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🎥 | Singer Demi Lovato's documentary becomes SWSX's opening night work


Photo Demi Lovato – Kevin Mazur / Getty Images for SiriusXM

Singer Demi Lovato's documentary becomes SWSX's opening night work

 
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This is a follow-up of Rovato's recovery from an accident in which he was transported to a hospital due to overdose of heroin in October 2018.
 

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Overdose

Overdose(English: overdose) Is an amount that causes an acute harmful effect on the body or mind.DrugIs to be used[1]..It has temporary or permanent consequences, and in the worst caseDeathMay do[1].JapaneseThen.Overdose,OverdoseHas been translated.Abbreviation is OD..Means excess English over And the dose dose WithCompound word.

Especially high-risk casesheroin,morphinePainkillers like,amphetamine,alcohol,BenzodiazepinesDrugs and when these are taken at the same time[2]..They are drugs that are close in acting and lethal doses.vice versa,marijuana,LSDThen.Safety factor (treatment index)Is high and there are few serious cases[3].

Intentional overdosesuicideMay mean an intention[1]..More in legal drugs than in illegal drugs[1].

Recently prescribed by a doctorPsychotropic drugsThere are a series of cases of overdose.アメリカ合衆国According to the survey conducted in Japan, drug deaths are often unintentional deaths.Prescription medicinesIs the majority[4]. in JapanPsychiatricFor patientsMultidrug mass prescriptionBecomes a problem[5], In a cabinet decision in 2012pharmacistAlthough the utilization of[6], Exceeded a certain number from 2014prescription OfMedical feeWill be reduced.Unexplained death in 2010 in JapanJudicial dissectionDrugs (3,000, 841%) and alcohol (28%) were frequently detected from about 22 people, and the breakdown of drugs was hypnotics (306, 10%) and neuropsychiatric drugs (10%).[7].OTC drugsThen,Drug storeIs sold atAntipyretic analgesicAre used.

Deaths from drug overdose have become an international concern in the United States and Britain[8][9]..In the United States, deaths from overdose have increased for the 11th consecutive year, and in 2010 there were 38,329 deaths from drug overdose other than alcohol, and the drug that causes death isOver-the-counter drugsOr illegal drugs, notPrescription medicinesMore than half are caused by[4]..Of which, it is used as an analgesicOpioidIt is a sedative hypnotic with the highest involvement of related drugs in 16,651 people.BenzodiazepinesThe number of related drugs is 6,497, which is the second and third place.AntidepressantContinues with 3,889 people[4]..The number of deaths from opioid analgesics, which is the most deadly in the United States, is[4], Medical cannabis is declining in legalized states[10].

History

Mental disorderBecause there are no boundaries in the diagnosis of mild conditions, pharmaceutical companies sell drugs, which is powerful.Sales PromotionIn the United States, the prevalence of mental illness increases by 20-25% each year,EuropeBut keep the numbers not too far apart[12].

And major pharmaceutical companies have also committed illegal acts in psychiatric medicine and other areas, such as hiding side effects, giving incentives to prescribing doctors, and marketing for illnesses that are not indicated. In the second half of 2010, each prescription company was fined hundreds of millions to billions of dollars and sold criminally.[13]..And it resulted in more deaths from prescription drugs than (illegal) drugs sold on the streets.[12].

In the United States, drug-related deaths increased 2000 times in 2005 compared to 1.5, resulting insuicide,ShootingWas to exceed[14]..In particular, the number of deaths from opioid analgesics, which was about 2000 in 4,000, exceeded 2010 in 16,000.[15].

(English edition(SAMHSA) by drug suicide attemptEmergency medical careに搬送された件数は、2005年の151,477件から2011年には228,277件へと51%増加し、その内訳は(おそらく重複も数え)抗不安薬や睡眠薬が48%、鎮痛剤が29%、抗うつ薬が22%、医薬品以外ではアルコールが39%、違法薬物11%と報告した[16].. BritishKeith VazCongressmen said the dire consequences of not acting now can be seen in America today.[17].

Deaths from drug overdose in the United Kingdom and the United StatesTraffic accidentIt has exceeded the number of deaths and has become an international concern.[8][9]..August 8st is International Overdose Awareness Day[18].

From this situation, in 2013,Mental disorder diagnosis and statistics manualWas the editorial chairman of the 4th edition ofAllen FrancesIn order to prevent dangerous over-prescription, suspicious prescriptions such as large quantities and many types are monitored by the sales system of dispensing pharmacies, etc. Proposing to discipline[19].. The FDA's post-approval monitoring program is inadequate, so it is necessary to identify and eliminate bad drugs.[19]..Ban on direct consumer advertising in the US, off-label marketing,IllnessIt is also necessary to ban[19].

Center for Disease Control and PreventionAccording to the company, 36 states have prescription drug monitoring programs in operation, which is a state-owned electronic database that tracks regulated prescription drugs and pharmacies.[20].

In 2010, four academic societies, including the Japanese Society of Depression, jointly made a request to prevent overdose.[5], The use of pharmacists has been proposed by the Japanese Cabinet decision in August 2012.[6]From 2014, it has been decided that medical fees will be reduced for prescriptions of anxiolytics / hypnotics, antidepressants, and antipsychotics that exceed a certain number.

In the United States, overdose deaths from prescribed opioids have quadrupled in the decade to 2009, and in the futureheroinThere was concern that it would lead to death due to illness, and no increase was seen.[21], Was the most drug overdose death in 2010 and 2011OxycodoneThe number of heroins that surged in 2012 surpassed[22].

2016 year 8 month,US Food and Drug AdministrationThe (FDA) has added the strongest in-frame warnings to these drugs for the combination of opioids and benzodiazepines, which can lead to extreme drowsiness, respiratory depression, coma and death.[23].

Both preventative measures have become important as the overdose and 2017% of the increased suicides are related to opioids, which have continued to increase until 40.[24].

Cause

Causes of overdose include misadministration, misjudgment / misjudgment,suicideIntention /Self-harmFor the purpose ofEscapism, To get a sense of euphoria, and so on.According to a survey in the United States, as many as 74.3% of deaths are unintentional deaths.[4].

As an example of misjudgment, if you are using a drug that has a similar action dose and lethal dose on a daily basis,ResistanceHowever, the same amount as before will not work, but if you stop using it for a while and your tolerance has recovered, you may overdose if you use it with the same feeling as before.[2]..High risk, especially after being released from detoxification facilities, drug rehabilitation facilities and prisons[2].

Others include accidental ingestion of drugs and misjudgment of dose.For example, a childMulti includingVitamin preparationThis is a case of overdose.Alcohol and other common causes of children's need for emergency care in the United StatesMethylphenidateAlong withEnergy drinkThere is (caffeineBecause it will be a large intake of.Deaths have also been reported)[25].

Attempts to commit suicide may result in overdose of prescription drugs.If you have a mental illness, you may repeat overdose[26].Self-harmIs essentially different from a suicide attempt in that it is less lethal,Self-harmPatients who do this often use multiple methods rather than repeating one method, and in these cases tend to ask a person for confession intervention immediately after overdose.[26].. In 2009UK National Institute of Medical TechnologyPractice guidelines (NICE) does not use the medication if there is a strong tendency suicide attempt or suicidal ideation, also in prospect one week at a relatively safe drug as used if abort if no effect Is recommended[27].. The 2008 Japanese guidelines also noted that there was no evidence to support the effectiveness of combination therapies such as antidepressants and antipsychotics for such patients, and that they were overdose, noting that they would prescribe multiple drugs of the same type. It is recommended to be aware of the dangers of taking medication[28].

in JapanMultidrug mass prescriptionIn some cases, prescription drugs that can be fatal in total are prescribed.[29][30]..Even after the guidelines, it is not uncommon for doctors to prescribe large doses to these patients.[31]..In addition, a vicious doctor intentionally prescribes a large amount of other drugs,Medical feeThere were also examples of earning such things, which became a problem.If the patient has never been to another psychiatrist, he or she will not be aware that he or she has been deceived and will subsequently suffer lifelong with strong side effects and sequelae.[32].

Induction of deadly behavior

A study in Japan revealed that many psychiatric attempted suicides were overdose shortly before, and their action on benzodiazepines reduced their judgment and impulsivity. It is speculated that such behavior may have been achieved due to increased sexuality.[33]..Alcohol, in particular, can impair judgment and lead to dangerous behaviors such as taking other drugs, resulting in serious overdose due to drug interactions.[34].

In Japan, 2010 out of 317 suicides (289%) were found at the 91 Diet session from the administrative dissection of the Tokyo Metropolitan Medical Inspectorate.Psychiatric medicineIt has been reported that it is a suicide after taking the drug, and that the action of taking the multidrug may cause suicide.[35].

Drugs and lethality

Opioid anesthetics such as heroin and morphine are at greatest risk of suppressing the respiratory center.Alcohol is comparable to them,Barbituric acidSleeping pills andBegetamine(Chlorpromazine-Promethazine-PhenobarbitalMixture) andPentobarbital(Hypnotic / sedative Labona) is also close in action and lethal dose.Also, drugs such as alcohol enhance the action of other drugs and can lead to serious events.For example, the combined use of alcohol and cocaine may be metabolized to cocaethylene, which is harmful to the heart.[37].

As a type of drug, instead of barbituric acid,BenzodiazepinesOften used,FlunitrazepamPowerful benzodiazepines such as (trade name Rohypnol, Cyrace) are still nearly lethal.In questionMultidrug mass prescriptionTherefore, it may have a serious effect without intentionally overdose.

For examplecaffeineThen, the difference between the action dose and the lethal dose is about 100 times, and in the case of such a drug, death due to overdose is unlikely to occur.But,Energy drink,[38]Occasionally reported deaths from overdose of caffeine tablets[39].

marijuana,LSD,PsilocybinHas a high safety factor as shown in the figure, and there are few serious cases or death reports.[3]..Legitimate drugs similar to other regulated drugs may be more likely to overdose than cannabis or existing hallucinogens[40].

Of anestheticPropofolIs the therapeutic index (LD50/ED50) Is 4.5 and its reciprocal (ED50/ LD50) Is 0.22, which is closer to the action dose and lethal dose than heroin.[41].

Diagnostic code

who(WHO)International statistical classification of diseases and related health problemsIn (ICD-10), T36-T50 isDrug addiction(Poisoning), which includes overdose due to misadministration and overdose.Also, intentional overdose may mean a suicide attempt,[1]It is controversial whether Poisoning in ICD means a suicide attempt, and it includes a considerable amount of unintended overdose.[42].

Corresponds to the mental disorderICD-10 Mental and behavioral disordersThen, F1x.0 isAcute poisoning(Acute intoxication) if it is a persistent problem that is causing significant harmHarmful use(Substance abuse), orAddiction syndromeThere is also the possibility of[43].

Symptoms and symptoms

In addition, regardless of the drug, by repeatedly overdose,liver,kidneyな ど内 臓There are also concerns about adverse effects, including functional deterioration of.

Also, if alcohol, sleeping pills, or psychiatric drugs are used in large doses, they are temporary.Memory disorderMay appear as a symptom.Specifically, I have no memory before and after taking a large amount of medication, temporarilydissociationSuch as presenting symptoms such as.Also, with anxiolytics and sleeping pillsParadoxical reactionIf this occurs, aggression may occur.These are temporary and will recover if the blood level of the drug drops.

Diagnosis and treatment

Toxidrome[46]
blood pressureHeart rateRespiratory ratebody temperaturepupilsweating
Anticholinergics~Rise~RiseDivergenceDeclineDecline
Cholinergic drug~~No changeNo changeShrinkRiseRise
OpioidDeclineDeclineDeclineDeclineShrinkDeclineDecline
Adrenaline agonistRiseRiseRiseRiseDivergenceRiseRise
SedativeDeclineDeclineDeclineDecline~DeclineDecline

Diagnosis and treatment of overdose is not difficult.If you are in a coma, diagnosis and treatment will be difficult.Sometimes the symptoms that the patient showsBlood testThe drug may be found in.If the drug is unknown, the most common procedure is taken.

In emergency hospitals, drug test kits such as Triage DOA are used, but even drugs that support detection are etizolam (trade name).Depas) Has a high detection threshold and cannot be detected unless a considerable amount is taken.

Antidotes exist for certain drugs.For exampleheroin,morphineSuch asOpioidSlowly to respond to the effects of withdrawalNaloxoneThe minimum effective amount of[47]

Within 1 hour of ingestionActivated carbonIs adsorbed by[48][49].Gastric lavage,Emetic,Oral bowel irrigation agentIs rare[49], Emetics and laxatives are not recommended, gastric lavage, oral bowel irrigation, and multiple activated charcoal are not recommended unless recommended by the National Toxicological Information Service[50].UK National Institute of Medical Technology(NICE) does not recommend the use of emetics in cases of self-harm[51].

Hypnotic sedative / alcohol overdose

ABC (Ensuring Airway and Circulation) for life support when respiratory rate and oxygen saturation are low[52].

If it is a hypnotic sedative(English: Benzodiazepine overdoseAndBarbituric acid overdoseSee also.BenzodiazepinesWith overdoseFlumazenilIs used as an antagonist[53]..Flumazenil is not recommended for patients with seizure-promoting drugs, including tricyclic antidepressants, a history of epilepsy, or benzodiazepine dependence[53].

If alcohol or sleeping pills are the cause, this in turn results from a sudden and complete withdrawal when they are chronically ingested in large amounts.WithdrawalSymptomsDelirium tremensIt should be noted that (DT) can be fatal.Delirium tremens becomes severe 2-3 days after withdrawal and peaks 4-5 days.

Overdose of stimulants

DiazepamTo sedate[52]..theseBenzodiazepinesShort term if not responding toAntipsychoticIs considered, but long-term administration should not be given[52].

Epidemiology

Number of deaths

In the United States, the number of investigations based on detailed causes of death files submitted by medical examiners and coroners is known.[4].. In 2010, there were 38,329 deaths in the United States due to drug overdose. 22,134 people (57.7%) are due to medicines.Of those 16,451 (74.3%) were unintentional deaths, and only 3,780 (17.1%) attempted suicide.Most of them are opioid analgesics (16,651), but benzodiazepines (6,497), antidepressants (3,889), antiepileptic / antiparkinson drugs (1,717), antipsychotics and neuroleptics (1,351), and psychiatric drugs. Drug deaths are also comparable to opioids in total.

Analysis of death certificates from all 1999 states in the United States from 2010 to 50 by stateMedical cannabisThe number of deaths from overdose of opioid analgesics in the state is declining with the legalization of[10]..Both analgesic action is the main action[10].

In the United Kingdom, there were a total of 2010 drug-related deaths in 2597, 307 for all benzodiazepines, and for analgesics.TramadolThere are reports of 132 people and 22 people due to legal drugs.[54]..The UK Drug Policy Commission reports that abused drug deaths in 2010heroin/morphine1,061 people (both opioids),Methadone503 people (opioids),cocaine180 people,amphetamine50, 9 ecstasy, 38 temazepam[55].

In Japan, the cause of death unknown in 2010 died in the XNUMX wards of TokyoAbnormal deathOf the 14,396 cases, there are 2938 people who have been judicial dissected.[7]..Multiple drugs were detected in the blood in 54% of the majority. In 2010, there were 841 (28%) for pharmaceuticals, 654 (22%) for ethanol (alcohol), 61 for carbon monoxide, 37 for hydrocyanic acid, and 31 for stimulants.The breakdown of the medicines is 306 hypnotics, 302 neuropsychiatric drugs, 79 antiepileptic drugs, and 25 antipyretic analgesic and anti-inflammatory drugs. From 2006 to 2010, 5 cases of MDMA, 6 case of morphine (opioid), and 1 case of cocaine were detected in "1 years".The purpose of this analysis is to contribute to the prevention of accidental death from poisoning, suicide, and abuse by analyzing trends in detected drugs.

Death from drug overdose in the United States (2014)[22]
heroinOpioid10,86323.1 %%
cocainePsychostimulant5,85612.4%
OxycodoneOpioid5,41711.5%
AlprazolamBenzodiazepines4,2179.0%
FentanylOpioid4,2008.9%
morphineOpioid4,0228.5%
MethamphetaminePsychostimulant3,7287.9%
MethadoneOpioid3,495%7.4
HydrocodoneOpioid3,2747.0%
DiazepamBenzodiazepines1,7293.7%

Emergency and special groups

In American infants, the use of emergency medicine due to drug overdose exceeds household items such as cleaning agents, and more than 7 people are transported by unintended overdose every year.[56]..The most common age group is 2 years old[56]..In the case of emergency transport of a child by taking medicine without supervisionOpioidIs 17.6%,BenzodiazepinesWas the most commonly involved drug type at 10.1%[57]..In addition, 12 kinds of medicines account for 45% of all hospitalizations.[57], It's a painkillerBuprenorphine,Oxycodone,HydrocodoneAnd of blood pressure improving drugsClonidine,Metoprolol,Amlodipine, Antidiabetic drugGlipizide,, of anxiolyticsClonazepam,Lorazepam, Smoking cessation drugBupropionMet[58].

In the United States, there were approximately 2007 emergency hospitalizations due to side effects of drugs in the elderly each year from 2009 to 10, with 65.7% hospitalizations due to unintentional overdose, resulting in 5 or more concomitant medications. Often leads to hospitalization[59]..Four drugs account for 67.0% of the causes, which are anticoagulantsWarfarin33.3%,Insulin13.9%, oral antiplatelet agents 13.3%, oral hypoglycemic agents 10.7%, and when expanded to 88.3% of the causes, there are five common drug categories: hematological agents, endocrine agents, cardiovascular operation. It was a drug, a drug for central nervous system, an anti-infectious disease drug[59].

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footnote

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  60. ^ GWAR Vocalist Dave Brockie's Cause of Death Ruled as Accidental Heroin Overdose

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