New Haven’s emergency last week surrounding the use of the synthetic cannabinoid K2 was dramatic, but ultimately non-lethal. Although emergency personnel made more than 100 trips to the hospital, in the end no-one died from their exposure to the drug. And that’s raised a question about the terminology we use to describe this crisis. Were these in fact overdoses?
The drugs that have been most often in the headlines in recent years have been opioids, and we’re very used to using the term overdose to describe deaths and near death experiences using these drugs.
But medically, the term overdose describes a fairly well defined state, said Dr Kathryn Hawk, an assistant professor of emergency medicine at Yale.
“It’s really about a life threatening emergency whether you either have compromised vital signs, you have respiratory depression, or hypoxia, or cardiac arrest," said Hawk. "Which at the end of the day is not what we saw.”
In fact she said, for a reaction like that we saw in the New Haven cases -- collapse and vomiting -- toxicologists prefer the word 'exposure' or 'poisoning.'
Hawk notes that the drug that can reverse opioid overdose, naloxone, was ineffective; what actually worked was supportive care. While the effects were nasty, they were not life threatening.
Hawk said the terminology does matter. “It is important when it comes to conveying the seriousness and the concern with what people were seeing," she said. "The challenge is that you often know what you’re dealing with in the moment, so it makes sense to treat it as if you’re concerned that it’s an overdose.”
And beyond clinical efficacy, some physicians have even made the point that the term overdose itself can be seen as a value judgement on the drug user, implying a personal responsibility that says that drug use is a choice.