DRUG, Abuse
The most frequently used drug among seamen, besides alcohol, is smoked cannabis (Marihuana or "grass"), which leaves a characteristic smell.
The prolonged consumption of any drug causes mental damage and personality alterations, and may mistake an addiction behaviour with some other mental disease.
The addiction signs and symptoms vary according to the drug, and even more if there is mixing. They appear suddenly in case of overdose (acute intoxication due to a higher dose or greater drug purity) or abstinence (physical and psychic symptoms after sudden withdrawal of the drug to which the subject is addicted to), or may appear slowly after prolonged use.
Drug abuse can be suspected if:
If suspected, ask the crew discreetly. Do not take, in the first instance, the word of the patient.
The following table lists the most common drugs, describes intoxication symptoms and the dangers of abuse.
| KIND OF DRUG (slang name) |
EFFECTS | LOOK FOR | DANGERS |
|---|---|---|---|
| HALLUCINOGEN (LSD (lysergic acid diethylamide) DMT. STP. PCP.) |
Illusions and severe hallucinations, feelings of indifferenc, incoherent language,cold sweat in hands and feet, vomits, laugh or cry, euphoria or depression, shivers, tremor, irregular breathing. | Paper towels with drawings, lump of sugar with central decolouration, small tube of liquid, tinytablets. | Suicidal or homicidal impulses, unexpected behaviour, accidental death, persecutory ideas, "bad trip" (disorientation, depression,vertigo and panic), flash back, psychosis, psychic dependence, fast tolerance. |
| AMPHETAMINES ((weight loss pills) METAMPHETAMINE (speed, ice).) |
Aggressive behaviour, silly laugh, stupidity, fast language,confused thought, lack of appetite, extreme fatigue, dry mouth, halitosis, tremor, dilated pupils, sweat; the subject wets his lips, rubs and scratches his nose excessively,extreme restlessness, irritability, violence, persecutory ideas. | Tablets or pills of different colours,compulsive cigarette smoker, syringes, powder of different textures and colours, sniffing products, pipes, rock crystals without colour, taste or smell. | Hallucinations, death after overdose, permanent heart damage or heart attacks; loss of weight, paranoid psychosis or depression with suicidal impulses in abstinence. High tolerance and psychological dependence. There are no safe doses. |
| BARBITURATES (sleeping pills, goof balls). |
Disinhibition, somnolence, stupor, blunting, blurred language, drunken look, vomiting, staggering, quarrelsome. | Tablets or pills of different colours,syringes. | Loss of consciousness, coma, death after overdose, addiction, fits or death due to sudden abstinence. Higher risk when mixing with alcohol. Abscesses due to injection. |
| CANNABIS: MARIHUANA AND HASHISH (grass, pot). |
Insomnia, talkative, happy mood, dilated pupils, loss of coordination, longing for sweets, unexpected behaviour, memory loss, time and space distortion, excitation followed by lethargy. | Intense smell of burnt rope or leaves,with characteristic sweet smell, cigarette paper, finger stains, pipes, envelopes with "grass" or dark resin balls. | Induces consumption stronger drugs, lung and reproductive system damage, and long term brain damages. Tolerance and some psychological dependence. |
| COCAINE (crack) |
Muscle spasms, convulsions, marked mood changes, excitation, hallucination, dilated pupils. | White odourless shiny powder in a rock shape (viscous and yellow) as porcelain pieces or marble, mirror, shaving blades,fine tubes, pipes, lighters. | Fits and headaches, death after overdose, persecutory ideas, psychological dependence (physical as well), heart and respiratory dysfunction, nasal ulcers. |
| VOLATILE SOLVENTS (INHALED) (petrol based glues, lighter liquid,antifreeze, paint thinners, propelling gases, shoe polish, acetone, etc). |
Drunken look, dreamer or inexpressive face, breath smells of glue or solvent, excessive nasal secretion, lacrimation, bad muscle control, delirium, hallucinations, aggressive, lossof consciousness,"sniff rash". | Glue tubes, glue stains, plastic bags,empty aerosol containers, lighter liquid containers, petrol or solveent cans. | Lung brain, heart or liver lesion, death by suffocation or asphyxia, anaemia, fire risk, psychological dependence. |
| DRUGS SIMILAR TO
BARBITURATES ( benzodiazepines : chlordiazepoxide, diazepam, flunitrazepam and others.) |
Similar to those of barbiturates (some more sleep inducers and other more relaxants). | Valium® tablets(yellow 5 mg., blue 10 mg.); other doses or brands have different presentation (pills,tablets, ampoules). | Panic and psychotic attacks,tolerance and physical dependence, sometimes physical (more with prolonged consumption and sudden withdrawal). |
| DESIGNER DRUGS: MDMA OR "EXTASIS". MDA. |
Hallucinogens and stimulants, disinhibition, aroused sensory conscience, dilated pupils, dry mouth, insomnia, high pulse and blood pressure, difficult body co-ordination, nausea, vertigo. In high doses, confusion, visual and auditive hallucinations. | Tablets and pills (great variety of colours, shapes and sizes). | Cardiac, respiratory and renal toxics, psychosis,brain damage.Tolerance and some dependence. Sudden death. |
| STUPIFYING SUBSTANCES AND
OPIATES (Heroin. Morphine.) |
Stupor, sleepiness, injection sites, lacrimation, anorexia, blood staining on shirt sleeves,"nodding", contracted pupils (small), which do not react to light, inattentive, slow breathing and pulse, nausea & vomiting, dry mouth, red face, high pulse and blood pressure. | Needles or syringes, ,cotton, tourniquet(shoelace, string or belt), burnt spoons, bent paper envelopes, white powder leftovers on nostrils or swollen mucosa, tin foil; salmon, purple or orange tablets, glass ampoules, white to brown powder, tin foil. | Death after overdose or septicaemia, mental deterioration, brain, heart and liver lesions, embolism, infections due to non sterile needles and other material(abscesses, hepatitis, AIDS…), psychic and physical dependence. |
| ALKYL NITRITES: (Amyl, butyl and isobutyl nitrite. Nitrates, bananas, pappers, rush, snappers. ) |
Perception distortion, vertigo,weakness, headaches, face and neck congestion. | Glass ampoules with light yellow liquid, aromatic smell and spicy taste. Small brownballs. | Delirium, heart and respiratory problems, low blood pressure and loss of consciousness. Quick tolerance. |
Source: D. Stockney, Drug Warning. Spanish adaptation 1997.
Any drug found must be collected, identified and we must ask for MEDICAL ADVICE VIA RADIO .
If the patient is unconscious but essential life processes are preserved, we know for certain that the drug used is heroin, we notice very small pupils (as dots), there is respiratory depression and a slow pulse (50 to 60 beats per minute), we may try to revert the effects by giving a slow ampoule of its antagonist naloxone (DRAWER 3, first aid kits A and B), intramuscularly or subcutaneously, which may be repeated after 3 to 5 minutes if there is no response.