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Background: A record number of Opioid-related deaths occurred in Northern Ireland in 2021 and it is acknowledged that the Covid-19 pandemic compounded drugs related deaths crisis. This co-production study set out to refine the design of a wearable device for Opioid users to detect and subsequently prevent a potential overdose situation.

Results: All focus group participants expressed an interest in the wearable technology when it was presented to them and agreed, that in principle, such a device would be extremely beneficial to help reduce the risk of overdose within the active drug using community. Participants outlined factors which would help or hinder the design of this proposed device and their decision to wear it, if it were readily available to them. Findings from wearable phase indicated that it was feasible to use a wearable device for monitoring Opioid users' biomarkers remotely. The provision of information regarding the specific functionality of the device was considered key and could be disseminated via front line services. The data acquisition and transfer process would not be a barrier for future research.

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Conclusion: Understanding the benefit and disadvantages of technologies such as a wearable device to prevent Opioid-related deaths will be critical for mitigating the risk of overdose for people who use Heroin. It was also clear that this would be particularly relevant during Covid-19 lock-down periods, when the effects of the pandemic further exacerbated the isolation and solitude experienced by people who use Heroin.

Methylphenidate is the most commonly prescribed psychostimulant in clinical use today. Known methylphenidate metabolites include ritalinic acid, corresponding lactams, and p-hydroxymethylphenidate. Recent in vitro work using rat liver preparations has indicated that the methylphenidate ethyl ester, ethylphenidate, is formed upon incubation with ethanol. This report describes the first detection of ethylphenidate in human blood and liver samples obtained from two suicide victims who had overdosed on methylphenidate and coingested ethanol. Amounts of ethylphenidate detected in whole blood specimens in these two cases (8 ng/mL and 1 ng/mL, respectively) were small relative to methylphenidate and ritalinic acid concentrations. Nonetheless, given the high likelihood that methylphenidate and ethanol coingestion frequently occurs, the detection of ethylphenidate in humans warrants further investigation into the extent of its formation as well as into any associated toxicity in nonoverdose situations.

A cocaine overdose occurs when someone has used too much of the drug in a short period of time. Sometimes, as little as a few milligrams can cause a coke overdose. The amount is dependant on the individual and the potency of the cocaine. When an overdose occurs, it causes the user's brain and body to shut down and stop working properly. Since cocaine is so addictive, it can be difficult for users to quit even when they are experiencing overdose-related symptoms.

As a stimulant, cocaine increases activity in the central nervous system. It can affect the brain, lungs and heart. During an overdose, the user may experience an increase in temperature, blood pressure and heart rate. The increase in temperature could lead to overheating and hyperthermia, which could potentially be fatal. The increase in heart rate could lead to fatal heart attacks and heart failure.

Other factors can contribute to a fatal overdose as well. Cocaine bought on the streets is often mixed with other drugs, such as fentanyl. This synthetic opioid has been linked to a high amount of overdose deaths.

Coke overdose symptoms will be related to the functions of the central nervous system, and they can often be extreme. What happens during a coke overdose is not the same for everyone. Symptoms can be both psychological and physical. Some of the signs of cocaine overdose include:

Since there is no measurable amount of cocaine that causes an overdose, everybody is at risk when using the drug. However, long-term users face a higher risk. When a person's tolerance increases, they need to use more cocaine to feel a euphoric effect. They may start to take large amounts in a short period of time. This cycle puts these users in a dangerous position and causes their risk of an overdose to increase.

People addicted to cocaine are also more likely to intentionally mix the drug with other substances, like alcohol, to experience a more intense high. Alcohol is a downer, and coke is a stimulant. These substances have opposite effects on the body. Each one will heighten the impact of the other, increasing the danger of overheating on cocaine or experiencing other overdose symptoms.

If you believe that someone is showing coke overdose symptoms, it is crucial that you act quickly. The first thing you should do is seek professional medical attention. Call 911 and stay on the line, keeping an eye on the person who is experiencing the overdose.

In the short term, medical intervention is key when it comes to treating a cocaine overdose. Medical personnel will check the vitals of the person and treat their specific symptoms. Treatment typically focuses on lowering the person's blood pressure and heart rate, often through a sedative.

For many people, an overdose is a wake-up call and a crucial sign that it's time to get help. Treatment often includes monitored detoxification to mitigate withdrawal symptoms. Therapy is also a critical part of treatment following a cocaine overdose.

After an overdose occurs and your loved one recovers, it is best to point them in the direction of help. If your loved one requires urgent treatment, please don't wait. You could prevent another overdose from happening. Call Diamond House Detox at 888 205-9455 or contact us online to learn more.

New details of a federal investigation into a \"massive\" fentanyl ring were released Monday as officials announced 11 additional suspects -- out of 23 total in custody -- had been arrested in connection with the illegal sale and distribution of the ultra-deadly synthetic opioid, which health officials say is a major factor in the country's overdose epidemic.

Scattering the unhoused across the city will only lead to more overdose deaths, Peer Recovery Coach Dani Ludwig added. It was previously reported that by mid-summer, nearly four dozen people had been administered Narcan for opioid overdose at the encampment, where the drug was kept on ready supply.

We present a case of a single-drug, massive verapamil overdose in a failed suicide attempt that was refractory to standard resuscitation techniques, IV calcium and bicarbonate, HIE therapy and continuous venovenous hemodialysis (CVVH), but rapidly responded to intravenous lipid infusion.

A literature review suggested the use of lipid therapy as a possible antidote, and on hospital day four our patient was started on an intralipid infusion with a 100 ml bolus of 20% followed by continuous infusion at 0.5 ml/kg/hr. Three hours after the infusion was started, the norepinephrine dose was decreased by more than 50% to 0.3 g/kg/hr. After a further 48 hours, vasopressin had been stopped and her vasopressor requirement had dropped to 0.01 g/kg/hr of epinephrine and 0.05 g/kg/hr of norepinephrine. On hospital day six, our patient regained a junctional heart rhythm with a heart rate of 65-70 bpm and transvenous pacing was discontinued. Her respiratory status had also improved significantly enough to stop APRV, nitric oxide and cisatracurium. On day seven, she was weaned off vasopressors and changed to pressure support ventilation. Her renal function improved, urine output increased, and CVVH was discontinued. At this point, it was felt that she had overcome the acute effects of verapamil overdose, and her calcium, HIE therapy and intravenous lipids were discontinued. Her blood pressure normalized and her heart rhythm was sinus tachycardia with a rate into the 110s. A total of 4,200 mL of intralipid was administered over the initial seven days in the intensive care unit.

Several studies have demonstrated the efficacy of fat emulsion therapy in verapamil overdose in animals [14, 15, 25]. The initial study by Tebbutt et al. showed a dramatic effect, with lipid therapy nearly doubling the time to death, the mean lethal dose and the median lethal dose (LD50) of rodents being infused with verapamil, as compared with saline [14]. Bania et al. then demonstrated in a canine model that lipid infusion combined with standard resuscitation techniques led to increased survival, characterized by increased mean arterial pressures detectable within 30 minutes of starting the lipid infusion. At 60 minutes, there was a significant improvement in maximal ventricular pressure, and an observed but non-significant improvement in heart rate, cardiac output, and systemic vascular resistance. At 120 minutes, the survival percentage of animals receiving lipid therapy was 100%, compared to 14% survival of controls receiving saline [25]. A follow-up study in rodents showed that the greatest survival benefit with bolus dosing occurred at 18.6 ml/kg, while the greatest benefit to heart rate, mean arterial pressure, and base excess occurred at 24.8 ml/kg. These doses are higher than the recommended maximal daily dose of 10 ml/kg/day used for artificial parenteral nutrition in humans, which suggests that high dosing may be necessary to reverse severe drug toxicity [15].

Three recent cases illustrate the potential of lipid therapy in calcium channel blocker overdose. Young et al. present a case of multidrug overdose including 13.44 g of verapamil in combination with bupropion, zolpidem, quetiapine, clonazepam and benazepril [26]. Their patient presented to the hospital hypotensive and acidotic, requiring mechanical ventilation and norepinephrine to maintain arterial pressure. Lipid therapy was initiated almost immediately upon arrival, and within an hour the norepinephrine dose was halved. The patient was extubated on day two, and discharged on day five with no neurologic deficits. Montiel et al. describe a second case of a patient who ingested 3.6 g of sustained-release diltiazem who was treated with hyperinsulinemic euglycemia therapy in combination with lipid therapy [27]. Their patient had an improvement in blood pressure within one hour of beginning intravenous lipid, and was discharged from the intensive care unit on day nine with a full recovery. Finally, French et al. report a case of sustained verapamil overdose treated with lipid emulsion therapy. Notably, the serum level of verapamil in their case was slightly decreased after administration of lipids [28]. 006ab0faaa