96-425: Alcohol intoxication , commonly described in higher doses as drunkenness or inebriation , and known in overdose as alcohol poisoning , is the behavior and physical effects caused by recent consumption of alcohol . The technical term intoxication in common speech may suggest that a large amount of alcohol has been consumed, leading to accompanying physical symptoms and deleterious health effects. Mild intoxication
192-446: A carbohydrate , followed by a 15-minute wait and re-measurement of blood glucose level to assess if blood glucose has returned to normal levels. If an individual recognizes the symptoms of hypoglycemia coming on, blood sugar should promptly be measured, and a sugary food or drink should be consumed. The person must be conscious and able to swallow. The goal is to consume 10–20 grams of a carbohydrate to raise blood glucose levels to
288-406: A psychiatric disorder . Demographics affected by factitious hypoglycemia include women aged 30–40, particularly those with diabetes, relatives with diabetes, healthcare workers, or those with history of a psychiatric disorder. The classic way to identify surreptitious insulin use is through blood work revealing high insulin levels with low C-peptide and proinsulin . The production of glucose
384-425: A respiratory depression , coma, or death. Complications may include seizures , aspiration pneumonia , low blood sugar , and injuries or self-harm such as suicide . Alcohol intoxication can lead to alcohol-related crime with perpetrators more likely to be intoxicated than victims. Alcohol intoxication typically begins after two or more alcoholic drinks . Alcohol has the potential for abuse. Risk factors include
480-429: A stupor . At very high blood alcohol concentrations , for example above 0.3%, the respiratory system becomes depressed and the person may stop breathing. Comatose patients may aspirate their vomit (resulting in vomitus in the lungs, which may cause "drowning" and later pneumonia if survived). CNS depression and impaired motor coordination along with poor judgment increase the likelihood of accidental injury occurring. It
576-742: A BAC greater than 0.04%. In the United States, the United Kingdom, and Australia, public intoxication is a crime (also known as "being drunk and disorderly" or "being drunk and incapable"). In some countries, there are special facilities, sometimes known as " drunk tanks ", for the temporary detention of persons found to be drunk. Some religious groups permit the consumption of alcohol; some permit consumption but prohibit intoxication; others prohibit any amount of alcohol consumption altogether. Many denominations of Christianity, such as Catholicism , Orthodoxy and Lutheranism , use wine as
672-562: A basic code of ethics known as the five precepts , of which the fifth precept is an undertaking to refrain from the consumption of intoxicating substances (except for medical reasons ). In the bodhisattva vows of the Brahmajala Sutra , observed by Mahayana Buddhist communities, distribution of intoxicants is likewise discouraged, as well as consumption. In the Gaudiya Vaishnavism branch of Hinduism , one of
768-670: A data review, the Pediatric Endocrine Society concluded that neonates aged less than 48 hours begin to respond to hypoglycemia at serum glucose levels of 55–65 mg/dL (3.0–3.6 mmol/L). This is contrasted by the value in adults, children, and older infants, which is approximately 80–85 mg/dL (4.4–4.7 mmol/L). In children who are aged greater than 48 hours, serum glucose on average ranges from 70 to 100 mg/dL (3.9–5.5 mmol/L), similar to adults. Elderly patients and patients who take diabetes pills such as sulfonylureas are more likely to suffer from
864-536: A fasting day in some Ashkenazi traditions. It has been customary and in many cases even mandated to drink moderately so as to stay sober , and only after the prayers are over. During the Seder on Passover , there is an obligation to drink four ceremonial cups of wine while reciting the Haggadah . It has been assumed as the source of the wine-drinking ritual at communion in some Christian groups. During Purim , there
960-537: A fasting state, and thus hypoglycemia. The glycogen storage diseases associated with hypoglycemia include type 0 , type I , type III , and type IV , as well as Fanconi syndrome . Some organic and amino acid acidemias, especially those involving the oxidation of fatty acids , can lead to the symptom of intermittent hypoglycemia, as for example in combined malonic and methylmalonic aciduria (CMAMMA), propionic acidemia or isolated methylmalonic acidemia . A primary B-cell tumor , such as an insulinoma ,
1056-511: A few hours. Hypoglycemia is treated by eating a sugary food or drink, for example glucose tablets or gel, apple juice, soft drink, or lollipops. The person must be conscious and able to swallow. The goal is to consume 10–20 grams of a carbohydrate to raise blood glucose levels to a minimum of 70 mg/dL (3.9 mmol/L). If a person is not able to take food by mouth, glucagon by injection or insufflation may help. The treatment of hypoglycemia unrelated to diabetes includes treating
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#17327835261291152-410: A few hours. During the 48-hour neonatal period, the neonate adjusts glucagon and epinephrine levels following birth, which may trigger transient hypoglycemia. In children who are aged greater than 48 hours, serum glucose on average ranges from 70 to 100 mg/dL (3.9–5.5 mmol/L), similar to adults, with hypoglycemia being far less common. The most reliable method of identifying hypoglycemia
1248-456: A figure of 300,000 deaths per year in the world through drug overdose. 1,015,060 US residents died from drug overdoses from 1968 to 2019. 22 people out of every 100,000 died from drug overdoses in 2019 in the US. From 1999 to Feb 2019 in the United States, more than 770,000 people have died from drug overdoses. In the US around 107,500 people died in the 12-month period ending August 31, 2022, at
1344-399: A healthcare setting or through pharmacy errors, also called iatrogenic hypoglycemia. When individuals take insulin without needing it, to purposefully induce hypoglycemia, this is referred to as surreptitious insulin use or factitious hypoglycemia . Some people may use insulin to induce weight loss, whereas for others this may be due to malingering or factitious disorder , which is
1440-423: A hypoglycemic episode. A single blood sugar reading below 70 mg/dL is also not specific enough to characterize a hypoglycemic episode. Whipple's triad is a set of three conditions that need to be met to accurately characterize a hypoglycemic episode. The three conditions are the following: The biggest difference in blood glucose levels between the adult and pediatric population occurs in newborns during
1536-512: A low enough dosage. Drug overdose is sometimes used as a means to commit suicide , as the result of intentional or unintentional misuse of medication . Intentional misuse leading to overdose can include using prescribed or non-prescribed drugs in excessive quantities in an attempt to produce euphoria . Usage of illicit drugs , in large quantities, or after a period of drug abstinence can also induce overdose. Cocaine and opioid users who inject intravenously can easily overdose accidentally, as
1632-620: A meal, resulting in insulin being non-functional. At a later time, the antibodies fall off insulin, causing insulin to be functional again leading late hypoglycemia after a meal, called late postprandial hypoglycemia . Another mechanism causing hypoglycemia is due to antibodies formed against insulin receptors , called insulin receptor antibodies . The antibodies attach to insulin receptors and prevent insulin breakdown, or degradation, leading to inappropriately high insulin levels and low glucose levels. Low blood sugar may occur in healthy neonates aged less than 48 hours who have not eaten for
1728-500: A medical epidemiologist at the Centers for Disease Control and Prevention said that in 2005 more than 22,000 American people died due to overdoses, and the number is growing rapidly. Paulozzi also testified that all available evidence suggests unintentional overdose deaths are related to the increasing use of prescription drugs, especially opioid painkillers. However, the vast majority of overdoses are also attributable to alcohol . It
1824-537: A minimum of 70 mg/dL (3.9 mmol/L). Examples of products to consume are: Improvement in blood sugar levels and symptoms are expected to occur in 15–20 minutes, at which point blood sugar should be measured again. If the repeat blood sugar level is not above 70 mg/dL (3.9 mmol/L), consume another 10–20 grams of a carbohydrate and remeasure blood sugar levels after 15–20 minutes. Repeat until blood glucose levels have returned to normal levels. The greatest improvements in blood glucose will be seen if
1920-515: A moderate rate of consumption. In the Church of Jesus Christ of Latter-day Saints , alcohol consumption is forbidden, and teetotalism has become a distinguishing feature of its members. Jehovah's Witnesses allow moderate alcohol consumption among its members. In the Quran , there is a prohibition on the consumption of grape-based alcoholic beverages, and intoxication is considered an abomination in
2016-475: A part of the Eucharist and permit its consumption, but consider it sinful to become intoxicated. Romans 13:13–14 , 1 Corinthians 6 :9–11, Galatians 5 :19–21 and Ephesians 5:18 are among a number of other Bible passages that speak against intoxication. While some Protestant Christian denominations prohibit the consumption of alcohol based upon biblical passages that condemn drunkenness, but others allow
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#17327835261292112-546: A person is identified, rapid treatment is necessary and can be life-saving. The main goal of treatment is to raise blood glucose back to normal levels, which is done through various ways of administering glucose, depending on the severity of the hypoglycemia, what is on-hand to treat, and who is administering the treatment. A general rule used by the American Diabetes Association is the "15-15 Rule," which suggests consuming or administering 15 grams of
2208-430: A rate of 294 deaths per day. 70,630 people died from drug overdoses in 2019. The U.S. drug overdose death rate has gone from 2.5 per 100,000 people in 1968 to 21.5 per 100,000 in 2019. The National Center for Health Statistics reports that 19,250 people died of accidental poisoning in the U.S. in the year 2004 (eight deaths per 100,000 population). In 2008 testimony before a Senate subcommittee, Leonard J. Paulozzi,
2304-518: A sense of hunger and drives the person to eat, in an attempt to increase glucose. Hypoglycemia is most common in those with diabetes treated by insulin , glinides , and sulfonylureas . Hypoglycemia is rare in those without diabetes, because there are many regulatory mechanisms in place to appropriately balance glucose , insulin , and glucagon . Please refer to Pathophysiology section for more information on glucose , insulin , and glucagon . The most common cause of hypoglycemia in diabetics
2400-420: A severe hypoglycemic episode. Whipple's triad is used to identify hypoglycemia in children who can communicate their symptoms. Other conditions that may present at the same time as hypoglycemia include the following: Hypoglycemic symptoms are divided into two main categories. The first category is symptoms caused by low glucose in the brain, called neuroglycopenic symptoms. The second category of symptoms
2496-413: A sin. Others, such as Christianity, use it in rituals. Alcohol intoxication leads to negative health effects due to the recent drinking of large amount of ethanol (alcohol). When severe it may become a medical emergency . Some effects of alcohol intoxication, such as euphoria and lowered social inhibition , are central to alcohol's desirability. As drinking increases, people become sleepy or fall into
2592-718: A slower rate of metabolism. Alcohol intoxication is described as a mental and behavioural disorder by the International Classification of Diseases . ( ICD-10 ). Definitive diagnosis relies on a blood test for alcohol, usually performed as part of a toxicology screen. Law enforcement officers in the United States and other countries often use breathalyzer units and field sobriety tests as more convenient and rapid alternatives to blood tests. There are also various models of breathalyzer units that are available for consumer use. Because these may have varying reliability and may produce different results than
2688-444: A social situation where heavy drinking is common and a person having an impulsive personality. Diagnosis is usually based on the history of events and physical examination. Verification of events by witnesses may be useful. Legally, alcohol intoxication is often defined as a blood alcohol concentration (BAC) of greater than 5.4–17.4 mmol/L (25–80 mg/dL or 0.025–0.080%). This can be measured by blood or breath testing . Alcohol
2784-402: A state of increased insulin, specifically increased insulin-like growth factor II , which decreases glucose levels. The Roux-en-Y gastric bypass , is a weight-loss surgery performed on the stomach, and has been associated with hypoglycemia, called post-gastric bypass postprandial hypoglycemia . Although the entire mechanism of hypoglycemia following this surgery is not fully understood, it
2880-464: A state of sepsis those organs may not receive enough oxygen, leading to decreased glucose production due to organ damage. Other causes of serious illness that may cause hypoglycemia include liver failure and kidney failure. The liver is the main site of glucose production in the body, and any liver failure or damage will lead to decreased glucose production. While the kidneys are also sites of glucose production, their failure of glucose production
2976-407: A state of sepsis, the body uses large amounts of glucose for energy. Glucose use is further increased by cytokine production. Cytokines are a protein produced by the body in a state of stress, particularly when fighting an infection. Cytokines may inhibit glucose production, further decreasing the body's energy stores. Finally, the liver and kidneys are sites of glucose production, and in
Alcohol intoxication - Misplaced Pages Continue
3072-514: Is medications used to treat diabetes such as insulin , sulfonylureas , and biguanides . Risk is greater in diabetics who have eaten less than usual, recently exercised, or consumed alcohol . Other causes of hypoglycemia include severe illness, sepsis , kidney failure , liver disease , hormone deficiency, tumors such as insulinomas or non-B cell tumors, inborn errors of metabolism , and several medications. Low blood sugar may occur in otherwise healthy newborns who have not eaten for
3168-691: Is a risk factor in some cases of catastrophic injury , in particular for unsupervised recreational activity. A study in the province of Ontario based on epidemiological data from 1986, 1989, 1992, and 1995 states that 79.2% of the 2,154 catastrophic injuries recorded for the study were preventable, of which 346 (17%) involved alcohol consumption. The activities most commonly associated with alcohol-related catastrophic injury were snowmobiling (124), fishing (41), diving (40), boating (31) and canoeing (7), swimming (31), riding an all-terrain vehicle (24), and cycling (23). These events are often associated with unsupervised young males, often inexperienced in
3264-482: Is an obligation to become intoxicated; however, as with many other decrees, this has been avoided in many communities by allowing sleep during the day as a replacement. During the U.S. Prohibition era in the 1920s, a rabbi from the Reform Judaism movement proposed using grape juice for the ritual instead of wine. Although refuted at first, the practice became widely accepted by orthodox Jews as well. In
3360-399: Is associated with chronically low levels of the stress hormone cortisol , which leads to decreased glucose production. Hypopituitarism , leading to decreased growth hormone , is another cause of hypoglycemia in children, particularly with long periods of fasting or increased exercise. Briefly, inborn errors of metabolism are a group of rare genetic disorders that are associated with
3456-570: Is associated with hypoglycemia. This is a tumor located in the pancreas . An insulinoma produces insulin , which in turn decreases glucose levels, causing hypoglycemia. Normal regulatory mechanisms are not in place, which prevent insulin levels from falling during states of low blood glucose. During an episode of hypoglycemia, plasma insulin , C-peptide , and proinsulin will be inappropriately high. Hypoglycemia may occur in people with non-B cell tumors such as hepatomas , adrenocorticoid carcinomas, and carcinoid tumors. These tumors lead to
3552-564: Is blocked by alcohol. In those who misuse alcohol, hypoglycemia may be brought on by a several-day alcohol binge associated with little to no food intake. The cause of hypoglycemia is multifactorial, where glycogen becomes depleted in a state of starvation . Glycogen stores are then unable to be repleted due to the lack of food intake, all compounded the inhibition of glucose production by alcohol. Children with primary adrenal failure, also called Addison's disease , may experience hypoglycemia after long periods of fasting . Addison's disease
3648-552: Is broken down in the human body at a rate of about 3.3 mmol/L (15 mg/dL) per hour, depending on an individual's metabolic rate ( metabolism ). The DSM-5 defines alcohol intoxication as at least one of the following symptoms that developed during or close after alcohol ingestion: slurred speech, incoordination, unsteady walking/movement, nystagmus (uncontrolled eye movement), attention or memory impairment, or near unconsciousness or coma. Management of alcohol intoxication involves supportive care. Typically this includes putting
3744-509: Is called a diagnostic fast , in which a patient undergoes an observed fast to cause a hypoglycemic episode, allowing for appropriate blood work to be drawn. In some, the hypoglycemic episode may be reproduced simply after a mixed meal, whereas in others a fast may last up to 72 hours. In those with a suspected insulinoma , imaging is the most reliable diagnostic technique, including ultrasound , computed tomography (CT) imaging, and magnetic resonance imaging (MRI) . After hypoglycemia in
3840-406: Is caused by the body's reaction to low glucose in the brain, called adrenergic symptoms. Everyone experiences different symptoms of hypoglycemia, so someone with hypoglycemia may not have all of the symptoms listed above. Symptoms also tend to have quick onset. It is important to quickly obtain a blood glucose measurement in someone presenting with symptoms of hypoglycemia to properly identify
3936-400: Is compounded by respiratory failure. Patients may also present with hypothermia. Alcohol is metabolized by a normal liver at the rate of about 8 grams of pure ethanol per hour. 8 grams or 10 mL (0.34 US fl oz) is one British standard unit . An "abnormal" liver with conditions such as hepatitis , cirrhosis , gall bladder disease, and cancer is likely to result in
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4032-408: Is dangerous for a number of reasons. The hypoglycemic person not only gains awareness of hypoglycemia at very low blood glucose levels, but they also require high levels of carbohydrates or glucagon to recover their blood glucose to normal levels. These individuals are also at far greater risk of severe hypoglycemia. While the exact cause of hypoglycemic unawareness is still under research, it
4128-472: Is estimated that about one-third of alcohol-related deaths are due to accidents and another 14% are from intentional injury. In addition to respiratory failure and accidents caused by its effects on the central nervous system, alcohol causes significant metabolic derangements. Hypoglycaemia occurs due to ethanol's inhibition of gluconeogenesis , especially in children, and may cause lactic acidosis , ketoacidosis , and acute kidney injury . Metabolic acidosis
4224-403: Is intoxicated by alcohol by some means other than a blood-alcohol test, it is necessary to rule out other conditions such as hypoglycemia , stroke, usage of other intoxicants, mental health issues, and so on. It is best if their behavior has been observed while the subject is sober to establish a baseline. Several well-known criteria can be used to establish a probable diagnosis. For a physician in
4320-477: Is medications used to treat diabetes such as insulin , sulfonylureas , and biguanides . This is often due to excessive doses or poorly timed doses. Sometimes diabetics may take insulin in anticipation of a meal or snack; then forgetting or missing eating that meal or snack can lead to hypoglycemia. This is due to increased insulin without the presence of glucose from the planned meal. Recurrent episodes of hypoglycemia can lead to hypoglycemic unawareness , or
4416-599: Is mostly referred to by slang terms such as tipsy or buzzed . In addition to the toxicity of ethanol , the main psychoactive component of alcoholic beverages, other physiological symptoms may arise from the activity of acetaldehyde , a metabolite of alcohol. These effects may not arise until hours after ingestion and may contribute to a condition colloquially known as a hangover . Symptoms of intoxication at lower doses may include mild sedation and poor coordination. At higher doses, there may be slurred speech, trouble walking , and vomiting. Extreme doses may result in
4512-449: Is not significant enough to cause hypoglycemia. Instead, the kidneys are responsible for removing insulin from the body, and when this function is impaired in kidney failure, the insulin stays in circulation longer, leading to hypoglycemia. A number of medications have been identified which may cause hypoglycemia, through a variety of ways. Moderate quality evidence implicates the non-steroidal anti-inflammatory drug indomethacin and
4608-562: Is often misused as a descriptor for adverse drug reactions or negative drug interactions due to mixing multiple drugs simultaneously . Signs and symptoms of an overdose vary depending on the drug or exposure to toxins . The symptoms can often be divided into differing toxidromes . This can help one determine what class of drug or toxin is causing the difficulties. Symptoms of opioid overdoses include slow breathing, heart rate and pulse. Opioid overdoses can also cause pinpoint pupils, and blue lips and nails due to low levels of oxygen in
4704-407: Is reasonable to assume the cause of hypoglycemia is due to insulin, glinides, or sulfonylurea use. In those without a history of diabetes with hypoglycemia, further diagnostic testing is necessary to identify the cause. Testing, during an episode of hypoglycemia, should include the following: If necessary, a diagnostic hypoglycemic episode can be produced in an inpatient or outpatient setting. This
4800-457: Is the ingestion or application of a drug or other substance in quantities much greater than are recommended. Typically it is used for cases when a risk to health will potentially result. An overdose may result in a toxic state or death . The word "overdose" implies that there is a common safe dosage and usage for the drug; therefore, the term is commonly applied only to drugs, not poisons , even though many poisons as well are harmless at
4896-540: Is the initial treatment of an overdose. Ventilation is considered when there is a low respiratory rate or when blood gases show the person to be hypoxic . Monitoring of the patient should continue before and throughout the treatment process, with particular attention to temperature, pulse , respiratory rate , blood pressure , urine output, electrocardiography (ECG) and O 2 saturation. Poison control centers and medical toxicologists are available in many areas to provide guidance in overdoses both to physicians and to
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#17327835261294992-572: Is thought that meals cause very high levels of glucagon-like peptide-1 (also called GLP-1), a hormone that increases insulin, causing glucose levels to drop. Antibodies can be formed against insulin, leading to autoimmune hypoglycemia. Antibodies are immune cells produced by the body, that normally attack bacteria and viruses, but sometimes can attack normal human cells, leading to an autoimmune disorder . In autoimmune hypoglycemia, there are two possible mechanisms. In one instance, antibodies bind to insulin following its release associated with
5088-744: Is thought that these individuals progressively begin to develop fewer adrenergic-type symptoms, resulting in the loss of neuroglycopenic-type symptoms. Neuroglycopenic symptoms are caused by low glucose in the brain, and can result in tiredness, confusion, difficulty with speech, seizures, and loss of consciousness. Adrenergic symptoms are caused by the body's reaction to low glucose in the brain, and can result in fast heart rate, sweating, nervousness, and hunger. See section above on Signs and Symptoms for further explanation of neuroglycopenic symptoms and adrenergic symptoms. In terms of epidemiology, hypoglycemic unawareness occurs in 20–40% of type 1 diabetics. Other causes of hypoglycemia in diabetics include
5184-504: Is through identifying Whipple's triad . The components of Whipple's triad are a blood sugar level below 70 mg/dL (3.9 mmol/L), symptoms related to low blood sugar, and improvement of symptoms when blood sugar is restored to normal. Identifying Whipple's triad in a patient helps to avoid unnecessary diagnostic testing and decreases healthcare costs . In those with a history of diabetes treated with insulin , glinides , or sulfonylurea , who demonstrate Whipple's triad, it
5280-1015: Is very rare for a victim of an overdose to have consumed just one drug. Most overdoses occur when drugs are ingested in combination with alcohol. Drug overdose was the leading cause of injury death in 2013. Among people 25 to 64 years old, drug overdose caused more deaths than motor vehicle traffic crashes. There were 43,982 drug overdose deaths in the United States in 2013. Of these, 22,767 (51.8%) were related to prescription drugs. The 22,767 deaths relating to prescription drug overdose in 2013, 16,235 (71.3%) involved opioid painkillers, and 6,973 (30.6%) involved benzodiazepines . Drug misuse and abuse caused about 2.5 million emergency department (ED) visits in 2011. Of these, more than 1.4 million ED visits were related to prescription drugs. Among those ED visits, 501,207 visits were related to anti-anxiety and insomnia medications, and 420,040 visits were related to opioid analgesics. New CDC data in 2024 demonstrates U.S. drug overdose deaths have significantly declined, marking
5376-470: The Israelite tribe of Dan who, as a Nazirite , is prohibited from cutting his hair and drinking wine. Proverbs 31:4 warns against kings and other rulers drinking wine and similar alcoholic beverages, Proverbs 31:6–7 promotes giving such beverages to the perishing and wine to those whose lives are bitter as a coping mechanism against the likes of poverty and other troubles. In Judaism, in accordance with
5472-410: The U.S. state of North Carolina, and have been replicated in the U.S. military. Nevertheless, scale-up of healthcare-based opioid overdose interventions is limited by providers' insufficient knowledge and negative attitudes towards prescribing take-home naloxone to prevent opioid overdose. Programs training police and fire personnel in opioid overdose response using naloxone have also shown promise in
5568-476: The hadith of Muhammad . The schools of thought of Islamic jurisprudence have interpreted this as a strict prohibition of the consumption of all types of alcohol and declared it to be haram ( lit. ' forbidden [in Islam ] ' ), although other uses may be permitted. In Buddhism , in general, the consumption of intoxicants is discouraged for both monastics and lay followers. Many Buddhists observe
5664-517: The pancreas . This drop in insulin allows the liver to increase glycogenolysis . Glycogenolysis is the process of glycogen breakdown that results in the production of glucose. Glycogen can be thought of as the inactive, storage form of glucose. Decreased insulin also allows for increased gluconeogenesis in the liver and kidneys . Gluconeogenesis is the process of glucose production from non- carbohydrate sources, supplied from muscles and fat. Once blood glucose levels fall out of
5760-489: The potency , which is a factor in overdosing. For example, lean is usually created as a drinkable mixture, the cough syrup is combined with soft drinks, especially fruit-flavored drinks such as Sprite , Mountain Dew or Fanta , and is typically served in a foam cup . A hard candy, usually a Jolly Rancher , may be added to give the mixture a sweeter flavor. The substance that has been taken may often be determined by asking
5856-414: The U.S. Supervised injection sites (also known as overdose prevention centers) have been used to help prevent drug overdoses by offering opioid reversal medications such as naloxone, medical assistance and treatment options. They also provide clean needles to help prevent the spread of diseases like HIV/AIDS and hepatitis . Stabilization of the person's airway, breathing, and circulation ( ABCs )
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#17327835261295952-586: The United Arab Emirates; to 0.05% in Australia, South Africa, Germany, Scotland, and New Zealand (0.00% for underage individuals); to 0.08% in England and Wales , the United States and Canada. The United States Federal Aviation Administration prohibits crew members from performing their duties within eight hours of consuming an alcoholic beverage, while under the influence of alcohol, or with
6048-494: The United Kingdom and most other countries. In some jurisdictions, it is also an offense to serve alcohol to an already-intoxicated person, and, often, alcohol can only be sold by persons qualified to serve responsibly through alcohol server training . The blood alcohol content (BAC) for legal operation of a vehicle is typically measured as a percentage of a unit volume of blood. This percentage ranges from 0.00% in Romania and
6144-524: The activity, and may result in drowning . Alcohol use is also associated with unsafe sex. Laws on drunkenness vary. In the United States, it is a criminal offense for a person to be drunk while driving a motorized vehicle , except in Wisconsin , where it is only a fine for the first offense. It is also a criminal offense to fly an aircraft or (in some American states ) to assemble or operate an amusement park ride while drunk. Similar laws also exist in
6240-495: The acute-treatment setting, acute alcohol intoxication can mimic other acute neurological disorders or is frequently combined with other recreational drugs that complicate diagnosis and treatment. Acute alcohol poisoning is a medical emergency due to the risk of death from respiratory depression or aspiration of vomit if vomiting occurs while the person is unresponsive. Emergency treatment strives to stabilize and maintain an open airway and sufficient breathing while waiting for
6336-423: The age group of people aged within their 18th–24th years (in a study of a group for the years 1999–2004). In the United States during the years 2010–2012, acute intoxication was found to be the direct cause of an average of 2,221 deaths, in the sample group of those aged within their 15th year or older. The same mortality route is thought to cause indirectly more than 30,000 deaths per year. A normal liver detoxifies
6432-420: The alcohol to metabolize. This can be done by removal of any vomit or, if the person is unconscious or has impaired gag reflex , intubation of the trachea. Other measures may include Additional medication may be indicated for treatment of nausea , tremor , and anxiety . Alcohol intoxication was found to be prevalent in clinical populations within the United States involving people treated for trauma and in
6528-405: The amount of glucose in the body, especially after meals. Glucagon is another hormone involved in regulating blood glucose levels, and can be thought of as the opposite of insulin. Glucagon helps to increase blood glucose levels, especially in states of hunger. When blood sugar levels fall to the low-normal range, the first line of defense against hypoglycemia is decreasing insulin release by
6624-442: The anti-malarial quinine . Low quality evidence implicates lithium , used for bipolar disorder . Finally, very low quality evidence implicates a number of hypertension medications including angiotensin converting enzyme inhibitors (also called ACE-inhibitors), angiotensin receptor blockers (also called ARBs), and β-adrenergic blockers (also called beta blockers). Other medications with very low quality evidence include
6720-467: The antibiotics levofloxacin and trimethoprim-sulfamethoxazole , progesterone blocker mifepristone , anti-arrhythmic disopyramide , anti-coagulant heparin , and chemotherapeutic mercaptopurine . If a person without diabetes accidentally takes medications that are traditionally used to treat diabetes, this may also cause hypoglycemia. These medications include insulin , glinides , and sulfonylureas . This may occur through medical errors in
6816-530: The assumption of suicide . The distribution of naloxone to injection drug users and other opioid drug users decreases the risk of death from overdose. The Centers for Disease Control and Prevention (CDC) estimates that U.S. programs for drug users and their caregivers prescribing take-home doses of naloxone and training on its utilization are estimated to have prevented 10,000 opioid overdose deaths. Healthcare institution-based naloxone prescription programs have also helped reduce rates of opioid overdose in
6912-454: The biblical stance against drinking, drinking wine is restricted for priests. The biblical command to sanctify the Sabbath and other holidays has been interpreted as having three ceremonial meals with wine or grape juice , known as Kiddush . A number of Jewish marriage ceremonies end with the bride and groom drinking a shared cup of wine after reciting seven blessings ; this occurs after
7008-678: The blood of alcohol over a period of time that depends on the initial level and the patient's overall physical condition. An abnormal liver will take longer but still succeeds, provided the alcohol does not cause liver failure . People having drunk heavily for several days or weeks may have withdrawal symptoms after the acute intoxication has subsided. A person consuming a dangerous amount of alcohol persistently can develop memory blackouts and idiosyncratic intoxication or pathological drunkenness symptoms. Long-term persistent consumption of excessive amounts of alcohol can cause liver damage and have other deleterious health effects. Alcohol intoxication
7104-406: The blood. A person experiencing an opioid overdose might also have muscle spasms, seizures and decreased consciousness. A person experiencing an opiate overdose usually will not wake up, even if their name is called or they are shaken vigorously. The drugs or toxins that are most frequently involved in overdose and death (grouped by ICD-10 ): Masking undesired taste may impair judgement of
7200-515: The carbohydrate is chewed or drunk, and then swallowed. This results in the greatest bioavailability of glucose, meaning the greatest amount of glucose enters the body producing the best possible improvements in blood glucose levels. A 2019 systematic review suggests, based on very limited evidence, that oral administration of glucose leads to a bigger improvement in blood glucose levels when compared to buccal administration . This same review reported that, based on limited evidence, no difference
7296-465: The decreased ability to recognize hypoglycemia. As diabetics experience more episodes of hypoglycemia, the blood glucose level which triggers symptoms of hypoglycemia decreases. In other words, people without hypoglycemic unawareness experience symptoms of hypoglycemia at a blood glucose of about 55 mg/dL (3.0 mmol/L). Those with hypoglycemic unawareness experience the symptoms of hypoglycemia at far lower levels of blood glucose. This
7392-403: The film Animals Are Beautiful People , an entire section was dedicated to showing many different animals including monkeys, elephants, hogs, giraffes, and ostriches, eating over-ripe marula tree fruit causing them to sway and lose their footing in a manner similar to human drunkenness. Birds may become intoxicated with fermented berries and some die colliding with hard objects when flying under
7488-523: The first 48 hours of life. After the first 48 hours of life, the Pediatric Endocrine Society cites that there is little difference in blood glucose level and the use of glucose between adults and children. During the 48-hour neonatal period, the neonate adjusts glucagon and epinephrine levels following birth, which may cause temporary hypoglycemia. As a result, there has been difficulty in developing guidelines on interpretation and treatment of low blood glucose in neonates aged less than 48 hours. Following
7584-418: The following: Serious illness may result in low blood sugar. Severe disease of many organ systems can cause hypoglycemia as a secondary problem. Hypoglycemia is especially common in those in the intensive care unit or those in whom food and drink is withheld as a part of their treatment plan. Sepsis , a common cause of hypoglycemia in serious illness, can lead to hypoglycemia through many ways. In
7680-501: The four regulative principles forbids the taking of intoxicants, including alcohol. In the Bible, the Book of Proverbs contains several chapters related to the negative effects of drunkenness and warns to stay away from intoxicating beverages . The Book of Genesis refers to the use of wine by Lot's daughters to rape him. The story of Samson in the Book of Judges tells of a monk from
7776-504: The general public. Specific antidotes are available for certain overdoses. For example, naloxone is the antidote for opiates such as heroin or morphine . Similarly, benzodiazepine overdoses may be effectively reversed with flumazenil . As a nonspecific antidote, activated charcoal is frequently recommended if available within one hour of the ingestion and the ingestion is significant. Gastric lavage , syrup of ipecac , and whole bowel irrigation are rarely used. The UN gives
7872-436: The hypoglycemic episode. Glucose is the main source of energy for the brain, and a number of mechanisms are in place to prevent hypoglycemia and protect energy supply to the brain. The body can adjust insulin production and release, adjust glucose production by the liver , and adjust glucose use by the body. The body naturally produces the hormone insulin , in an organ called the pancreas . Insulin helps to regulate
7968-546: The improper breakdown or storage of proteins , carbohydrates , or fatty acids . Inborn errors of metabolism may cause infant hypoglycemia, and much less commonly adult hypoglycemia. Disorders that are related to the breakdown of glycogen, called glycogen storage diseases , may cause hypoglycemia. Normally, breakdown of glycogen leads to increased glucose levels, particularly in a fasting state. In glycogen storage diseases, however, glycogen cannot be properly broken down, leading to inappropriately decreased glucose levels in
8064-1047: The influence. In elephant warfare, practiced by the Greeks during the Maccabean revolt and by Hannibal during the Punic wars , it has been recorded that the elephants would be given wine before the attack, and only then would they charge forward after being agitated by their driver. It is a regular practice to give small amounts of beer to race horses in Ireland. Ruminant farm animals have natural fermentation occurring in their stomach, and adding alcoholic beverages in small amounts to their drink will generally do them no harm, and will not cause them to become drunk. Alcoholic beverages are extremely harmful to dogs, and often for reasons of additives such as xylitol , an artificial sweetener in some mixers. Dogs can absorb ethyl alcohol in dangerous amounts through their skin as well as through drinking
8160-466: The liquid or consuming it in foods. Even fermenting bread dough can be dangerous to dogs. In 1999, one of the royal footmen for Britain's Queen Elizabeth II was demoted from Buckingham Palace due to his "party trick" of spiking the meals and drinks of the Queen's pet corgi dogs with alcohol which in turn would lead the dogs to run around drunk. Overdose A drug overdose ( overdose or OD )
8256-835: The majority of these fatalities. Hypoglycaemia Hypoglycemia ( American English ), also spelled hypoglycaemia or hypoglycæmia ( British English ), sometimes called low blood sugar , is a fall in blood sugar to levels below normal, typically below 70 mg/dL (3.9 mmol/L). Whipple's triad is used to properly identify hypoglycemic episodes. It is defined as blood glucose below 70 mg/dL (3.9 mmol/L), symptoms associated with hypoglycemia, and resolution of symptoms when blood sugar returns to normal. Hypoglycemia may result in headache , tiredness, clumsiness, trouble talking, confusion , fast heart rate , sweating , shakiness, nervousness , hunger, loss of consciousness , seizures , or death . Symptoms typically come on quickly. The most common cause of hypoglycemia
8352-770: The management of diabetes and prevention of hypoglycemia. Hypoglycemia , also called low blood sugar or low blood glucose, is a blood-sugar level below 70 mg/dL (3.9 mmol/L). Blood-sugar levels naturally fluctuate throughout the day, the body normally maintaining levels between 70 and 110 mg/dL (3.9–6.1 mmol/L). Although 70 mg/dL (3.9 mmol/L) is the lower limit of normal glucose, symptoms of hypoglycemia usually do not occur until blood sugar has fallen to 55 mg/dL (3.0 mmol/L) or lower. The blood-glucose level at which symptoms of hypoglycemia develop in someone with several prior episodes of hypoglycemia may be even lower. The symptoms of low blood sugar alone are not specific enough to characterize
8448-447: The margin between a pleasurable drug sensation and an overdose is small. Unintentional misuse can include errors in dosage caused by failure to read or understand product labels. Accidental overdoses may also be the result of over-prescription, failure to recognize a drug's active ingredient or unwitting ingestion by children. A common unintentional overdose in young children involves multivitamins containing iron . The term 'overdose'
8544-484: The normal range, additional protective mechanisms work to prevent hypoglycemia. The pancreas is signaled to release glucagon , a hormone that increases glucose production by the liver and kidneys, and increases muscle and fat breakdown to supply gluconeogenesis . If increased glucagon does not raise blood sugar levels to normal, the adrenal glands release epinephrine . Epinephrine works to also increase gluconeogenesis and glycogenolysis , while also decreasing
8640-479: The person in the recovery position, keeping the person warm, and making sure breathing is sufficient. Gastric lavage and activated charcoal have not been found to be useful. Repeated assessments may be required to rule out other potential causes of a person's symptoms. Acute intoxication has been documented throughout history, and alcohol remains one of the world's most widespread recreational drugs . Some religions, such as Islam, consider alcohol intoxication to be
8736-523: The person. However, if they will not, or cannot, due to an altered level of consciousness , provide this information, a search of the home or questioning of friends and family may be helpful. Examination for toxidromes , drug testing, or laboratory test may be helpful. Other laboratory test such as glucose , urea and electrolytes , paracetamol levels and salicylate levels are typically done. Negative drug-drug interactions have sometimes been misdiagnosed as an acute drug overdose, occasionally leading to
8832-456: The potential for the first year with fewer than 100,000 fatalities since 2020. The CDC data shows a nearly 17% drop in reported overdose deaths during the 12 months ending in June, totaling 93,087. This is a notable decrease from the 111,615 deaths recorded in the same period ending in June 2023. While the opioid crisis continues to take a heavy toll, fentanyl remains a major driver, contributing to
8928-408: The tests used for law-enforcement purposes, the results from such devices should be conservatively interpreted. Many informal intoxication tests exist, which, in general, are unreliable and not recommended as deterrents to excessive intoxication or as indicators of the safety of activities such as motor vehicle driving, heavy equipment operation, machine tool use, etc. For determining whether someone
9024-401: The underlying problem. Among people with diabetes, prevention starts with learning the signs and symptoms of hypoglycemia. Diabetes medications, like insulin , sulfonylureas , and biguanides can also be adjusted or stopped to prevent hypoglycemia. Frequent and routine blood glucose testing is recommended. Some may find continuous glucose monitors with insulin pumps to be helpful in
9120-405: The use of glucose by organs, protecting the brain's glucose supply. After hypoglycemia has been prolonged, cortisol and growth hormone are released to continue gluconeogenesis and glycogenolysis , while also preventing the use of glucose by other organs. The effects of cortisol and growth hormone are far less effective than epinephrine. In a state of hypoglycemia, the brain also signals
9216-402: Was found in plasma glucose when administering combined oral and buccal glucose (via dextrose gel) compared to only oral administration. The second best way to consume a carbohydrate it to allow it to dissolve under the tongue, also referred to as sublingual administration . For example, a hard candy can be dissolved under the tongue, however the best improvements in blood glucose will occur if
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