticholinergic syndrome requiring careful administration of physostigmine in some cases. Gamma hydroxybutyrate intoxication . Users of gamma hydroxybutyrate (liquid ecstasy) and its derivates can present to emergency departments with signs of overdose, withdrawal and associated trauma as well as delirium. This patient group demonstrates reduced consciousness to deep coma requiring thorough cardiovascular monitoring and airway protection with intubation and, in some cases, mechanical ventilation.