Signs and Treatment of Drug Overdose a Comparison of Heroin and Ecstasy

Drug Overdoes

Ecstasy vs. Heroin overdoses -- treatment and diagnosis

For many EMTs, depending on the city and time they are stationed in, one of the most common problems they will have to cope with is dealing with a drug overdose. However, although all drug overdoses are dangerous, not all illegal drug overdoses are the same, symptomatically or in their treatment. A great deal of misinformation exists regarding drug overdoses and their treatment in popular culture -- even the popular film "Pulp Fiction" which depicts a 'successful' treatment of snorted heroin is in fact inaccurate -- ephedrine to the heart would not have saved a victim of a heroin overdose in real life. (Kuhn, 2003)

When dealing with any suspected drug overdose, the first thing to determine is in fact the victim's symptoms are indeed due to the ingestion of a drug, rather than of alternate cause. This is especially important to note with drugs such as heroin and ecstasy, both of which are sometimes fatal within as short a span of two to four hours, even for some hardened addicts whom have had a 'break' from the drug for whatever reason for a few weeks. Once the cause of the victim's symptoms as an illegal drug overdose, is determined, through asking witnesses or the victim him or herself, it is important to note specifically that symptoms of a heroin overdose include but are not limited to spasm's in the sufferer's muscles, affected breathing (either slow, labored, shallow or stopped), as well as the classic 'pinpointed' pupils. The victim may also report a dry mouth, have cold and clammy skin, a bluish discoloration on the tongue or fingernails and exhibit lips spasms. If able to speak, the victim may report stomach and/or intestinal tract disturbance, including constipation if a long-term user. The victim will usually have a weak pulse, low blood pressure, and exhibit signs of drowsiness disorientation and listlessness. Signs of a coma or delirium are also possible. The first response of the EMT must be to alleviate the victim's low blood pressure, help the victim to become more alert, and prevent the victim from choking on his or her own vomit in the case of stomach disturbance. ("Heroin," Overdose.com, 2004)

Heroin is a very unpredictable drug in its work on the central nervous system. "Depending on purity and the user, a lethal dose of heroin may range from 200 to 500mg, but hardened addicts have survived doses of 1800mg and over." However, as with any drug there is no such a thing as a safe dosage, as the drug varies in tolerance, amount and purity taken on a constant basis, and overdoses can occur even at very small levels when the user simply takes more than he or she is accustomed to take. ("Heroin," Overdose.com, 2004)

Ecstasy in contrast to the depressant opiate heroin stimulates rather than depresses the central nervous system. Also unlike heroin, it is a created or synthetic compound. "Ecstasy is frequently used in combination with other drugs, which increases the users risk of an overdose. However, it is rarely consumed with alcohol, as alcohol is believed to diminish its effects. Ecstasy is most often distributed at late-night parties." This creates one of the most dangerous aspects of the drug, which is dehydration due to the drug's stimulate properties, combined with the hot and enclosed environment of the rave and club scene where water is difficult to come by. ("Ecstasy," Overdose.com, 2004)