Biochemical, Social and Psychiatric Aspects of Drug Overdoses

Abstract

In Part A investigations have been made into the problem of
deliberate drug overdoses, with the intention of setting up a
permanent data base for collection of clinical and social information
about patients admitted to the West Midlands Regional
Poisoning Treatment Centre after drug overdose incidents. This
involved the development and use of a computer-coded questionnaire
sheet.

An analysis of the information collected over 40 months was
carried out and confirmed many of the findings of similar reports
from other geographical locations.
The study probed deeper into the social aspects of the drug over~
dose problem than is usual and the clinical data was collected ina
more purposeful fashion and involved more detailed description of
symptoms and their associated drug levels in body fluids than previous
studies.

The study also reinforced the intentional nature of adult drug
overdoses and suggested that the behaviour seen might itself be interpreted
as a "coping strategy" to enable patients to deal with stressful
situations rather than as a "cry for help" as is the view held at
present by most workers in the field.

It was evident that a high proportion of drug overdose patients
took salicylate analgesics and that this proportion tended to be
younger and to have bought the drug in large quantity containers.
In Part B the metabolism and kinetics of salicylate were investigated
in normal human volunteers and in overdosed patients. This
involved the development of an improved colourimetric method for
estimating salicylic acid in body fluids. The study yielded further
evidence of the rate limitation of some of the pathways of salicylate
metabolism.

Lowering of brain glucose associated with salicylate overdose was
observed for the first time in humans, confirming the interference of
salicylate with carbohydrate metabolism in the central nervous system
previously reported in animals.

The study revealed that the ratio of salicylate in the cerebrospinal
fluid to that in plasma did not reach the high levels previously reported
in infants and this confirmed the difference in metabolic disturbances
reported in different age ranges of salicylate overdose patients.

Date of Award	1980
Original language	English