Teenage toxins: Recreational poisoning in the adolescent

Abstract

Adolescents are experimenting with recreational drugs on a regular basis, particularly at social gatherings such as parties, raves and mass events. A combination of reduced fluid intake, physical activity and drug-induced hyperthermia leads to complications such as heat stroke, delirium and potentially death. The clinician needs to be aware of the variety of pharmacologically active substances available in the recreational marketplace in order to diagnose and manage these patients. Recreational misadventure, because of incorrect dosage or mixing multiple substances, is a common reason for teenagers presenting to hospital with toxidromes. Death from club drug overdose is more likely to be associated with suicidal intent, related risky behaviour and trauma, as well as the inherent toxicity of the drug itself. Although many teenagers are concerned about 'drink spiking' with club drugs, the most common agent causing drink spiking incidents is ethanol.

Binge drinking among Brazilian students: A gradient of association with socioeconomic status in five geo-economic regions

“…BD is defined as consuming at least four/five alcoholic drinks on one single occasion (Wechsler and Nelson 2001) and this behavior is sometimes referred to as “heavy episodic drinking” (Kuntsche et al 2004). The practice of BD by adolescents is a risk behavior, due to the physiological effects of alcohol intoxication and possible death (Gunja 2011), and also for being associated with higher rates of sexual violence (Chersich et al 2007), traffic accidents (Zhao et al 2010), poor school performance, and involvement with other risk behaviors (Miller et al 2007) and higher incidence of alcoholism in the future (Pitkänen et al 2005). …”

Once was not enough: A case report of the concomitant intoxication of amlodipine (calcium channel blocker) and clonazepam (benzodiazepine)

“…Clonazepam is a long‐acting and highly potent benzodiazepine (BZD), which acts by increasing the frequency of opening of ligand‐gated chloride channel by binding to gamma‐amino‐butyric acid type A (GABA‐A) receptor 3,4 . The clonazepam like other benzodiazepines is used as adjuvant to substance abuse, and commonly coingested with alcohol, ketamine, amphetamine, and gamma‐hydroxybutyrate (GHB) 5 . To the best of our knowledge, till date, the reported case of clonazepam coingestion with amlodipine is nil.…”

“…3,4 The clonazepam like other benzodiazepines is used as adjuvant to substance abuse, and commonly coingested with alcohol, ketamine, amphetamine, and gamma-hydroxybutyrate (GHB). 5 To the best of our knowledge, till date, the reported case of clonazepam coingestion with amlodipine is nil.…”

“…3,4 The clonazepam like other benzodiazepines is used as adjuvant to substance abuse, and commonly coingested with alcohol, ketamine, amphetamine, and gamma-hydroxybutyrate (GHB). 5 To the best of our knowledge, till date, the reported case of clonazepam coingestion with amlodipine is nil.Here, we report a case of concomitant ingestion of amlodipine and clonazepam resulting in hypotension and hypokalemia without noncardiogenic pulmonary edema, which was managed with fluids, insulin, and inotropes.…”