How to Overdose

[Twentybyte]

How to Overdose. A guide by Firefighter Randy

Why am I making this? Well mostly because I wanna see people do it more often, also because when I do see people do it. They have no idea how and default to going /me unconscious after chugging a lemonade full of methaphetamine, heroin, zyn and rat poison. Where's the fun in that? Its' not fun.

 

We're gonna break this in to three main portions since I know people hate reading. OPIOID OVERDOSES, a classic, easy to do, fun to do, and preferably done in bathrooms in rancid gas stations. THE STIMULANT OVERDOSE, a little spicer, this is gonna include your MDMA, methaphetamine, and uppers. If its an upper, it pretty much does the same thing. And finally MISCELLANEOUS. This one will be kinda short, psychedelics, various substances like paint or rat poison, stuff that'll really fuck up your high, and why people mix it into their shit.

 

Where am I getting my information? Well when you see a thing or two, you know a thing or two.

 

OPIOID OVERDOSES

Its a beautiful sunny day in Mission Row, the pigeons are chirping, the vagrants are throwing up on the sidewalk, you and your buddies just found a sweet deal on tranq, as you inject it into your veins, suddenly you realize that whoops, its big F, fentanyl. Thats OK, you switched to fentanyl years ago when the heroin got more expensive than copper wiring could afford. Except whoever cut this wasn't a fan of the metric system, instead of micrograms of the stuff, you got hit with 4 milli's of white powdery goodness melted into a syringable cofiguration. Suddenly you get that warm blanket-y feeling as the respiratory drive that controls your breathing decides to take a nap. You have overdosed.

 

An opioid overdose, whether its heroin, morphine, prescription oxycontin, oxycodone, percocets or the big bad scary fentanyl all do the same exact thing when you intake a toxic amount of the narcotic. It causes a respiratory drive shut-down. Essentially you go from guppy breathes, to a slow down of respiration, to a snoring respiration, to your breathing stopping. The lack of oxygen will kill you if it isn't reversed by a manual ventilator bag valve mask, where air is literally pushed into your lungs and breathing is manually done by a rescuer, or the effect is reversed by Naloxone (Narcan).

 

Now Narcan isn't magical. If you've taken so much of the substance, the more narcan you're gonna need to reverse it. Also, your brain may still be hypoxic, if you weren't breathing for one, two minutes, and some heroic cop slams five packs of nasal narcan into you. You're gonna wake up angry, confused, disoriented, and angry. You're gonna go out swinging, or at the very least, combative. This is why in the whacky world of prehospital medicine, we bag patients before we hit them with narcan, oxygen fixes the issue, narcan makes them breathe again.

 

Here's some other side effects with Narcan!

-It can make you vomit

-Causes significant sweating

-It can make you vomit a lot.

-If pushed too fast, it can make you vomit.

-Honestly if someone slams it through your nose, you're probably gonna vomit when you come back to.

 

Here's a tl;dr opioid overdoses make you stop breathing, you need oxygen. If narcan is pushed too fast, you'll vomit. If narcan is pushed and you haven't had oxygen given to you, expect to come out swinging. Narcan isn't magical, it can fail, sometimes it doesn't always work if you've taken a lot of it.

 

STIMULANTS

Stimulants include any narcotic that makes your sympathetic nervous system go WOW! This includes but is not limited to: Cocaine, crack, methaphetamine, PCP, ritalin, and MDMA.

 

I'm not going to into a terrible amount of detail here, a lot of these OD's have specific features that make them different. To give a good example, a methaphetamine overdose will cause significant body heat that will overtime cook your brain, while a cocaine overdose is more likely to overwork your heart into a Supraventricular tachycardic rhythm that will make your heart go 😮 before exploding. So we'll touch on a few of these and let you use google for the rest. All of these make your heart rate go fast, your blood pressure go HIGH and make your eyes do a lil dance as your pupils dilate, constrict, then dilate some more.

 

Coke/cocaine OD: Elevated heart rate, tremors, nausea, vomiting, paranoia, delirium, significant rise in body temperature.

How does it kill you? Eventually either your heart beats so fast or your body gets so hot you go into heatstroke or your heart goes into cardiac arrest.

PCP OD: Seizures, high blood pressure, psychosis, agitation, lack of coordination and in some cases, going into a catatonic state.

Methaphetamine overdose: Psychosis, seizures, extreme body temperature increase, agitation, altered mental state.

 

When you take too much of a stimulant, think extremes. You're going to be in a fighting mood, your heart is too hot, your body is too hot, everything is insanity. Reality isn't real. The only fix to this by EMS is sedation, intubation, and putting you into a paralyzed sedated coma. Your body needs to take a chill pill. Until then, its going all out. Go throw some bricks at cop cars. Listen to the voice in your head.

 

 

BENADRYL OVERDOSE

BENADRYL (Diphenhydramine) is a first-generation antihistamine with anticholinergic and sedative properties. What?

 

OK essentially its an allergy medication that also makes you sleepy. I could go on, but it's an over the counter, fairly safe medication we give all the time. Why am I including it into this list? Welllllll.

Do you like spiders? You’re gonna wanna like spiders for this.

 

Benadryl toxicity is a common overdose in the United states, with over 3.2% of overdose deaths including the medication, often accidental overdoses, used as self-harm or purposefully overdosed for its psychedelic properties. I’m gonna tell you why thats a horrible idea.

 

At a MILD toxic amount of the medication, often past 300 mg, it will causes what we call in the bidness, anticholinergic responses. Which include dry mouth, disorientation, tachycardia, urinary retention, hyperthermia and nausea.

 

At SEVERE amounts. It gets worse. This is a fuck ton of benadryl. It does not cause happy dreams. Your character may have severe delirium, seizures, psychosis, hypotension, dystonic reactions, hallucinations, and cardiac arrhythmias (Side note, if you wanna do this, just say you have QT prolongation and QRS prolongation after they put an EKG on you, we’ll know what that means. Mostly, if a Paramedic is there. An EMT will just cry. Side side note, if you ever wanna roleplay cardiac problems, just PM me, I’ll give you some fun ones to fuck with people)

 

“Wait Firefighter extraordinaire Randy, what the fuck is psychosis? Dystonic reactions? Psycho mantis?” Great question! So you know how I mention spiders?

 

Oftentimes a diphenhydramine (benadryl) overdose will cause severe hallucinations that border on madness. Lots of spiders crawling everywhere, shapes, shadow people, horrors beyond your imagination. Your character should be in full blown madness as the frequent seizures, objects in your vision, and the spiders drive you into full blown delirium. 

 

Beyond a severe amount of the drug, you’ll go into respiratory arrest (arrest means stop in the medical world) and die if interventions aren’t done to flush the drug out of your system. Your character will be in an intensive care unit to manage the myriad of symptoms that come with this drug OD. Its not fun.

 

A WORD ON EXCITED DELIRIUM

Also because someone asked. Lets’ talk about ED. Uh, excited delirium.

 

Remember in the stimulant sections I mentioned hyperthermia, increased agitation and other fun effects from specifically crack, cocaine and methamphetamine? Well in the field that combination is called ‘Excited Delirium’. This isn’t medically agreed upon, infact it's mostly made up by Tazer:™ and police departments using tasers to kill people. However it's not completely made up.

 

When cocaine, crack and methaphetamine are used in excess amounts, they put significant stress on the heart, causing cardio-toxicity, eventually arrhythmias (or basically heart no worky right-y) as well as severe hyperthermia that can literally cook the brain and heart. This overheating, exertion and stress causes extreme agitation and delirium, hence the term “excited” in delirium. These patients will be extremely combative with first responders and if not promptly sedated could potentially face death in the short-term. These patients are also really fucking dangerous. 

 

So to clarify. EXD is a unique medical issue characterized by the acute onset of agitation, aggression, distress, and possibly sudden death due to significant amounts of stimulant drug use. That isn’t totally agreed upon and isn’t completely real. But there are cases that prove otherwise. 

 

The improper use of restraints, electrical conduction devices such as tasers, struggling and the kneeling of airways is not excited delirium. Thats’ murder. 

 

Never keep your patients prone. That also kills people. 

 

Sorry for the tangent, this part of the guide isn’t as funny. If you want to roleplay excited delirium, just note a couple of things. Its mostly due to a toxic amount of stimulants in your body, often cocaine, crack or methamphetamine. You’ll be extremely hot, your heart may be in a dozen arrhythmias, you could have a heart attack, you could drop into a cardiac arrest, your character should be angry, agitated, violent, significantly stronger due to a rush of adrenaline. Just know this is really more of a cocaine/crack/meth overdose, not so much a medical condition that's real.

 

FINAL NOTES

I'm mostly keeping this section blank. If you have suggestions for specific narcotic overdoses. I'll put them here. Google is your friend. To put a final touch on this. I want to put a call to arms.

 

"Why would I roleplay an overdose?" Because its fun. It can be fun. Too long have I seen medical roleplay on this server be essentially some form of /me goes unconscious. Drugs are done for a reason, and overdoses can be such a chaotic, intense and scary type of roleplay you just never see. Make your character a frequent flyer, know the Emergency room like the back of your hand. Overdose daily, once, twice, three times. Trust me, its realistic. Go out and be a menace, do some drugs, and fuck your characters life up.

 

Just don't be boring.

 

If you have any questions so do I. I might have the answers.

Edited April 16, 2024 by Twentybyte

[Cartoonhead]

Bookmarked, see you on the streets.

[Ratlady]

Lmao, this was very well-written. Applaud you---twas a fun and informative read.

Edited January 23, 2024 by Ratlady

[Galaxy]

See ya'll on the streets when you're ODing!!

[Twentybyte]

DISCLAIMER. U CAN'T OVERDOSE ON FENTANYL BY TOUCHING IT, OR BREATHING IT IN, OR BATHING IN IT.

 

and to the cop who keeps dming me that, you know who you are. stop it. go narcan a diabetic.

[Ratlady]

20 minutes ago, Twentybyte said:

DISCLAIMER. U CAN'T OVERDOSE ON FENTANYL BY TOUCHING IT, OR BREATHING IT IN, OR BATHING IN IT.

 

and to the cop who keeps dming me that, you know who you are. stop it. go narcan a diabetic.

 

 

I mean, technically, you can overdose by snorting it, can't you? 😜 

 

I wouldn't know. I keep my vices at pot and alcohol, but I work in a homeless shelter as a site assistant IRL and there's a HUGE fentanyl problem in the homeless community around here, sadly. 

 

I actually did a perimeter check outside our building last night and found an empty bottle of methadone someone had littered. I immediately gloved-up and tossed it, lol and we have narcan on-site 'coz of users. :T 

 

Thankfully I've only had to use narcan on someone IC and not IRL. 

Edited January 23, 2024 by Ratlady

[young.]

This is awesome, great info on Narcan and the effects that it can have on people after they miraculously wake up! Thanks!

[Twentybyte]

2 hours ago, Ratlady said:

 

 

I mean, technically, you can overdose by snorting it, can't you? 😜 

 

I wouldn't know. I keep my vices at pot and alcohol, but I work in a homeless shelter as a site assistant IRL and there's a HUGE fentanyl problem in the homeless community around here, sadly. 

 

I actually did a perimeter check outside our building last night and found an empty bottle of methadone someone had littered. I immediately gloved-up and tossed it, lol and we have narcan on-site 'coz of users. :T 

 

Thankfully I've only had to use narcan on someone IC and not IRL. 

You can't touch fentanyl and OD on it. And even breathing in the fentanyl dust won't give you enough of the narcotic to metabolize and OD on it. Snorting does make you high, but it usually isn't enough to OD. Every OD I've ever been on has been either an ingested drug that was cut with fentanyl, or an injection. You can absorb SOME through your skin after touching it for hours. But otherwise your skin is the ultimate fentanyl defense layer.

 

https://doh.wa.gov/community-and-environment/opioids/fentanyl-exposure-public-places

 

its not anthrax

Edited January 23, 2024 by Twentybyte

[Ratlady]

10 hours ago, Twentybyte said:

You can't touch fentanyl and OD on it. And even breathing in the fentanyl dust won't give you enough of the narcotic to metabolize and OD on it. Snorting does make you high, but it usually isn't enough to OD. Every OD I've ever been on has been either an ingested drug that was cut with fentanyl, or an injection. You can absorb SOME through your skin after touching it for hours. But otherwise your skin is the ultimate fentanyl defense layer.

 

https://doh.wa.gov/community-and-environment/opioids/fentanyl-exposure-public-places

 

its not anthrax

Speaking of.. I'm at work right now and some dude all fentied out was running around shirtless, harassing our guests and the people at the gas station next door. 

 

He's getting arrested at gunpoint as we speak lol.

 

Play stupid games, win stupid prizes 😂

[Hass]

thanks sent this thread to my nan and now she cant move 👍