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Information and Documents
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Poison Control Newsletter - Winter 2011 - Vol 2 Issue 4
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Synthetic Drugs – Dangerous and Deadly
One type is marketed as “synthetic marijuana.” The other is advertised as “fake cocaine” or “fake meth.” Both are marketed as legal equivalents to illegal drugs. But both cause alarming side effects that are generating a slew of calls to poison centers and spurring concern among doctors across the U.S.
America’s 57 poison centers first received calls about “synthetic marijuana” in late 2009. During 2010, they received 2,915 calls about these new products. And from January 1 to September 30 this year, they’ve received 5,083 calls. The synthetic marijuana products sell for between $30 and $40 per 3-gram bag, in packages labeled as incense or potpourri and marketed under brand names like “Spice,” “K2,” “Genie,” “Yucatan Fire,” “Sence,” “Smoke,” “Skunk” and “Zohai.”
In December 2010, the U.S. Drug Enforcement Agency – concerned about
reports of people experiencing vomiting,
hallucinations, racing heartbeat and elevated blood pressure – moved to make the substances illegal. More than a dozen states had already taken this action.
Late last year, poison centers began to receive calls about products marketed as “bath salts” sold both on the Internet as well as in gas stations and head shops. Packaging is usually a plastic bag filled with a white granular powder. The products are known as “Red Dove,” “Blue Silk,” “Zoom,” “Bloom,” “Cloud 9,” “Ocean Snow,” “Lunar Wave,” “Vanilla Sky,” “Ivory Wave,” “White Lightning,” “Scarface” and “Hurricane Charlie.” They produce increased heart rate, increased blood pressure, agitation, hallucinations, extreme paranoia and delusions. Poison centers took 303 calls about the products in 2010; between January 1 and Sept. 30, 2011, the number of calls had jumped to 5,226.
Many states have responded to the rising use of bath salts by passing laws to make them illegal, and in September 2011, the U.S. Drug Enforcement Administration issued a ban of the chemicals used to make these dangerous drugs.
The Kentucky Regional Poison Control Center wants you to be aware of the dangers of these products. Here are a few tips on what they are and the dangers surrounding them:
• Parents of teens should be on the lookout for such products in their children’s bedrooms and backpacks. Be particularly skeptical of products labeled “incense” or “bath salts.”
• Be aware of the signs and symptoms of drug use in loved ones: paranoia, changes in personality, agitation and anxiety are among the symptoms reported by users of these substances.
• Talk with family members about the dangers of these products. Don’t be fooled by the ready availability and legal status of new “designer drugs.” These products are not a “safe” or harmless alternative to other illicit drugs of abuse. Many can cause hallucinations and agitation that poison center experts say represent the opposite of a “mellow high.” In the case of bath salts, for example, poison center officials report instances of severe paranoia that has caused users to harm themselves and others.
• Keep the Kentucky Regional Poison Control’s number near your phone: 1-800-222-1222. Remember: You can call to ask about these substances even if you have not been exposed to them. The Kentucky Regional Poison Control Center is open 24 hours a day, seven days a week, and takes both emergency and nonemergency calls.
Seniors Are at Risk for Poisonings Too!
While many senior adults are not sure why they should be concerned about poison centers and poison prevention, the average amount of medicine – prescription, over-the-counter, vitamin and herbal – consumed by seniors continues to increase. At the same time, calls to America’s 57 poison centers about seniors also have steadily increased for the past few years, and many of these calls concern medicines.
These tips from the Kentucky Regional Poison Control Center can help keep senior adults poison-safe:
• Keep an up-to-date list of all medicines a person takes. These include prescriptions, over-the-counter products, vitamins and herbals.
• Share the list with all doctors and pharmacists to check for drug interactions. Surprisingly, even herbal supplements can interact with a prescription drug. Be sure to always check with a doctor before adding vitamins or herbal supplements to daily prescription medicines.
• If possible, use the same pharmacy to fill all prescriptions. This also helps with avoiding negative drug interactions.
• Keep all medicines in their original containers to avoid confusion with types of medicine and dosage. This is especially important when acetaminophen is an ingredient because taking too much can cause liver damage. Many pain relievers and sleeping products include acetaminophen and labels may not be clear as to what they contain.
• Always read the label prior to taking any medicine, and never try to take it in the dark or without glasses to avoid mistaking medicines or taking an overdose.
• Follow all medicine dosage instructions to avoid taking too much.
• Develop a system for medicine tracking to help show when it has been taken, such as a check-off list or medicine journal. This helps to ensure the medicine has been taken also helps prevent extra doses from being taken accidentally.
• Dispose of all medicines that are no longer needed, such as expired medicines and prescriptions that have been discontinued. This helps to prevent senior adults from taking the wrong medicine or drugs interacting with each other. Many communities have collection events or drop boxes for safe disposal of medicines, so ask your local pharmacist for suggestions.
• Never take someone else’s medicine. Even if it could be beneficial, it might interact with a person’s other medicines. Plus, taking other people’s prescriptions is illegal!
• Be very cautious when considering ordering medicines over the Internet. It is often impossible to tell if they are coming from another country, and the ingredients may not be what are claimed. This especially applies to supplements that make claims for “miracle cures.” Ask family members or a pharmacist to investigate the site before sending money or taking products obtained online.
• Keep the Kentucky Regional Poison Control Center’s toll-free number available for poison information and emergencies. If a poisoning is suspected, call 1-800-222-1222.
Cooking for Large Groups Is No Easy Task
Poison Prevention Tips for Holiday Cooking
The holiday season has finally arrived. Oftentimes, the best part about the holidays is spending time with family … and eating of course! However, even for an experienced chef, cooking a feast for a large group can be quite daunting.
The average home chef might consider cooking for two, three or even six people a manageable or even easy task. But during the holidays – when your guest list can reach 15, 16 or even 20 people – it is important that your guests leave with full bellies and not food poisoning.
According to the American Association of Poison Control Centers, food poisoning is generally a mild illness that most commonly results from poor food handling practices. Food poisoning usually occurs two to six hours after eating the contaminated food and can include nausea, fever, vomiting, stomach cramps and diarrhea. Depending on the exact type of food poisoning, how your body reacts to the toxin and the amount of contaminated food that was eaten, symptoms may last from several hours to two or three days. Food poisoning can be serious for people in poor health, for the very young and the elderly.
Practicing basic food safety preparation and storage is the best way to protect against food poisoning. Experts at the Kentucky Regional Poison Control Center offer the following recommendations to prevent food poisonings:
• Wash hands with soap and warm running water for at least 15 to 20 seconds before preparing any foods and especially after handling raw meat, poultry, fish or eggs.
• Keep preparation and storage areas clean; this includes countertops, stovetops and refrigerators.
• Wash utensils between each use. Never reuse utensils; this is a source of contamination.
• Do not defrost meat or poultry on the counter at room temperature. Thaw it in the refrigerator or microwave instead.
• Use a meat thermometer to confirm that meat, pork and poultry are properly cooked; visit www.foodsafety.gov for proper temperatures.
• Do not prepare food if you are sick or have any type of nose or eye infection.
• Store raw food below cooked food in the refrigerator so raw food cannot drip into cooked food and contaminate it.
• Use separate cutting boards for meats, poultry and fish.
And to ensure that the leftovers will be just as good the next day, properly seal and store leftovers in the refrigerator as soon as possible. Leaving perishable foods, including meats and dairy products, out longer than two hours significantly increases the risk of food poisoning. Throw food away if you are unsure how long it has been sitting out.
Be sure to keep these tips in mind as you cook and entertain family and friends this holiday season. And if you have questions about food poisoning or any other poison exposure, call the Kentucky Regional Poison Control Center at 1-800-222-1222.
Stay Away From Study Drugs
College can be difficult. Peer pressure, tuition, professors, term papers, campus activities and the desire for academic excellence can make life for a college student quite overwhelming at times. And although the college experience can bring about growth, sometimes the pursuit of excellence can harm their health if students add “study drugs” to the mix.
With final exams just around the corner, the American Association of Poison Control Centers encourages parents to talk to their children about the dangers of popular study drugs and the symptoms they may cause.
Study drugs are drugs that are abused as study aids. Students often believe that study drugs enhance or focus concentration and increase stamina when they cram for tests or write lengthy papers.
The use of study drugs is not new. For years, college students have looked for ways to make studying easier, more efficient and more manageable. The drugs of choice are stimulants (uppers) and include:
• Caffeine: Historically, this has been limited to drinking multiple cups of coffee or tea to help students through all-nighters. The dose is increased considerably, however, by taking caffeine pills or consuming multiple energy drinks. Caffeine pills can contain up to 200 mg. of caffeine in each pill, two to three times the amount in a cup of coffee. Energy drinks also contain a large amount of caffeine, and some contain additional stimulants.
• Prescription medicines: Some students use ADHD medicine as a study drug. These medicines contain the stimulants dextroamphetamine or methylphenidate. For some people with undiagnosed or preexisting mental health issues, these prescription drugs can make their conditions worse. Chronic use also can lead to addiction. It’s important for parents to remind their children to take their ADHD medicine correctly and never to take someone else’s prescription drugs.
According to the medical experts, the following symptoms may indicate someone is abusing study drugs. Call the Kentucky Regional Poison Control Center at 1-800-222-1222 if someone experiences:
• Anxiety, nervousness, jitters or agitation
• Tremors
• Increased heart rate
• Elevated blood pressure
• Insomnia
• Loss of appetite
• Upset stomach with nausea and vomiting
If you have questions about study drugs or any other poison exposure, call the Kentucky Regional Poison Control Center at 1-800-222-1222.
This newsletter is brought to you by the Kentucky Regional Poison Control Center and was produced with assistance from the American Association of Poison Control Centers and local poison centers across the country.
When you dial 1-800-222-1222, your call is answered by a medical professional with special training in poison management. Help is fast, free, confidential and available 24 hours a day, every day.
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This message is confidential, intended only for the named recipient(s) and may contain information that is privileged or exempt from disclosure under applicable law. Any patient health information must be delivered immediately to intended recipient(s). If you are not the intended recipient(s), you are notified that the dissemination, distribution or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at either the e-mail address or telephone number above and discard this e-mail. Thank you.
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Is Inequality Making Us Sick?
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A seven-part documentary series exploring racial and socioeconomic inequalities in health...MORE
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Vitamin D Deficiency Worsens Breast Cancer?
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Inadequate Levels of Vitamin D Linked to Sharply Increased Odds of Cancer Spread, Death
By Charlene Laino
WebMD Health News
Reviewed by Louise Chang, MD
May 16, 2008 -- Vitamin D deficiency is common among women diagnosed with breast cancer, and it may raise the risk of cancer spread and death, researchers report.
In a new study, women with vitamin D deficiency at the time of breast cancer diagnosis were 94% more likely to experience cancer spread and 73% more likely to die over the next 10 years, compared to women with adequate vitamin D levels.
More than 1 in 3 women studied had a vitamin D deficiency.
The study is the first to suggest a link between vitamin D deficiency and breast cancer progression, but it doesn't prove cause and effect. And it's too soon to recommend that all women with breast cancer start taking supplements to improve their outlook, says study head Pamela Goodwin, MD, professor of medicine at the University of Toronto.
But "women with breast cancer may want to get their vitamin D levels checked in a blood test and get them into the healthy optimal range," she tells WebMD.
The findings are scheduled to be reported at the annual meeting of the American Society of Clinical Oncology in Chicago.
Vitamin D Puts Brakes on Breast Cancer
Vitamin D is found in some foods, especially milk and fortified cereals, and is made by the body after exposure to sunlight. It is necessary for bone health, and some studies suggest that it may protect women from developing breast cancer in the first place.
From a biological point of view, it makes sense that vitamin D would put the brakes on breast cancer development and spread, Goodwin says.
"Breast cancer cells have vitamin D receptors, and when these receptors are activated by vitamin D, it triggers a series of molecular changes that can slow down cell growth, cause cells to die, and make the cancer less aggressive," she says.
For the new study, Goodwin and colleagues measured vitamin D levels in the blood of 512 women diagnosed with breast cancer in Toronto between 1989 and 1995. They were followed for a median of 12 years.
Only 24% had adequate levels of vitamin D when they were diagnosed with cancer. A total of 37.5% were deficient in vitamin D. The other 38.5% had insufficient levels of vitamin D.
Of note, Goodwin says, is that women with vitamin D deficiency were more likely to have aggressive cancers than those with sufficient levels.
Vitamin D Deficiency Linked to Poor Breast Cancer Prognosis
After 10 years, 83% of women with adequate levels were alive without signs of cancer spread (metastasis) vs. only 69% of women with vitamin D deficiency. Most of the deaths were from breast cancer.
For women with insufficient levels of vitamin D, there was a slightly increased risk of cancer spread compared to women with sufficient levels, but the difference was so small it could have been due to chance. "And their risk of death was the same," Goodwin says. "So the majority of the [negative] effect is in women with a deficiency."
But there was a point above which there seemed to be too much of a good thing, Goodwin says. If vitamin D blood levels were too high, the risk of dying appeared to rise, although the number of women with very high levels was so small that the finding could be due to chance.
"Our concern is that women may think, if some is good, more must be better, and increase vitamin D intake beyond what's optimal," she says.
So just what is optimal? A reading of 80 to 120 nanomoles per liter, according to Goodwin. That range has also been shown to be optimal for bone and heart health, she says.
Vitamin D Testing
If you don't know your vitamin D level, you're not alone: Doctors don't routinely order it as part of the blood tests taken for an annual physical, Goodwin says.
Julie Gralow, MD, chairwoman of ASCO's Cancer Communications Committee and associate professor of medicine at the University of Washington in Seattle, suggests that women with breast cancer take the initiative and ask about having their vitamin D levels measured.
"We now have a reliable test, and we know to safely correct deficiencies," she tells WebMD.
Goodwin says there is evidence to suggest that for women with a deficiency, taking 800 international units (IU) of vitamin D a day can raise levels to the optimal range.
For healthy people without a deficiency, current recommendations call for people between ages 0-50 to get 200 IU of vitamin D daily, with 400 IU recommended for those between the ages of 51 and 70. After age 70, 600 IU of vitamin D are recommended each day.
Goodwin and colleagues are now trying to confirm the findings in a second, similar study; results are due by the end of the year. If confirmed, the next step will be a study to determine whether giving supplements actually lowers the risk of recurrence and death in women with breast cancer.
The research was funded by the Breast Cancer Research Foundation.
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