of teenagers with drug-involved problems begins with both psychological and
physiological assessment. Along with the complexity of identifying the specific
substance impacting the patients condition, there are certain disturbances
that are characteristic of particular drug groups and predictable time intervals
during which drugs are typically active in the users body.
most likely to encounter marijuana users in the emergency room following an
accident or more rarely, a toxicity reaction. Effects of marijuana last up to
several hours and include a slow reaction time, creating a driving hazard for
those who have not developed compensatory skills. Novices are prone to anxiety
from disturbance of thought processes, dryness of mouth and eyes, a moderate
increase in heart rate, mild bronchodilation and the upsurge of a voracious
appetite. Although overdose from smoking marijuana is unlikely, the risk of
toxicity and passing out is greatly increased when the user ingests the drug,
as opposed to smoking. Lack of guaranteed purity in marijuana is a big danger
for users who may react to other substances sprayed on or mixed with the product
or its synthetic counterpart, THC. This could include PCP, room fresheners,
formaldehyde, pesticides or fungi. PCP is classed as a dissociative anesthetic
which disconnects intellectual control over instinctual behavior, putting the
user at risk for injuries and presenting serious physiological disturbances
at high doses.
known as Ecstasy, is the most available club drug.4 It
is taken for emotional release. The most likely problems bringing a teenager
to the hospital after using this drug are attributed to dehydration from not
drinking water while under the influence of this drug. Hyperthermia, hyponatremia,
exhaustion and blacking out may occur. Overdose is not likely though, as it
would require a dose of about fourteen pills. The patient may present with a
clenched jaw, grinding teeth, nystagmus, dry mouth and sweating. The effects
of Ecstasy last three to four hours but may be reactivated by smoking marijuana
within a twenty-four hour period. Purity is also an issue with this substance
and testing of pills has shown that they sometimes contain aspirin, caffeine,
ephedrine, amphetamines, PMA, MDA, MDE, and DXM. Lowering of sexual inhibitions,
and unreadiness to cope with emotional release sometimes create crises. Bruises
and blisters may be sustained from actions taken with lowered pain awareness.
from taking LSD may bring a teenager to the hospital with the presenting symptom
of unmanageability. The effect of this substance may last 6-14 hours and include
dramatic perceptual changes, synesthesia (the translation of one type of sensory
experience into another), rapid and extreme mood swings, panic and terror, and
severe physical complaints.
of arrested and detained juveniles has identified methamphetamine as the third
most commonly used drug in this group, following marijuana and cocaine.
6 The key ingredient, ephedrine, is not a controlled substance and teenagers
are attracted to it for its ability to create an electric sense of false vitality.
Meth is highly addictive because it is very stimulating and tolerance grows
quickly, requiring larger doses to get high. Emergency room nurses may encounter
meth addicts in the context of violence-related injuries. Some signs and symptoms
that may be clues to amphetamine use are: talkativeness, aggressiveness, increased
heart and respiratory rates, elevated blood pressure, elevated body temperature,
dry mouth, dilated pupils, anxiety, dizziness, loss of coordination, skin problems
and pallor. Effects last four to eight hours and overdoses may cause convulsions,
hyperthermia and death.
drug nurses need to be aware of is GHB, a white powder dissolvable in water.
GHB may be taken for relaxation or slipped into someones drink without
their knowledge, causing them to lose consciousness. This is a neurotransmitter
with effects lasting up to 3 hours. It is used as an aphrodisiac and is known
as a "date rape" drug. Slight increases in doses may lead to significant
intensification of effects, compounded by combination with alcohol, depressants,
or Ecstasy. Patients will need to be turned on their sides to prevent choking
while vomiting and a history of what other drugs may have been taken will need
to be obtained.
It would be helpful for nurses to recognize
the "street" or slang names that teens may use to identify the drug/s
they are using. The ONDCP Drug Policy Information (Office of National Drug Control
Policy, also known as the White
House) has a comprehensive list of drug street terms. Click here to investigate. Then, be prepared to answer the following question.
What is the meaning of the term "speedballing"?