Synthetic cannabinoids Synthetic cannabinoids are chemically related to THC, the active ingredient in marijuana. They are sometimes called synthetic marijuana or legal marijuana , but the effects can be considerably more powerful and more dangerous than marijuana’s effects. The current trend is lacing cannabinoids with anticoagulants. This form of cannabinoids, which is often sold in gas stations, can result in bleeding, easy bruising, and nosebleeds that need medical attention. In addition, synthetic cannabinoids can Novel synthetic opioids Novel synthetic opioids (NSOs) include carfentanil and 3-methylfentanyl. Carfentanil, a potent animal opioid sedative, is one of the strongest available. Carfentanil, a fentanyl analog, has a potency approximately 100 times more potent than fentanyl. The drug has been linked to a significant number of overdoses. It has been found added to heroin and other street drugs (Noble et al., 2021; NDEWS, 2021). In a study conducted by Noble et al. (2021), heroin and cocaine had a high prevalence for being positive for carfentanil in overdose cases from different regions of the United States. Cocaine is most prevalent to be laced with 3-methylfentanyl, increasing the likelihood of a drug overdose. These NSOs have emerged and proliferated since the mid- 2010s. 3-methylfentanyl is a synthetic opioid designed with a MDPV MDPV, also called flakka , is chemically similar to other synthetic cathinone drugs popularly called bath salts . It takes the form of a white or pink, foul-smelling crystal that can be eaten, snorted, injected, or vaporized in an e-cigarette or similar device. Vaporizing, which administers the drug very quickly into the bloodstream, may make it particularly easy to overdose. This is a synthetic cathinone that affects the brain in a similar manner Caffeine powder Bulk bags of pure caffeine powder are readily available online. These products may be attractive to young people looking for added caffeine stimulation or help losing weight. But they are extremely dangerous: just a teaspoon of pure caffeine powder is equivalent to about 25 cups of coffee—a lethal amount. In addition to death, severe caffeine overdose can cause fast and erratic heartbeat, seizures, vomiting, diarrhea, and disorientation, symptoms that are much more extreme than those from drinking too much coffee or tea or from consuming too many sodas or energy drinks (U.S. Food and Drug Administration; FDA, 2021). Drug abuse and assessment care The healthcare assessment related to drug abuse may take one of two paths. Path 1 focuses on identification, screening, and possible prevention. Path 2 focuses on the individual who may seek health care after having consumed one or more substances. This may include either the intentional or the unintentional consumption of a substance or medication. The assessment and care depend completely on the path and situation. Path 1: Identification and screening The CAGE assessment is a standardized screening tool that helps to identify individuals at risk for substance or drug abuse (Mayfield et al., 1974). This simple four-question screening tool is a reliable method to identify individuals at risk. If any question is answered yes, the individual should be considered at risk.
result in the user’s experiencing anxiety and agitation, nausea and vomiting, high blood pressure, shaking and seizures, hallucinations, and paranoia. The users may act violently or be in a delirium (Hassamal & Hassamal, 2021). Despite the similarity on the molecular level to marijuana, these drugs are much more dangerous than marijuana and have resulted in very serious health consequences that include overdose and aggressive or suicidal behavior in users. potency of 400–6,000 times that of morphine. Carfentanil was created as a potent synthetic opioid to tranquilize large animals. Carfentanil was confirmed in 635 post-mortem cases in 2017 and has subsequently decreased in post-mortem cases in 2020. Carfentanil post-mortem cases were predominantly in the Midwest (463) and the South (376) (Noble et al., 2021). In contrast, 3-methylfentanyl was reported in only 153 post-mortem cases between 2017 and 2020. 3-methylfentanyl cases were reported in 90% of the Pennsylvania cases, which supported a previous finding from the 1980s (Noble et al., 2021). In addition, Noble et al. (2021) supports the NDEWS findings that there is an increase in polysubstance use, especially when an overdose death occurs. as cocaine but that is 10 times more powerful. Like other drugs of this type, MDPV can cause a condition called excited delirium that involves hyperstimulation, paranoia, and hallucinations and can lead to violent aggression and self-injury. The drug has been linked to suicide and heart attack. It can also dangerously raise body temperature and lead to kidney damage or kidney failure (NIDA, 2020q). Self-Assessment Quiz Question #9 Synthetic drugs exist; of the following, which is the most lethal? a. Cannabinoid. b. Flakka. c. Carfentanil. d. 3-methylfentanyl. The CAGE Questionnaire 1. Have you ever felt you ought to Cut down on your drug use (or drinking)? 2. Have people Annoyed you by criticizing your drug use (or drinking)? 3. Have you ever felt bad or Guilty about your drug use (or drinking)? 4. Have you ever used drugs (or had a drink) first thing in the morning (Eye opener) to steady your nerves to get the day started (or to get rid of a hangover)? Path 2: Brief assessment, identification, and care Healthcare providers are often surprised when an individual suddenly appears with an acute drug-related crisis. Regardless of whether the substance is an illegal street drug or a prescription medication, the initial assessment and care are the same. As the health care provider, it is important to gather as much information as possible, keep the patient and staff safe, provide intervention and supportive care, and ensure that the patient receives the help necessary to deal with the drug problem (Waszak, 2018).
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