On the occasion of International Overdose Prevention Day, Pourquoi Docteur produced a series of articles and questioned readers through a questionnaire. Results.
This is the question that all users ask themselves when they ingest a drug. How far to go? What is the dose that will achieve the optimal effects without generating a negative reaction? When testing their limits, consumers fear two things: “badtrip” for their psyche, and overdose for their body. It is a risk that he takes, that he thinks he has mastered. Sometimes, however, he is wrong.
When we talk about overdose, we imagine the most terrible situations. We think of morphine, heroin, all those opiates to which a more or less important handful of consumers are dependent. In France, cases are rare. In the United States, on the contrary, an epidemic of opioid overdoses is decimating the youth; 28,000 people died in 2014. This worries, but also reassures: it is far from home.
But overdose is not the fate of injectors and marginal drug addicts, far from it. Its shadow hangs over all substances – alcohol, cocaine, amphetamines … – and threatens all audiences who consume them, to varying degrees and through varying mechanisms. August 31 is International Overdose Prevention Day. Why Doctor is devoting a series of articles to it in order to go around this little-known and underestimated accidental phenomenon.
On the occasion of this thematic week on overdose, we asked you through a questionnaire on the way you view drug consumption and the measures that should be taken to supervise addictive behaviors.
Yes to shooting rooms
You were largely in favor of a risk reduction measure now well known to the general public, due to its strong media exposure: lower-risk consumption rooms, which have demonstrated their ability to reduce overdose mortality as well as transmission. infectious diseases (HIV, hepatitis C) and public order disorders. Almost 65% of you are in favor of opening them. In France, the first two will see the light of day in Strasbourg and Paris in the coming weeks.
On the other hand, the majority of respondents did not wish to revisit the penal regime for cannabis use. Thus, nearly 53% are against decriminalizing its consumption, despite calls from the medical community to decriminalize use in order to promote health and preventive approaches.
A public little exposed to overdoses
Regarding the subject that most directly affected us this week, we observe that overdoses remain a marginal phenomenon, and as such, little known to the general public. Almost three quarters of respondents have never experienced an overdose of alcohol or illicit drugs, directly or indirectly.
Finally, most of you believe that a drug user is above all a patient, who therefore needs to be taken care of: only 40.3% think that users are “simple consumers”. However, the question asked did not allow many nuances to be incorporated, in particular on the intensity of the use, which probably determines the border between a user controlling his consumption and a person who has developed an addiction.
Read our series:
Naloxone: the long journey of the antidote to overdoses
Alcohol, cocaine, NPS: sensations taken to the extreme
Addictions: Australians committed to harm reduction
Drugs: How Centers Prevent Overdoses
Cannabis overdoses: details from the OFDT
Following an exchange with the OFDT, we mentioned in one of our articles the cases of cannabis overdoses. We reported a rate of 10% of all drug-related overdoses in France. This information turned out to be incorrect and we apologize for it. As a corrective measure, we are publishing the details provided by the OFDT on the issue.
“More and more cannabis-related deaths have been observed in recent years, but these are not strictly speaking overdoses, they are most often linked to cardiovascular and neurovascular complications”, explains François Beck, director of the ‘Observatory.
“The overdose mechanism means that from a certain dose, all individuals develop an effect (dose-effect relationship). For cannabis, even if a certain dose is required and especially chronic use, there is no dose-effect relationship, not all individuals will develop cardiovascular complications beyond a threshold dose. In the case of cannabis, we are talking about mortality attributable to the product ”.
“It has been shown an increased risk of triggering a myocardial infarction within an hour of taking smoked cannabis compared to periods of non-use. Cases of sudden cardiac death have been reported. Brain lesions responsible for cerebrovascular accidents (CVA) in regular cannabis users, reversible on stopping cannabis, have also been demonstrated. If the cardiovascular effects of cannabis are mainly present and potentially have more consequences for older people and / or with underlying heart or neurovascular diseases, the risk also exists for younger people without cardiovascular ground ”.
“In most studies, the influence of tobacco consumption (whether or not smoked with cannabis), a major risk factor for stroke and myocardial infarction, is not specified, which constitutes a limit ”, also underlines the OFDT.
The increase in the reporting of such cannabis-related deaths (between 15 and 31 cases per year over the past three years according to the DRAMES survey conducted by the ANSM) could in part be due to a greater awareness of experts to cardiovascular toxicity. cannabis, says OFD. In addition, “the products currently circulating are often highly dosed in THC, the active substance of cannabis (the content is today around 15% on average, against 5% at the end of the 1990s)”.
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