Cocaine, ecstasy or alcohol. Every day people with an overdose are treated at the emergency department of Erasmus MC. Hospital pharmacist and toxicologist Corine Bethlehem and emergency department nurse Ruben Veenema are guests at Studio Erasmus and explain how they deal with intoxications and whether or not it can be prevented.
'I think drug use has always been around', says Bethlehem. 'People still take drugs that were used fifty years ago, but I'm amazed by all the crazy drugs that are on the market now. And that people take and mix everything without any anxiety.'
These so-called mixed intoxications sometimes form horror scenarios for doctors. 'It's difficult when people have taken the "uppers" and "downers" at the same time, sometimes in combination with alcohol, or when lesser-known drugs are mixed', says Veenema.
Step-by-step plan
When someone comes in, nurses measure their heart rate, blood pressure and temperature. Based on this, someone falls into a certain category that fits a certain type of drug or alcohol. A so-called heteroanamnesis is also very important: has anyone seen what someone has taken or done? This is especially important if a patient is unconscious, which is often the case.
'The first thing we do in the emergency room when someone comes in with an intoxication is stabilising them', says Veenema. It is often not immediately important to know which drug someone has taken. 'Only when someone's temperature is extremely high, for example, is it important to examine their urine and/or blood.'
The laboratory tests for eight different common drug categories, such as benzodiazepines and amphetamines. 'Sometimes a drug is only effective for such a short time that before it is determined which drug someone has taken, the drug has already worn off and someone is already cycling back home', says Bethlehem. 'But sometimes an antidote has to be given, in which case it is important to know which drugs are involved.'
Risk-free drug use does not exist
You can do everything you can to use drugs as responsibly as possible. For example, by having your drugs tested and making sure that there is always a sober person present. However, that does not mean that it is safe. 'You can never use drugs without risk', says Bethlehem. 'You have people who react well to the same pill ten times at a festival, and die the eleventh time with exactly the same pill. That drug does not even have to be contaminated. There are all kinds of unpredictable factors in drug use that can cause you to succumb to it that evening.'
Watch the entire interview at Studio Erasmus (in Dutch)
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