DRUG ADDICITON 1

Drug Addiction and Overdose

Claire Eberhart

Missouri Southern State University

Ms. Christian

October 27, 2022

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Drug addiction is a condition described by the impulse or lack of control over repetitive

drug usage. This condition is a chronic disease that affects the brain, as continuous drug use can

chemically change the brain to make one crave a certain drug, no matter how destructive the

drug use becomes. This chemical change makes curing addiction very difficult, and treatment

can be a lifelong process for some (National Institutes of Health [NIH], 2018). Drug addiction is

often the effect of medicinal or recreational drug use that becomes abused beyond its original

intention. For example, opioids are commonly prescribed for pain relief following a procedure

or injury but can quickly lead to addiction if abused (Mayo Clinic, 2022). Alcohol is a drug that

is prevalent in many cultures, social situations, and even religious ceremonies. While many

people can consume alcohol in moderation without falling victim to addiction, alcoholism, more

formally known as alcohol use disorder, affects nearly 18 million Americans (U.S. National

Library of Medicine, n.d.). There are many other drugs that can lead to addiction, legal or

illegal, such as nicotine, marijuana, cocaine, MDMA, LSD, and more. Addiction progresses as

the user’s tolerance increases. The higher one’s tolerance becomes to a drug, the more their

body requires to achieve the same feeling that they felt using the drug for the first time (Mayo

Clinic, 2022).

Some people are also more susceptible to drug addiction than others. While in most

cases a person is responsible for their initial exposure to the drug, once addicted, it evolves into a

chronic disease that requires years of professional treatment to manage. The likelihood of

developing an addiction to a drug following exposure can be dependent on a person’s genes,

lifestyle, environment, and the age of exposure. Factors such as mental disorders, ethnicity,

socioeconomics, influence of friends and family, and quality of life can all play a role in how

vulnerable an individual is to drug abuse (NIH, 2018). Adolescents are also at risk for substance
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abuse, and exposure at such a young age can lead to issues with addiction into adulthood. The

good news is, substance abuse can be prevented with the help of positive parental influence,

pediatrician screenings, and drug abuse education in schools (Centers for Disease Control and

Prevention [CDC], 2020).

Overdose is a serious emergency that can occur when too much of a drug is taken at once

for the body to handle. While overdose can happen to anyone, it is a lot more prevalent amongst

those who have a history of drug abuse. This is because, as mentioned before, the more a person

uses a drug, the higher a tolerance they build to it, causing a continuous increase in dosage and

frequency. Eventually, the increase in dosage can escalate up to a fatal or near-fatal dose, known

as overdose. Overdose is a leading cause of death in the United States; however, nonfatal

overdoses are more prevalent than fatal ones (CDC, 2022).

While drug addiction can look different for everyone depending on their biology,

environment, and the substance they are using, there are some hallmark signs of

addiction. These include, but are not limited to, the frequent urge to use the drug, spending

copious amounts of money to acquire the drug, social isolation, decreased interest in things that

were once enjoyable, and facing withdrawal when attempting to quit using the drug (Mayo

Clinic, 2022). Another symptom of drug addiction is often the need to take higher doses of the

drug and an increase in frequency of usage; this is also known as binge drinking when referring

to alcohol abuse disorder. Substance abuse can also cause an increase of reckless behavior, such

as driving under the influence, having unprotected sex, or putting oneself in any other dangerous

situation in order to acquire the drug; these risky behaviors can also be a result of impaired

thinking from using the drug (U.S. National Library of Medicine, n.d.).
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Overdose symptoms look much different than the symptoms of addiction. This is

because the body has received a toxic dose of a drug and turns to other means besides

metabolization to rid itself of the drug. Some signs of overdose include increase or decrease of

vitals, cold and clammy skin, shortness of breath, and vomiting. The patient may experience

symptoms such as confusion or drowsiness, abdominal pain, or even enter a coma (Casarella,

2022).

The idea that drug addiction or substance abuse can be completely cured is still a topic

that is up for debate. This is because it is hard to gauge how “fixed” an individual’s addiction

really is. Additionally, in almost every circumstance, “staying clean” or length of time “clean” is

considered the measurement of recovery from substance abuse. This means that a person will

not be able to go back to using the substance in moderation, even if it is a legal drug such as

alcohol. Avoidance of a previously addicted drug is something that a recovering addict will most

likely have to manage for the rest of their life. This can be achieved by a combination of

treatments, including a change in one’s home environment, modifications to their medical

treatment, and attending rehabilitation therapy (NIH, 2018).

Knowing a patient’s substance use history is vital information in order to be able to

provide that patient with safe and effective dental care. This is because substance abuse has

many oral manifestations to be aware of and can impact the patient’s plan of care. Many

substances, an example being alcohol, can increase a patient’s risk of oral cancers and

periodontal disease. Other drugs may have more hallmark oral symptoms, such as perforations

in the nasal septum and hard palate as the result of snorting cocaine. These manifestations are

not only something that a hygienist may need to work around but be on the lookout for when

performing extra- and intra-oral exams (Cuberos et al., 2020). Another modification that might
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need to be made for a patient who struggles with substance abuse is the avoidance of certain

drugs in the dental office. Anesthetics that contain epinephrine are to be avoided on patients

with a history of cocaine, ecstasy, methamphetamines, and marijuana use. Patients with a history

of opioid abuse should not be prescribed opioids following a dental procedure. Patients with a

history of alcohol abuse may need to be evaluated for their ability to control bleeding (Cuberos et

al., 2020). Other modifications such as social aspects and patient education can also be made to

help their appointments run smoother.

Patients who suffer from substance abuse, or have in the past, are at higher risk for

overdose in the dental office; dental anxiety can increase this risk even more. A patient worried

about their appointment that day may rely on drugs to ease their anxieties. When an additional

stressor is in the equation, such as dental anxiety, this may lead to a patient taking a higher dose

than they normally would. Opioids are responsible for a majority of fatal drug overdoses in the

United States; the dental office is not an exception to where opioid overdose can occur (Davis,

n.d.). Assuming a patient took opioids just before their dental appointment, it could be possible

for the signs and symptoms of their overdose to not be present until they are in the dental chair.

In the event that a patient was to overdose on opioids in the MSSU Dental Hygiene

Clinic, this would be the dental team emergency plan. After identifying the signs and symptoms

of overdose in my patient, I (rescuer one) would get the attention of the student clinician (rescuer

two) in the cubicle nearest to me. Without alarming the patient, I would instruct rescuer two to

retrieve the supervising dentist, the assigned instructor, and the central sterilization assistant

(rescuer three). Assuming that, at this point, the patient has fallen unconscious and no pulse is

detected, I would begin CPR until rescuer two returns with the supervising dentist, assigned

instructor, and rescuer three. Rescuer two would help with CPR and watch the clock, along with
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assisting me in monitoring vitals. Rescuer three would bring the emergency kit and portable

oxygen to the cubicle. Simultaneously, the instructor would contact the Dental Hygiene

Department Chair, and, together, they would then determine if the AED, Naloxone (also known

as Narcan), and contacting EMS is necessary. With the patient still unconscious, but a returned

shallow pulse, I would stop performing CPR and check the patient’s respiration. If they are still

experiencing shallow breathing, I would get permission from the instructor and Department

Chair to administer Naloxone if on hand. Rescuer three would find the nearest telephone and

call 911 to report the emergency and explain that an ambulance is needed immediately; they

would also need to contact campus security by dialing 2222 (626-2222 if on a cell

phone). Rescuer three would need to give the operator the location of the emergency, which is

the W. Robert Corley Dental Hygiene Clinic; MSSU Health Science Building, 3950 East

Newman Road; (north entrance of Health Science Building). The student at the front desk would

need to monitor the front entrance and guide the EMTs to the emergency once they have

arrived. I would continue to monitor and document the patient’s vitals until EMS is on the scene

and prepare the incident report form. All other student clinicians and faculty would need to be

ready to assist with basic life support and remain calm.

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Bibliography

Casarella, J. (2022, September 8). Drug overdose. WebMD. https://www.webmd.com/mental

health/addiction/drug-overdose

Centers for Disease Control and Prevention. (2020, February 10). Teen Substance Use & Risks.

Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/fasd/features/

teen-substance-use.html

Centers for Disease Control and Prevention. (2022, February 14). Understanding

drug overdose and deaths. Centers for Disease Control and Prevention. https://www.

cdc.gov/drugoverdose/epidemic/index.html

Cuberos, M., Chatah, E. M., Baquerizo, H. Z., & Weinstein, G. (2020, June 15). Dental

management of patients with substance use disorder. Clinical Dentistry Reviewed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7294521/

Davis, C. (n.d.). Naloxone Prescription Mandates. The Network for Public Health. https://www.

networkforphl.org/wp-content/uploads/2020/10/Fact-Sheet-Naloxone-Prescription-

Mandates.pdf

Mayo Foundation for Medical Education and Research. (2022, October 4). Drug addiction

(substance use disorder). Mayo Clinic. https://www.mayoclinic.org/diseases-

conditions/drug-addiction/symptoms-causes/syc-20365112

U.S. Department of Health and Human Services. (2018, June). Understanding drug use and

addiction drug facts. National Institutes of Health. https://nida.nih.gov/publications/

drugfacts/understanding-drug-use-addiction

U.S. National Library of Medicine. (n.d.). Alcohol use disorder (AUD). MedlinePlus.

https://medlineplus.gov/alcoholusedisorderaud.html