General reference
IV injection and smoking: Immediate onset, peak effect after about 3 to 5 minutes, and duration of about 15 to 20 minutes
Intranasal use: Onset after about 3 to 5 minutes, peak effect at 20 to 30 minutes, and duration of about 45 to 90 minutes
Oral use: Onset after about 10 minutes, peak effect at about 60 minutes, and duration of about 90 minutes
Pregnancy
can adversely affect the fetus; the rate of placental abruption and spontaneous abortion is higher.
Symptoms and Signs of Intoxication
Acute effects
Toxicity or overdose
Binges, often over several days, lead to an exhaustion syndrome or "washed out" syndrome, involving intense fatigue and need for sleep.
People who smoke the drug may develop pneumothorax or pneumomediastinum
Chronic effects
Withdrawal
Usually a clinical diagnosis
IV benzodiazepines
Avoidance of beta-blockers
Cooling for hyperthermia as needed
Toxicity or overdose
Body stuffers and body packers may need gastrointestinal decontamination or even surgical removal.
rhabdomyolysis, hyperthermia, and resultant acidosis or multisystem dysfunction.
Hyperthermia can be life threatening and should be managed aggressively with sedation plus evaporative cooling, ice packs, and maintenance of intravascular volume and urine flow with IV normal saline solution.
Phenothiazines are not used for sedation because they lower seizure threshold, and their anticholinergic effects can interfere with cooling.
Abuse
More Information
The following English-language resources may be useful. Please note that THE MANUAL is not responsible for the content of these resources.
Findtreatment.gov: Listing of licensed US providers of treatment for substance use disorders
