Poisoning and illicit drug overdose: A new epidemic in federal capital

Only acid and alkali ingestion killed 76 people in a year

Islamabad: Well over 3,400 patients have been presented with various types of poisoning and drugs toxicity in private and public sector hospitals of the federal capital from June 2016 to May 2017 and it is shocking that over 70 per cent of the patients reported took the poison as an attempt for suicide.

Recently a study was carried out done by Association of Critical Care Medicine in major hospitals in both private and public sectors involving Pakistan Institute of Medical Sciences, Polyclinic hospital and major private hospitals of the federal capital.

Data collected by ‘The News’ has revealed that a total of 3,426 patients were reported at the hospitals in the federal capital after taking toxic substances from June 2016 to middle of May this year.

Of these, as many as 1,047 reached hospitals after intake of Benzodiazepines, 712 after taking Organophosphorus, 592 after overdose of narcotics, 484 after acid ingestion and 277 cases of overdose of alcohol along with 89 cases of suicide attempts after taking wheat pills. Another 87 cases were reported at the hospitals after taking overdose of antidepressants and 63 cases with overdose of Crystal methamphetamine and cocaine.

It was found that in last one year, well over 3,400 cases with poisoning were reported at the hospitals in Islamabad of which nearly 70 per cent cases were of suicide attempts while 30 per cent were found to be victims of accidental overdose of toxic substance or drug overdose, said ICU Medical Specialist at PIMS Dr. Muhammad Haroon while sharing some of the features of study conducted with ‘The News’.

He said Benzodiazepines, sleeping pills were the most commonly abused drugs for suicide attempts, however, the mortality was negligible due the fact that benzodiazepines are a lot safe than previously marketed barbiturates that killed a lot of victims in the past.

The antidote of benzodiazepines that is flumazenil was not available in any public sector hospital of the twin cities of Islamabad and Rawalpindi and all the patients had to purchase it from private hospitals or medical stores, he said.

He added that after Benzodiazepines, the most commonly used poison for suicidal attempts was organophosphorus poisons and carbamates. These substances are available in almost all kinds of insecticides, rodenticides, anti-mosquito sprays and a number of household chemicals, he said.

Dr. Haroon said most of the patients after intake of like substances are presented with diarrhoea, vomiting, sweating, salivating, urination and pinpoint pupils. If not treated in time, shock, kidney injury, multi-organ failure ensues. Unfortunately, its antidote Pralidoxime is also not available in public sector hospitals in the region, he said.

He said narcotics include both synthetic chemicals like nalbuphine, codeine etc and crude form heroin/Harry. Naloxone, the antidote is available in majority of hospitals and if given in time, it may reverse the course of disease immediately. Majority of people were habitual prescription medicine users and had accidental overdose, he said.

He added the cases of ingestion of concentrated acids and alkali infections were also significant in number and mortality and morbidity was highest in this group of patients, mostly with suicide attempts. Patients in this group had severe burns of face, mouth, food pipe, windpipe, and even perforation of viscera like stomach, said Dr. Haroon.

He said as many as 76 patients in this group died even after receiving treatment. Those who survived were also left with multiple complications, he said.He added that cases of alcohol overdose were also common and majority of patients recovered without critical events. “However, those having acute pancreatitis, bloody vomiting, delirium and encephalopathy had poor prognosis.”

The cases of intake of Wheat pill or Aluminium phosphide poisoning were also fatal in majority of cases though patients who got ventilator and pacemaker in time survived well, said Dr. Haroon.

He said the poisonings and drug overdose killed more patients in 2016-2017 as compared to the number of deaths caused by dengue fever.He added the Association of Critical Care Medicine has launched an awareness campaign to refrain individuals from suicidal attempts and majority of the audience were young people who are depressed and frustrated. Poisonings can be termed as a new epidemic all over the world and probably the biggest challenge for humanity, said Dr. Haroon.