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M05.07.05 Self-Awareness
Signs and Symptoms of Intoxication and Withdrawal by Substance
| Substance | Signs & Symptoms of Intoxication | Treatment of Intoxication | Signs & Symptoms of Withdrawal | Treatment of Withdrawal | Location/Effect of Drug Action |
|---|---|---|---|---|---|
| Alcohol | Talkative, gregarious, moody, disinhibited | If severe, consider mechanical ventilation | Tremors, hallucinations, seizures, DTs | Thiamine, MVI, folic acid, benzodiazepines | Decreases glutamate and increases GABA |
| Amphetamine/Cocaine | Euphoria, hypervigilance, autonomic hyperactivity, weight loss, pupillary dilatation, perceptual disturbances | Antipsychotics and benzodiazepines, antihypertensives | Anxiety, tremors, headaches, increased appetite, depression, risk of suicide | If suicidal, consider antidepressants | Mesolimbic pathway, nucleus accumbens |
| Bath Salts (Synthetic Cocaine, Flakka) | Irritability, perceptual disturbances, agitation | Symptoms can last up to 1 week | Antipsychotics and/or benzodiazepines | Anxiety and depression | If suicidal: consider SSRIs |
| Cannabis | Impaired motor coordination, slowed sense of time, social withdrawal, increased appetite, conjunctival injection, psychosis | Antipsychotics if needed | Irritability, anxiety | N/A | Inhibitory G protein, GABA, increased serotonin |
| K2/Spice (Synthetic Marijuana) | Perceptual disturbances, agitation, seizures | Antipsychotics and/or benzodiazepines | Not yet known | Not yet known | N/A |
| Hallucinogens | Ideas of reference, perceptual disturbances, impaired judgment, dissociative symptoms | Place in quiet room • Antipsychotics, benzodiazepines | N/A | N/A | Stimulate glutamate and serotonin |
| Inhalants | Belligerence, apathy, aggression, impaired judgment, stupor or coma | Nasal crusting, rash, drunken appearance, dilated pupils • Use can be fatal • Parkinsonism has been associated with huffing | Antipsychotics | Nausea, excessive sweating, muscle cramps, headaches, chills, agitation, shaking, and hallucinations | Benzodiazepines, antipsychotics |
| Opiates | Apathy, dysphoria, pinpoint pupils, drowsiness, slurred speech, coma, death | Naloxone | Fever, chills, runny nose, diarrhea, muscle spasms, cramps | Clonidine, methadone, buprenorphine | Mu, kappa, and delta receptors • Nucleus accumbens |
| Krokodil (Desomorphine) | Skin, blood vessel, bone, and muscle damage leading to gangrene, phlebitis, sepsis | Symptomatic | Not yet known | N/A | Not yet known |
| Phencyclidine (PCP) | Belligerence, psychomotor agitation, violence, nystagmus, hypertension, seizures | Place in quiet room • Antipsychotics • Benzodiazepines | Elevated body temperature, seizures, and muscle breakdown • Muscle twitching, agitation, and hallucinations may also occur | Benzodiazepines, antipsychotics | Antagonist of N-methyl-D-aspartate glutamate receptors |
| Anabolic Steroids | Irritability, aggression, mood instability, psychosis | Antipsychotics | Depression, headaches, anxiety | If depressed, consider SSRIs | May activate dopamine and serotonin release |
| Ecstasy (MDMA, Molly, E, X) | Euphoria, mild hallucinations, visual distortions, enhanced sensations, hyperthermia, bruxism, autonomic hyperactivity, seizures, dry mouth | Dantrolene, benzodiazepines | Hydration | Depression, anxiety, and panic attacks | SSRIs |
| Benzodiazepine | Slurred speech, confusion, memory deficits, falls | Respiratory depression (rare) | Supportive flumazenil or mechanical ventilation if needed | Increased anxiety, tremors | Insomnia |
| Barbiturates | Restlessness, agitation, insomnia, N/V, anxiety | Tremors, seizures, hallucination, increased heart rate | Respiratory depression | Supportive mechanical ventilation if needed | Anxiety, depression |
Important Notes:
- This table provides a general overview and is not exhaustive.
- Treatment recommendations may vary depending on the severity of intoxication or withdrawal symptoms.
- Always seek professional medical advice in case of suspected substance use intoxication or withdrawal.
Bibliography:
- National Institute on Drug Abuse: https://www.nih.gov/about-nih/what-we-do/nih-almanac/national-institute-drug-abuse-nida
- American Society ofpen_spark