6. Energy Drinks
Red Bull, Monster, Octane, Rock Star, and
others added daily
A Soda on “Crack”
25-40 mg Caffeine vs up to 280 mg Caffeine
SUGARRRR
Effects on
heart rate and
blood pressure
6
7. Energy Drinks
Cases of exercise induced cardiac arrest
with contributing use of energy drinks.
Dehydration
Caffeine + Exercise = increased diuresis
RedBull and Vodka= why some of you feel
hung over!!!!
7
8. Energy Drinks
Ephedrine - A stimulant that works on the central
nervous system. It is a common ingredient in weight-loss
products and decongestants, but there have been
concerns about its effects on the heart.
• Taurine - A natural amino acid produced by the body that helps
regulate heart beat and muscle contractions. Many health experts
aren't sure what effect it has as a drink additive (and the rumor that
taurine comes from bull testicles is false).
• Ginseng - A root believed by some to have several medicinal
properties, including reducing stress and boosting energy levels.
• B-vitamins - A group of vitamins that can convert sugar to energy and improve muscle tone.
• Guarana seed - A stimulant that comes from a small shrub native to Venezuela and Brazil.
• Carnitine - An amino acid that plays a role in fatty acid metabolism.
• Creatine - An organic acid that helps supply energy for muscle contractions.
• Inositol - A member of the vitamin B complex (not a vitamin itself, because the human body can
synthesize it) that helps relay messages within cells in the body.
• Ginkgo biloba - Made from the seeds of the ginkgo biloba tree, thought to enhance memory.
8
10. Huffing
Background
Breathable chemical vapors that cause a
mind altering effect on the user.
Usually pressurized containers.
Can be Non-Solvent
Street Names
Poppers, Snappers, Bang, Hippie Crack, Head
Cleaner, Rush, Poor Man’s Pot, Bagging
11. Huffing
Types of Huffing Materials
Volatile Solvents
Liquids that vaporize at room temperatures
Paint thinner, gasoline, White-out™, Glue (Rubber
Cement™)
Aerosols
Sprays containing propellants and solvents
Spray paint, Deodorant, Fabric Protector
Silver and Gold spray paints are most popular
12. Huffing
Types of Huffing Materials (cont.)
Gases
Substances that lack definite shape or volume.
Butane, Air conditioner Refrigerants, Dust Off™
Medical gasses
Chloroform, Nitrous Oxide (laughing gas)
Whippets
Nitrates
Amyl Nitrate and Butyl Nitrate
Sexual enhancement
Found in adult books stores
13. Huffing
So who uses this stuff?
ANYONE!!!
Over 1,000,000 reported uses
12-17 year olds most common
4th most abused substance for high school
age
14. HUFFING
Suffocation, inhaling fluid or vomit into the
lungs, and accidents each cause about 15%
of deaths linked to inhalant abuse.
Approximately 8.9% of youth ages 12—17
have misused inhalants.
55% of deaths linked to inhalant abuse are
caused by “Sudden Sniffing Death
Syndrome.” SSDS can occur on the first use
or any use.
15. HUFFING
22% of inhalant abusers who died of SSDS
had no history of previous inhalant abuse.
In other words, they were first-time users.
16. Huffing
Sudden Sniffing Death Syndrome (SSDS)
Usually associated with aerosols and gasses
Causes Heart Failure and eventually death
Can occur first time use
Occurs when startled or surprised.
Surge of Epinephrine
Increased Heart Rate and Blood Pressure
Inhalant use makes myocardium more sensitive
17. Huffing
Put your thinking hat on……..
! What commonly prescribed medication for young
adults could make this syndrome occur more
often?
18. Huffing
Put your thinking hat on……..
What commonly prescribed medication for
young adults could make this syndrome
occur more often...
RITALIN—BUT WHY???
19. Huffing
Put your thinking hat on……..
What commonly prescribed medication for
young adults could make this syndrome
occur more often...
RITALIN—BUT WHY???
Ritalin has a sympathomimetic effect…Big
word for adrenaline.
Adrenaline = Epinephrine
22. Huffing
What EMS needs to know…………….
Patient Presentation
Similar to intoxication
Drowsiness
Lightheadedness
Loss of inhibitions
Long Term Exposure
Hallucinations D E LAWA
RE
Belligerence Blue Hens
23. Huffing
What we are going to treat
No rapid fix
Oxygen, Oxygen, Oxygen
Airway support
Be aware of residual substances
Patient Safety
Bring substance if safe
Decontamination
Off gassing
24. Huffing
INHALET EXAMPLE EFFECTS
Toluene Spray paint Hearing loss
Glue Damage to spinal cord or
De-waxer/floor stripper brain
Fingernail polish Liver and kidney damage
Trichloroethylene Cleaning fluid Hearing loss
Correction fluid Liver and kidney damage
Hexane Glue Limb spasms
Gasoline Blackouts
Nitrous Oxide Whipped cream dispensers Limb spasms
Gas cylinders Blackouts
Benzene Gasoline Bone marrow damage
27. Salvia
Effects last usually less than 5 minutes
EMS may only gets reports of behavior
Comes in various strengths
1x up to 100x
Smoked, chewed, and brewed
Street Names
Deviner’s Sage, Sally-D, Magic Mint
28. Salvia
Signs and symptoms
Bright lights, vivid colors and shapes, as well as,
body movements and body or object distortions.
Other effects include uncontrolled laughter, a sense
of loss of body, overlapping realities, and
hallucinations
29. Salvia--Effects
Feelings of calmness: 42.2%
Weird thoughts: 36.4%
Things seeming unreal: 32.4%
Floating feelings: 32%
Mind racing: 23.2%
Feeling lightheaded: 22.2%
(Baggott, et al) from the University of California Berkeley and California Pacific Medical Center Research Institute conducted a
survey of 500 salvia users
33. Salvia
Brett’s Law
Originated in Delaware
Brett Chidester
Committed Suicide @ 17yrs.
Note stated that a"er using Salvia he found
life was not worth living
44. Salvia
Delaware, Florida, Illinois, Kansas,
Mississippi, Missouri, North Dakota, South
Dakota,Ohio,Oklahoma, Virginia and
others have passed their own laws.
Schedule 1
Alabama, Alaska, California Florida, Iowa,
Michigan, New Jersey, New York, Ohio,
Oregon, Pennsylvania, California and
Texas have proposed legislation.
45. Salvia
Who’s using it…………….
2008
1.8 million (est.) individuals 12 and older have used it
750,000 within the past year
Most common age was 18-25
National Survey on Drug Use and Health Report published by SAMHSA in February 2008
55. Ketamine
Now used more often then Cocaine in the
UK.
The trip — also called K-hole — that
results from ketamine usually lasts up to 2
hours.
56. KETAMINE
•Users may become nauseated or vomit, become
delirious, and have problems with thinking or
memory.
•At higher doses, ketamine causes movement
problems, body numbness, and slowed breathing.
57. Date Rape Drugs
Rohypnol
Roofies, roach, forget-me pill
Anti-anxiety medication
10x Valium
Memory loss, Hypotension, Nausea, and
Drowsiness, Loss of inhibitions
58. Date Rape Drugs
GHB
Gamma-Hydroxybutyric Acid
Naturally occurring in the body
Once used legally by bodybuilders
Still used in hospital as a sedative
Mixed with alcohol as a liquid
Patients may complain of a salty taste that
was in the drink
Airway management it top concern
59. Date Rape Drugs
GHB
Gamma-Hydroxybutyric Acid
Naturally occurring in the body
Once used legally by bodybuilders
Still used in hospital as a sedative
Mixed with alcohol as a liquid
Patients may complain of a salty taste that
was in the drink
Airway management it top concern
60. Date Rape Drugs
GHB
Gamma-Hydroxybutyric Acid
Naturally occurring in the body
Once used legally by bodybuilders
Still used in hospital as a sedative
Mixed with alcohol as a liquid
Patients may complain of a salty taste that
was in the drink
Airway management it top concern
61. Pain Medications
Between 2006 and 2007
Cocaine use decreased 23 percent.
Prescription medication abuse increased 12
percent
2007 Substance Abuse and Mental Health Services Administration (SAMHSA).
Over 15 million Americans
Most common is OxyContin™
62. Polypharm
Heroin laced with Fentanyl
WHAT’S THE PROBLEM?
2005-2006 = Over 1,000 Deaths
WET
CHIP
BUDDA
Many “pill popper” patients are on anti-
depressants
Side effect of anti depressants?