Poisoning from Illicit Human Drugs: Depressants Petra A

Poisoning from Illicit Human Drugs: Depressants Petra A. Volmer, DVM, MS, DABVT, DABT

BASIC INFORMATION BENZODIAZEPINES Animal exposures to illicit drugs are uncommon but are usu- Description ally emergency situations when they do occur. In most cases, Benzodiazepines are prescription antianxiety, anticonvulsant, and ingestion of the owner’s prescription products occurs; however, sedative drugs. They are controlled substances, whose distribution drugs manufactured in clandestine laboratories may also be con- is regulated by the DEA. Common names include lorazepam sumed. Most street drugs contain impurities that can confuse the (Ativan ), clorazepate (Tranxene ), prazepam (Centrax ), clonazepam diagnosis. In many instances, animal caretakers are reluctant to (Klonopin ), flurazepam (Dalmane ), triazolam (Halcion ), chlordi- provide information surrounding the exposure. In general, the azepoxide (Librium ), halazepam ( Paxipam ), temazepam ( Restoril), most common drugs of abuse are the depressants (barbiturates, oxazepam (Serax ), diazepam (Valium ), and alprazolam (Xanax ). benzodiazepines, marijuana), opioids, and stimulants (amphet- Flunitrazepam (Rohypnol ) is referred to as the date rape drug; it is amines and cocaine). illegal in the United States. Some street names include downers, V (for valium), rophies, roofies, roach, and rope (flunitrazepam). BARBITURATES Causes and Toxicity Description Benzodiazepines bind to receptors in the brain and cause central Sources of barbiturates include amobarbital ( Amytal ), aprobarbital nervous system (mental) depression. Benzodiazepines have a wide (Alurate ), butabarbital (Busodium, Butalan, Butisol ), mephobarbi- margin of safety between doses that cause drowsiness and doses tal (Mebaral ), pentobarbital (Nembutal ), phenobarbital (Solfoton, that are lethal. Luminal, Barbita), and secobarbital ( Seconal). Barbiturates are controlled substances whose distribution is regulated by the U.S. Drug Enforcement Administration (DEA). Street names include Clinical Signs barbs, downers, red devils, goof balls, yellow jackets, block bust- Low doses can cause weakness, disorientation, and depression. At ers, pinks, reds and blues, and Christmas trees. Secondary poison- higher doses, vocalization, restlessness, tremors, and seizures are ing can occur from ingestion of carcasses of animals euthanized possible. with pentobarbital. Causes and Toxicity The principal effect of barbiturates is depression of the central ner- Diagnostic Tests vous system, especially the brain. Diagnosis is based on a history of exposure and consistent clinical signs. Analysis of urine or blood for benzodiazepines can be per- Clinical Signs formed by an outside laboratory. Barbiturates cause weakness, drowsiness, incoordination, and, in severe cases, coma, depression of respiration (diminished breath- Treatment Options ing), and death. Animals exhibiting signs must be monitored and protected from Diagnostic Tests injury (such as falling downstairs or off furniture). Your veterinar- Diagnosis is based on a history of exposure and compatible clini- ian may recommend induction of vomiting if the exposure was cal signs. Barbiturates can be detected in stomach contents, blood, recent and a large amount of drug was ingested. Activated charcoal urine, and feces; however, testing must be performed at outside may be administered to bind with the drug and prevent its absorp- laboratories. tion into the body. For severe exposures, hospitalization may be required for administration of intravenous fluids and supportive Treatment Options care. Flumazenil (Romazicon ), an antidote for the benzodiazepines, If exposure was recent and the animal is not showing any clinical may be administered in severe cases if it is available. signs, vomiting can be induced under the direction of a veterinar- Prognosis ian. Your veterinarian may administer activated charcoal to help Prognosis for most benzodiazepine ingestions is good. bind the barbiturate in the gut and prevent its absorption into the body. For severe ingestions, the animal may be hospitalized for MARIJUANA monitoring of the heart and lungs, as well as administration of Description intravenous fluids and supportive care. Prognosis All parts of the marijuana plant ( Cannabis sativa ) are toxic. Marijuana is available as the dried herb, a resin (hash or hashish), For animals with recent ingestions that are treated rapidly, the or a sticky liquid (hash oil). Street names include hemp, pot, grass, prognosis is good. Mary Jane, sinsemilla, hash, hashish, Bhang, Ganja, charas, Thai stick, reefer, and wacky-backy. Continued

Causes and Toxicity Treatment Options The toxic constituents in marijuana act on the brain and influence Induction of vomiting may be recommended, and activated char- the interpretation of stimuli from sensory organs. A wide margin coal may be administered following large ingestions. Animals of safety exists between doses that cause early behavioral effects showing signs should be protected from injury (such a falling off and doses that are lethal. furniture) and given supportive care. Prognosis Clinical Signs Prognosis in most cases is excellent, with most effects being Affected animals may be restless, nervous, and disoriented. temporary. Vomiting, diarrhea, tremors, incoordination, weakness, and dilated pupils may occur. Signs may last 18-72 hours. Diagnostic Tests Diagnosis is based on a history of exposure and compatible clinical signs. Marijuana compounds may be detected in urine.