Drugs of abuse: management of intoxication and antidotes

  • Ivan D. Montoya
  • David J. McCann
Part of the Experientia Supplementum book series (EXS, volume 100)


Illicit drug intoxications are an increasing public health problem for which, in most cases, no antidotes are clinically available. The diagnosis and treatment of these intoxications requires a trained clinician with experience in recognizing the specific signs and symptoms of intoxications to individual drugs as well as polydrug intoxications, which are more the rule than the exception. To make the diagnosis, the clinical observation and a urine toxicology test are often enough. Evaluating the blood levels of drugs is frequently not practical because the tests can be expensive and results may be delayed and unavailable to guide the establishment of a, treatment plan. Other laboratory tests may be useful depending on the drug or drugs ingested and the presence of other medical complications. The treatment should be provided in a quiet, safe and reassuring environment. Vital signs should be closely monitored. Changes in blood pressure, respiratory frequency and temperature should be promptly treated, particularly respiratory depression (in cases of opiate intoxication) or hyperthermia (in cases of cocaine or amphetamine intoxication). Intravenous fluids should be administered as soon as possible. Other psychiatric and medical complication should receive appropriate symptomatic treatment. Research on immunotherapies, including vaccines, monoclonal and catalytic antibodies, seems to be a promising approach that may yield specific antidotes for drugs of abuse, helping to ameliorate the morbidity and mortality associated with illicit drug intoxications.


Catalytic Antibody Body Packer Heroin Overdose Anal Toxicol Toxicol Clin Toxicol 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Birkhäuser Verlag/Switzerland 2010

Authors and Affiliations

  • Ivan D. Montoya
    • 1
  • David J. McCann
    • 1
  1. 1.Division of Pharmacotherapies and Medical Consequences of Drug Abuse, National Institute on Drug Abuse (NIDA)National Institutes of Health (NIH)BethesdaUSA

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