Drug overdose
Classification and external resources
Activated carbon is a commonly used agent for decontamination of the gastrointestinal tract in overdoses.
ICD-10	T36-T50
ICD-9	960-979
MeSH	D015537

The term drug overdose (or simply overdose or OD) describes the ingestion or application of a drug or other substance in quantities greater than are recommended^[1] or generally practiced.^[2] An overdose may result in a toxic state or death.^[2]

Classification[link]

The word "overdose" implies that there is a common safe dosage and usage for the drug; therefore, the term is commonly only applied to drugs, not poisons, though even certain poisons are harmless at a low enough dosage.

Drug overdoses are sometimes caused intentionally to commit suicide or as self-harm, but many drug overdoses are accidental, the result of intentional or unintentional misuse of medication. Intentional misuse leading to overdose can include using prescribed or unprescribed drugs in excessive quantities in an attempt to produce euphoria.

Usage of illicit drugs of unexpected purity, in large quantities, or after a period of drug abstinence can also induce overdose. Cocaine users who inject intravenously can easily overdose accidentally, as the margin between a pleasurable drug sensation and an overdose is small.^[3]

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^[4] A common unintentional overdose in young children involves multi-vitamins containing iron. Iron is a component of the hemoglobin molecule in blood, used to transport oxygen to living cells. When taken in small amounts, iron allows the body to replenish hemoglobin, but in large amounts it causes severe pH imbalances in the body. If this overdose is not treated with chelation therapy, it can lead to death or permanent coma.

The term 'overdose' is often misused as a descriptor for adverse drug reactions or negative drug interactions due to mixing multiple drugs simultaneously.

Signs and symptoms[link]

Signs and symptoms of an overdose varies depending on the drug or toxin exposure. 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.^[6] Opioid overdoses can also cause pinpoint pupils, and blue lips and nails due to low levels of oxygen in 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 if they are shaken vigorously.

Causes[link]

The drugs or toxins which are most frequently involved in overdose and death (grouped by ICD-10):

Diagnosis[link]

Determination of the substance which has been taken may often be determined by asking 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 the assumption of suicide.^[7]

Prevention[link]

The distribution of naloxone to injection drug users and other opioid drug users decreases the risk of death from overdose.^[8] CDC estimates that US programs for drug users and their caregivers prescribing take-home doses of naloxone and training on its utilization are estimated to have reversed 10,000 opioid overdose deaths.^[9][10] Healthcare institution-based naloxone prescription programs have also helped reduce rates of opioid overdose in the US state of North Carolina, and have been replicated in the US military.^[11][12] 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.^[13] Programs training police and fire personnel in opioid overdose response using naloxone have also shown promise in the US.^[14][15]

Management[link]

Stabilization of the ABCs are 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 O₂ saturation.^[16] Poison control centers and Medical toxicologists are available in many areas to provide guidance in overdoses to both physicians and the general public.

Antidotes[link]

Specific antidotes are available for certain overdoses--for example, Naloxone is the antidote for opiates such as heroin or morphine. Charcoal is frequently recommended if available within one hour of the ingestion and the ingestion is significant.^[17] Gastric lavage, syrup of ipecac, and whole bowel irrigation are rarely used.^[17]

Epidemiology[link]

The National Center for Health Statistics report that 19,250 people died of accidental poisoning in the U.S. in the year 2004 (8 deaths per 100,000 population).^[18]

In 2008 testimony before a Senate subcommittee, Medical Epidemiologist Dr. Leonard J. Paulozzi^[19] of the Centers for Disease Control and Prevention stated that in 2005 (the most recent year for which data was available) more than 22,000 American lives were lost due to overdoses, and the number is growing rapidly. Dr. Paulozzi also testified that all available evidence suggests that unintentional overdose deaths are related to the increasing use of prescription drugs, especially opioid painkillers.^[20]

See also[link]

• List of drug-related deaths
• Water intoxication

References[link]

Further reading[link]

External links[link]

Look up overdose in Wiktionary, the free dictionary.

• Fact sheets on illicit drugs, overdose prevention, detox and harm reduction strategies.

v t e Recreational drug use Major recreational drugs Opioids Buprenorphine (Subutex · Suboxone) Codeine Dextropropoxyphene (Darvon · Darvocet) Diamorphine (heroin) \ Morphine (Opium) Hydrocodone Hydromorphone (Dilaudid) Methadone Mitragyna speciosa (Kratom) Oxycodone Depressants Barbiturates Benzodiazepines Ethanol (Alcoholic beverages) GHB Kava Nonbenzodiazepines Stimulants Amphetamine Arecoline (Areca) Betel Caffeine (Coffee Tea) Cathinone (Khat) Cocaine (Coca) Ephedrine (Ephedra) Mephedrone Methamphetamine Methylphenidate Nicotine (Tobacco) Theobromine (Cocoa) Entactogens MDA MDMA (Ecstasy) Hallucinogens Psychedelics Bufotenin Psychoactive toads Vilca Yopo DMT (Ayahuasca) LSA LSD-25 Mescaline Peruvian Torch Peyote San Pedro Psilocybin \ Psilocin (Psilocybin mushrooms) Dissociatives DXM Inhalants Nitrous oxide alkyl nitrites – poppers, such as amyl nitrite Ketamine MXE Muscimol (Amanita muscaria) PCP Salvinorin A (Salvia divinorum) Deliriants Atropine and Scopolamine Datura Deadly Nightshade Henbane Mandrake Dimenhydrinate Diphenhydramine Cannabinoids JWH-018 THC (Cannabis Hashish Hash oil) Oneirogens Calea zacatechichi Silene capensis Drug culture Cannabis 420 Cannabis cultivation Cannabis smoking Legal history of cannabis in the United States Legality of cannabis Marijuana Policy Project Medical cannabis NORML Religious and spiritual use of cannabis Stoner film Psychedelic Art Drug Experience Literature Music Other Club drug Counterculture of the 1960s Dance party Drug paraphernalia Drug tourism Entheogen Hippie Party and play Poly drug use Rave Self-medication Sex and drugs Problems with drug use Abuse Dependence Prevention Opioid replacement therapy Rehabilitation Responsible use Drug-related crime Fetal alcohol spectrum disorder Illegal drug trade Long-term effects of cannabis Neurotoxicity Overdose Date-rape drug Passive smoking (of tobacco or other substances) Legality of drug use International 1961 Narcotic Drugs 1971 Psychotropic Substances 1988 Drug Trafficking Cannabis reform at the international level State level Drug policy Decriminalization Prohibition Supply reduction Policy reform Demand reduction Drug Policy Alliance Harm reduction Law Enforcement Against Prohibition Liberalization Students for Sensible Drug Policy Transform Drug Policy Foundation Drug policy by country Australia Canada Germany India Netherlands Portugal Sweden Switzerland Soviet Union United States Just Say No Office of National Drug Control Policy School district drug policies California Colorado Maryland Virginia Other Arguments for and against drug prohibition Capital punishment for drug trafficking Designer drug Drug court Drug possession Drug test Hard and soft drugs Illegal drug trade in Colombia Mexican Drug War Narc Opium production in Afghanistan Politics of drug abuse War on Drugs Zero tolerance Lists of countries by... Alcohol consumption Cannabis legality Annual use Lifetime use Cigarette consumption Cocaine use Opiates use

Cory Monteith
Monteith at the 2011 Toronto International Film Festival
Born	Cory Allan Michael Monteith (1982-05-11) May 11, 1982 (age 30) Calgary, Alberta, Canada
Occupation	Actor, Musician
Years active	2004–present

Cory Allan Michael Monteith^[1] (born May 11, 1982)^[2] is a Canadian actor and musician, best known for his role of Finn Hudson on the Fox television series Glee.

Early life[link]

Monteith was born in Calgary, Alberta and raised in Victoria, British Columbia.^[3] His parents divorced when he was seven, and he was raised by his mother.^[4][5] By 13, Monteith, once a promising student, who, at age 5, could read at a fourth-grade level, dropped out of school. Monteith estimates that by the time he quit school for good at age 16, he had attended 12 different schools, including alternative programs for troubled teens. He went drinking with his friends and had a drug addiction. Monteith went to rehab at 19 after his family gave him an ultimatum: either he gets clean or they would report him to the police and press charges for stealing a significant amount of money to fuel his addiction. Looking back, he stated, "I finally said, 'I'm gonna start looking at my life and figure out why I'm doing this.'"^[6]

He has worked various jobs, such as a Wal-Mart people greeter, taxi driver, school bus driver, and roofer.^[7]

He received his high school diploma in 2011 from an alternative school he attended in Victoria, British Columbia.^[6]

Monteith is a huge fan of the NHL's Vancouver Canucks.^[8]

Career[link]

Acting[link]

Monteith began his acting career in Vancouver, British Columbia. He played minor roles in Final Destination 3, Whisper, and Deck the Halls. He had a recurring role in Kyle XY.^[9] He also made guest appearances in such Canadian-filmed television serials as Smallville, Supernatural, Flash Gordon, Stargate Atlantis and Stargate SG-1.^[7]

Monteith at Venice High School for a Glee location shoot in December 2011^[10]

In 2005 he appeared in Killer Bash about a tormented geek's soul that was taking revenge on his murderer's children by taking over a girl's twin body. The following year he made a brief appearance in Urban Legend: a Bloody Mary. In 2007, he starred in the MTV series Kaya.^[11]

In 2009, Monteith was cast in the Fox series Glee, playing Finn Hudson, the male lead of the glee club and the quarterback of McKinley High School.^[9] For his audition tape, he drummed on Tupperware using pencils. The first time he sang in front of an audience was at his in-person audition, at which he sang "Honesty" by Billy Joel.

In April 2010, Monteith was cast in the romantic comedy movie Monte Carlo.^[12] In May 2010, the cast of Glee went on a two week live tour with stops in Los Angeles, Phoenix, Chicago and New York City.^[13] The cast performed hits from the show and several skits between songs. The following May, the cast went on a second, longer tour with mostly new songs and all-new skits, performing for four weeks in the U.S. and Canada, and eleven days in England and Ireland.^[14][15]

On August 8, 2010, he co-hosted the Teen Choice Awards.^[16] Monteith hosted the Gemini Awards in Toronto on November 13, 2010.^[17]

In December 2010, it was announced that Monteith would be starring in and co-producing a new untitled workplace-caper comedy for Fox 2000.^[18] In January 2011, he shot the film Sisters&Brothers with Dustin Milligan, which premiered at the Toronto International Film Festival on September 11, 2011.^[19][20]

In 2011, he filmed a PSA for Straight But Not Narrow, an online PSA organization aimed at changing the minds of young, straight guys and girls in their attitude and viewpoint towards the LGBT community.^[21]

In 2012, he co-hosted the GLAAD Media Awards in New York City with co-star Naya Rivera.^[22]

Music[link]

Monteith plays drums for the Indie rock band Bonnie Dune based in Los Angeles. Members include lead singer Justin Wilczynski (who co-starred with Monteith on the short-lived MTV series, Kaya), guitarist Seth Roberts (who is the singer of the band Lakes), and bassist Joshua Kerr.

Filmography[link]

Monteith at the GLAAD Awards on April 17, 2010

Awards[link]

Awards won[link]

• Hollywood Style Awards 2010
  • Male Future Style Icon Award
• SAG Awards 2010
  • Outstanding Performance by an Ensemble in a Comedy Series
• 2011 Teen Choice Awards
  • Choice TV: Actor Comedy

Nominations[link]

• SAG Awards 2011
  • Outstanding Performance by an Ensemble in a Comedy Series
• Teen Choice Awards 2009
  • Choice TV: Actor Breakout Star Male
• Teen Choice Awards 2010
  • Choice TV: Comedy Actor
  • Choice Smile^[3]
• 2011 Teen Choice Awards
  • Summer: Movie Star – Male
• 2012 People's Choice Awards
  • Favorite TV Comedy Actor

Discography[link]

References[link]

External links[link]

Wikimedia Commons has media related to: Cory Monteith

• Cory Monteith at the Internet Movie Database
• Cory Monteith on Twitter

Amy Winehouse
Amy Winehouse at the Eurockéennes festival in France (2007)
Background information
Birth name	Amy Jade Winehouse
Born	(1983-09-14)14 September 1983 Southgate, London, UK
Died	23 July 2011(2011-07-23) (aged 27) Camden, London, UK
Genres	Soul, R&B, jazz, blues
Occupations	Singer, songwriter, composer, arranger
Instruments	Vocals, guitar, drums
Years active	1993–2011
Labels	Island, Lioness, Universal Republic (U.S.)
Associated acts	Dionne Bromfield, Mark Ronson, Tony Bennett, Nas, Zalon, Tyler James, Paul Weller, The Rolling Stones, Lily Allen
Website	www.amywinehouse.com

Amy Jade Winehouse (14 September 1983 – 23 July 2011) was an English singer and songwriter known for her powerful deep contralto vocals^[1] and her eclectic mix of musical genres including R&B, soul and jazz.^[2] Winehouse's 2003 debut album, Frank, was critically successful in the UK and was nominated for the Mercury Prize. Her 2006 follow-up album, Back to Black, led to six Grammy Award nominations and five wins, tying the then record for the most wins by a female artist in a single night, and made Winehouse the first British female to win five Grammys,^[3][4] including three of the "Big Four": Best New Artist, Record of the Year and Song of the Year.

In 2007 she won a Brit Award for Best British Female Artist; she had also been nominated for Best British Album. She won the Ivor Novello Award three times: once in 2004 for Best Contemporary Song (musically and lyrically) for "Stronger Than Me", once in 2007 for Best Contemporary Song for "Rehab", and once in 2008 for Best Song Musically and Lyrically for "Love Is a Losing Game".

Winehouse died of alcohol poisoning on 23 July 2011. Her album Back to Black subsequently became the UK's best selling album of the 21st century.^[5] In 2012, Winehouse was listed at number 26 on VH1's 100 Greatest Women In Music.^[6]

Early life[link]

Amy Winehouse was born in the Southgate area of North London to a Jewish family, with some Russian ancestry on her mother's side^[7][8] who also influenced her interest in jazz.^[9] Her father, Mitchell "Mitch" Winehouse, was a taxi driver, her mother, Janis Winehouse (née Seaton),^[10] a pharmacist.^[11] Her grandmother, Cynthia, was a singer^[12] and she had an older brother, Alex (born 1979).^[13] Mitch often sang Frank Sinatra songs to young Amy, who also took to a constant habit of singing to the point that teachers found it difficult keeping her quiet in class.^[14] Winehouse's parents separated when she was nine.^[15]

When Winehouse was nine years old, her grandmother Cynthia suggested she attend the Susi Earnshaw Theatre School for furthering her vocal education.^[16] She attended the Earnshaw school for four years and founded a short-lived rap group called Sweet 'n' Sour with Juliette Ashby, her childhood friend^[17] before seeking full-time training at Sylvia Young Theatre School; however, Winehouse was allegedly expelled at 14 for "not applying herself" and also for piercing her nose.^[13][18] (Sylvia Young herself has denied this – "She changed schools at 15 – I've heard it said she was expelled; she wasn't. I'd never have expelled Amy.")^[19] She also appeared in an episode of The Fast Show, 1997, with other children from the Sylvia Young School^[20] and later attended The Mount School, Mill Hill, the BRIT School in Selhurst, Croydon, Southgate School and then Ashmole School.^{[21][22][23][24]}

Music career[link]

Early career[link]

After toying around with her brother Alex's guitar, Winehouse received her first guitar when she was 13 and began writing music a year later. Soon after, she began working for a living, including, at one time, as an entertainment journalist for the World Entertainment News Network, in addition to singing with local group the Bolsha Band.^[13][25] In July 2000 she became the featured female vocalist with the National Youth Jazz Orchestra; her influences were to include Sarah Vaughan and Dinah Washington.^[26] Her boyfriend at the time, soul singer Tyler James, sent her demo tape to an A&R person.^[9] Winehouse signed to Simon Fuller's 19 Management in 2002. While being developed by the management company, she was kept as a recording industry secret.^[27] Her future A&R representative at Island/Universal, Darcus Beese, heard of her by accident when the manager of The Lewinson Brothers showed him some productions of his clients, which featured Winehouse as key vocalist. When he asked who the singer was, the manager told him he was not allowed to say. Having decided that he wanted to sign her, it took several months of asking around for Beese to eventually discover who the singer was. However, Winehouse had already recorded a number of songs and signed a publishing deal with EMI by this time. Incidentally, she formed a working relationship with producer Salaam Remi through these record publishers.^[27]

Beese introduced Winehouse to his boss, Nick Gatfield, and the Island head shared his enthusiasm in signing the young artist. Winehouse was signed to Island/Universal, as rival interest in Winehouse had started to build to include representatives of EMI and Virgin starting to make moves. Beese told HitQuarters that he felt the reason behind the excitement, over an artist who was an atypical pop star for the time, was due to a backlash against reality TV music shows, which included audiences starved for fresh, genuine young talent.^[27]

Winehouse's greatest love was 1960s girl groups.^[28] Her stylist, Alex Foden, borrowed her "instantly recognisable" beehive hairdo (a weave^[29][30]) and she borrowed her Cleopatra makeup from The Ronettes.^[28] Her imitation was so successful, as the Village Voice reports: "Ronnie Spector—who, it could be argued, all but invented Winehouse's style in the first place when she took the stage at the Brooklyn Fox Theater with her fellow Ronettes more than 40 years ago—was so taken aback at a picture of Winehouse in the New York Post that she exclaimed, "I don't know her, I never met her, and when I saw that pic, I thought, 'That's me!' But then I found out, no, it's Amy! I didn't have on my glasses."^[31]

New York Times reporter, Guy Trebay, discussed the multiplicity of influences on Winehouse's style. Trebay noted: "her stylish husband, Blake Fielder-Civil, may have influenced her look." Additionally, Trebay observes:

She was a 5-foot-3 almanac of visual reference, most famously to Ronnie Spector of the Ronettes, but also to the white British soul singer Mari Wilson, less famous for her sound than her beehive; to the punk god Johnny Thunders...; to the fierce council-house chicks... (see: Dior and Chanel runways, 2007 and 2008); to the rat-combed biker molls photographed by the Swiss photographer Karlheinz Weinberger in the 1960s; to a lineage of bad girls, extending from Cleopatra to Louise Brooks’s Lulu and including Salt-n-Pepa, to irresistible man traps that always seemed to come to the same unfortunate end.^[32]

[edit] Major label success and Frank

Performing at the Bowery Ballroom, New York City in 2007

Winehouse's debut album, Frank, was released on 20 October 2003. Produced mainly by Salaam Remi, many songs were influenced by jazz and, apart from two covers, every song was co-written by Winehouse. The album received positive reviews^[33][34] with compliments over the "cool, critical gaze" in its lyrics^[2] and brought comparisons of her voice to Sarah Vaughan,^[35] Macy Gray and others.^[2]

The album entered the upper levels of the UK album chart in 2004 when it was nominated for BRIT Awards in the categories of "British Female Solo Artist" and "British Urban Act". It went on to achieve platinum sales.^[36] Later in 2004 she won the Ivor Novello (songwriting) Award for Best Contemporary Song, alongside Salaam Remi, with her contribution to the first single, "Stronger Than Me".^[37] The album also made the short list for the 2004 Mercury Music Prize. In the same year she performed at the Glastonbury Festival, the V Festival, the Montreal International Jazz Festival (7 July 2004, at the Club Soda), and on the Jazzworld stage. After the release of the album, Winehouse commented that she was "only 80 percent behind [the] album" because of the inclusion by her record label of certain songs and mixes she disliked.^[9] Additional singles from the album were "Take the Box", "In My Bed"/"You Sent Me Flying" and "Pumps"/"Help Yourself".