nervousone
Bluelighter
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- Sep 2, 2009
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Fatal intravenous misuse of transdermal fentanyl
Clinical record
A 35-year-old woman with a history of intravenous drug use was brought by ambulance to the emergency department after an intravenous overdose of the contents of a transdermal fentanyl patch.
The ambulance had been called to a private home where there were two people unconscious, a man and a woman. Both appeared to have had acute narcotic overdoses. It was later confirmed that they had shared (and injected intravenously) the contents of a transdermal fentanyl patch (5 mg) found at the scene. Both patients were rapidly assessed by the ambulance officers, and the initial resuscitation concentrated on the male patient, who, at first assessment, appeared to be in a more critical state. He was unrousable and was reported to have Cheyne–Stokes respiration. His blood sugar level was checked (10.5 mmol/L) and he was given 1.2 mg naloxone intravenously. He recovered consciousness within five minutes and subsequently absconded from the scene while the second patient was being treated.
In the interim, the female patient had suffered a cardiorespiratory arrest. Cardiopulmonary resuscitation was commenced, with the assistance of police officers who were also in attendance. According to ambulance records, her initial rhythm was electromechanical dissociation, which subsequently deteriorated into ventricular fibrillation. A direct current countershock (200 J energy) was applied. The patient went into asystole. She was intubated and intermittent positive pressure ventilation with 100% oxygen was started. Naloxone 1.6 mg, adrenalin 10 mg (total dose) and atropine 2 mg were administered intravenously. Subsequently, she developed a narrow complex tachycardia with a rate of 130 beats/minute and had a palpable cardiac output. The total time spent at the scene was 40 minutes, and transport time to hospital took 5 minutes.
On arrival at the emergency department she was unconscious, with a Glasgow Coma Score of 3. Her pupils were dilated and non-reactive to light. She was making occasional attempts at respiration and was ventilated as above with 100% oxygen. Her heart rate was 120 beats/minute in sinus rhythm, systolic blood pressure 55 mmHg and oxygen saturation 97%. One litre of Haemaccel and a noradrenalin infusion were administered, resulting in an initial improvement in systolic blood pressure to 95 mmHg. It was evident that she had vomited at the scene, and clinical signs were consistent with aspiration, which was later confirmed on chest x-ray. Laboratory results for arterial blood, serum and urine are shown in Box 1. She was transferred to the intensive care unit, where she subsequently developed diabetes insipidus, abnormal liver function, disseminated intravascular coagulation and had ongoing haemodynamic instability.
The next day, cerebral computed tomography (CT) scan showed changes in the basal ganglia and mild generalised cerebral swelling consistent with severe hypoxia (Box 2A). A CT scan of her abdomen showed generalised changes in the bowel wall and mesentery consistent with bowel necrosis (Box 2B). Surgical intervention was considered to offer little in view of the severe neurological damage and multiorgan failure. Following extensive discussion with family members, inotropic support was withdrawn and she died soon afterwards.
https://www.mja.com.au/public/issues/177_10_181102/ree10446_fm.pdf
An aerosol isn't a gas, it's a suspension of solids or liquids in air. You wouldn't be heating a drug to vaporisation, that would be unfeasible in the vast majority of cases. You are effectively spraying a mist of it. Sorry to continue OT.In order to convert the opioid/benzodiazepine chemical compound itself into a gaseous state, that would require the compound being heated to its vaporization point, would it not? And obviously, this temperature has the potential to be exceedingly hot, especially if the intended aerosolized drug is meant to be non-lethal. So, in my somewhat informed opinion, I do not think that it could be a pure form of the opioid/benzodiazepine in its gaseous state.
I really think it depends on the person, and how they are... I have been using since i could remember, but never would really say i was a full blown drug addict.. I was recreational, more then others at times in my life. But i used meth for a lil over a year, and honestly didnt think i had a problem. I was a completely person, and yes i seen it.. but denial was a bitch.. But one day when i woke up and didnt want to get out of bed inless i new i was going to get the help from the drug because i had no energy my body was drained, and still is in so many wayys i have changed in so many ways because of rehab... but i still cant kick it completely.. Or am i not ready, yes in so many ways.. BUT THATS MY ADDICT KICKIN IN.. I am ready and have been, but its on my mind daily, from the beginning tilll end of the day. My will power is good now, but it should be great.. I have a 3 yr old, and thats why i do control it, and dont use meth anymore.. But i still will frequently stay up one night when i dont have him on synthetic over the counter shit. and i know its not right.. But is that gonna make me fall into the trap again, Im scared of that. Because my thought process changes every sec of the say about it.. I hate to love it.. But its the demon or something inside me, if thats what ppl believe.. I guess it makes sense in alot of ways. But maybe its ok to have fun, but not plan the drug use.. thats recreational right? Idk. Any advice would be great thanks so muchIt's not desperation. it is called addiction...My ex had one of the first reported cases of WB in September 1991, he was in the hospital for 4 months, he couldn't move, he couldnt even open his eyes, and he stayed that way for months. So if anyone thinks "This happens to other people" think again. My ex was on deaths door and his doctor to this day has no idea how he survived. His doctor is one of the doctors who was mentioned in that report..WB is no joke man, it is a killer, and with this black tar crap, well all I can say is thank God for methadone..I mutilated my body because once the veins are gone, I just stuck the needle anywhere, in my forarm, my butt, my legs. I had so many absesses that I am surprized I didn't lose an arm or a leg..I have scars all over my body, and that sucks. I am not saying this to brag, I am saying this because if it means one person won't put that needle in their arm for the first time tonight, everything I said is worth it. I am 54 years old and most of my friends are dead or in prison, please guys, if you are thinking about picking up a rig, think it through...Think what your life will be one year from today..I don't wish my nightmare on my worst enemy..I love to party, just no more stuff and no needles.....
LillyF40
Case 3
A 23-year-old male presented initially with severe unilateral left upper limb oedema with no history of trauma. he was treated with warfarin. He presented 2 months later with ischaemia distal to the mid-forearm and dry gangrene of all the digits of the left hand (Fig. 4). He admitted to having injected a Subutex® solution into his brachial artery because he could not find a vein. He initially refused amputation and absconded, but presented again 3 months later with sepsis and wet gangrene of the digits. All digits on his left hand were amputated at the level of the proximal phalanx. Following this, he again injected Subutex® into his left brachial artery, resulting in worsening ischaemia from the level of the mid-forearm distally. He was given intravenous iloprostol and prophylactic antibiotics, but his forearm turned gangrenous, requiring a below-elbow amputation.
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Fucking ridiculous, right? But sadly, I get it. I can totally relate to the thought process that would drive someone to do that again.WOW. Lol. He really had to do it twice?? Awesome thread.![]()
That's a ridiculous statement. What makes you think that the case studies included in this thread are a representative sample? It sounds to me like you are desperately trying to convince yourself that methamphetamine use is harmless, when that couldn't be further from the truth. You can't make a direct like-for-like comparison of the hazards posed by two drugs like that. If an IV opioid user had access to a clean supply of drug, and had the knowledge and equipment to practise perfect IV technique, they would actually encounter relatively little chronic toxicity. The same cannot be said of methamphetamine; it is a highly neurotoxic drug.majority of the case studies involve opiates. so stats prove opiates and all its derivatives are more Dangerous than meth