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NARCOTIC INTOXICATION Unfortunately, narcotic abuse is common, although it is rare among military personnel. This group of drugs includes the most effective and widely used pain killers in existence. Prolonged use of narcotic drugs, even under medical supervision, inevitably leads to physical and psychological dependence. The more commonly known drugs within this group are opium, morphine, heroin, codeine, and methadone (a synthetic narcotic). In addition, Darvon 7 and Talwin7 are included in this group because of their narcotic-like action. Next to cocaine (discussed later), heroin is the most popular narcotic drug because of its intense euphoria and long-lasting effect. It is far more potent than morphine but has no legitimate use in the United States. Heroin appears as a white, gray, or tan fluffy powder. The most common method of using heroin is by injection directly into the vein, although it can be sniffed. Codeine, although milder than heroin and morphine, is sometimes abused as an ingredient in cough syrup preparations. Symptoms of narcotic drug abuse include slow, shallow breathing; possible unconsciousness; constriction (narrowing) of the pupils of the eyes to pinpoint size; drowsiness; confusion; and slurred speech. The narcotic user, suddenly withdrawn from drugs, may appear as a wildly disturbed person who is agitated, restless, and possibly hallucinating. Initial symptoms start within 2 to 48 hours and peak at about 72 hours. Although these signs and symptoms are not life-threatening, most users will state that they feel so bad they wish they were dead. The signs and symptoms of withdrawal immediately stop upon re-administering a narcotic and withdrawing the drug by tapering the dose over several days. ALCOHOL INTOXICATION Alcohol affects the body of the abuser in stages. Initially, there is a feeling of relaxation and well-being, followed by confusion with a gradual disruption of coordination, resulting in inability to accurately and efficiently perform normal activities and skills. Continued alcohol consumption leads to a stuporous state of inebriation that results in vomiting, an inability to walk or stand, and impaired consciousness (sleep or stupor). Excessive consumption can cause loss of consciousness, coma, and even-in extreme cases - death from alcohol poisoning. The potential for physical and psychological addiction is very high when alcohol is abused. The severely intoxicated individual must be closely monitored to avoid inhalation of vomit (aspiration) and adverse behavioral acts to the patient or others. Withdrawal from alcohol is considered to be life-threatening and should be appropriately treated in a healthcare facility. Individuals withdrawing from alcohol are at a greater risk of serious complications or death than those withdrawing from narcotics. The effects of alcohol withdrawal include severe agitation, anxiety, confusion, restlessness, sleep disturbances, sweating, profound depression, delirium tremens ("DTs," a particular type of confusion and shaking), hallucinations, and seizures. Table 5-6.-Classification of Abused Drugs Table 5-6.-Classification of Abused Drugs-Continued |
 
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