Rave concerts are one of the places people might be tempted to take illicit drugs for an extra high, but the euphoric effects come with the danger of overdosing and all its serious consequences. — Filepic (for illustration purposes only)
A drug overdose occurs when an individual takes too much of a drug, whether it be prescription medications, over-the-counter medications or illicit drugs.
This typically leads to a toxic level of the drug in their body that is more than their organs can safely process.
This can overwhelm the bodily systems, leading to harmful effects, and in some cases, even death.
A drug overdose can be intentional or accidental.
It may involve a single type of drug, a combination of drugs (polydrug), or a combination of substances, such as drugs and alcohol.
Various drugs have been associated with overdose-related deaths.
In this article, we are focusing on methamphetamine and ecstasy, which are commonly abused in Malaysia.
Methamphetamine
Methamphetamine, a type of psychostimulant, is highly addictive.
It is usually found in crystalline or tablet forms.
Also known in short as meth or syabu in Malay, this drug produces an euphoric effect by rapidly increasing the level of dopamine in the brain regions associated with pleasure and reward.
Dopamine is a neurochemical associated with pleasurable sensation.
Methamphetamine intake is usually accompanied by a sudden surge of euphoria, positive mood and increased alertness, among other effects.
A higher dose of methamphetamine can result in hypertension (high blood pressure), violent behaviour, rapid or confused speech, rapid pulse, paranoia, sweating, physical restlessness and nervousness.
A non-fatal methamphetamine overdose is associated with hypertension, altered mental state and tachycardia (increased heart rate).
Methamphetamine overdose-related deaths are due to:
- Multiple organ congestion: The build-up of fluid in multiple organs, which can also happen in conditions such as severe heart failure
- Cerebrovascular haemorrhage: Where blood vessels in the brain rupture and bleed due to increased blood pressure causing a type of stroke
- Pulmonary oedema: The accumulation of fluid in the lungs, severely impairing breathing and oxygen exchange
- Ventricular fibrillation: A life-threatening heart rhythm-associated disorder where the ventricles of the heart quiver due to disrupted cardiac electrical activity
- Hyperpyrexia: Extremely high body temperature that can damage vital body organs and cause death, and
- Acute cardiac failure: Sudden and severe impairment of the heart’s ability to pump blood effectively.
In some cases, drug-induced hyperthermia (excessive body heat) can trigger rhabdomyolysis, a condition where muscle tissue breaks down and releases harmful substances into the bloodstream.
These substances can damage the kidneys and lead to kidney failure.
Ecstasy
Ecstasy, or 4-Methylenedioxymethamphetamine (MDMA), is a type of recreational drug that is often taken illegally in social settings such as nightclubs, raves, parties, festivals and concerts.
MDMA can act both as a hallucinogen and stimulant, hence producing euphoria, an energising effect, altered sensory perception, and distortions in time and perception.
MDMA intoxication usually comes with prominent symptoms such as muscle rigidity (increased muscle tone and stiffness), mydriasis (dilated pupils), hyperthermia, tachycardia, hypertension, diaphoresis (excessive sweating), tremors, anorexia, agitation and anxiety.
These are all due to excessive stimulation of the sympathetic nervous system (i.e. the body’s alert system).
Of these, hyperthermia is the most life-threatening.
In MDMA-induced hyperthermia, the drug floods our brain with chemicals like serotonin and dopamine.
When MDMA increases serotonin levels, it can essentially “turn up the heat” in our body.
This temperature increase triggers our body’s “fight-or-flight” response.
Our heart beats faster, muscles become tense, and we might start moving around more.
These changes increase our body’s metabolism, hence generating extra heat.
Increased muscle activity also produces heat, further contributing to the rise in body temperature.
The intense muscle contractions can cause rhabdomyolysis and its potential consequence of kidney failure.
This intense activity also leads to the production of acidic byproducts, which can further damage cells and disrupt bodily functions.
Collectively, MDMA-induced hyperthermia can damage brain cells, leading to confusion, seizures, coma, and even death.
Brain swelling can also occur due to increased fluid pressure within the brain.
High temperatures increase the demand on the heart, which can lead to rapid heart rate, irregular heartbeat, and potentially heart failure.
Extreme heat can damage blood vessels, increasing the risk of bleeding or blood clots, a condition known as disseminated intravascular coagulation (DIC).
Additionally, hyperthermia can contribute to acute respiratory distress syndrome (ARDS), where fluid accumulates in the lungs, making breathing difficult.
Given the significant dangers, we urge the public to understand that recreational drug use is not without severe risks and to abstain from using these substances entirely.
Associate Professor Dr Jayakumar Murthy is an addiction neuroscientist, Assoc Prof Dr Isa Naina Mohamed is a clinical pharmacologist and Dr Rashidi Mohamed Pakri Mohamed is a family medicine specialist at Universiti Kebangsaan Malaysia. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
