Module 12: working with intoxicated young people: learner's workbook

3.1 Recognising intoxication

Page last updated: 2004

Remember that since indicators of intoxication may not always be immediately apparent, it can sometimes be difficult to detect, especially with lower doses. Young people may become intoxicated with even small doses of alcohol or drugs, and this may manifest itself in different ways. We sometimes think of intoxication as being the extreme case where people are severely drug-affected. However, young people may also become giggly, and a little 'silly' which can be either the result of intoxication or just having fun.

It is important not to assume from a person's appearance, social circle and usual drug-using patterns that they are definitely intoxicated, even when they appear to be. This is particularly important to be aware of with young people who might usually associate themselves with 'heavy' drug-using peers.

Intoxication can be mimicked by:

  • brain injury (e.g. concussion)
  • shock
  • diabetes
  • blood poisoning
  • mental illness
  • heat exhaustion/sunstroke/dehydration.
You may well be able to think of other medical conditions to add to this list. It is obviously critical to differentiate these conditions from intoxication, as they can be life-threatening.

The following provides a guide to the general effects of the different categories of drugs. It also lists indicators that you might observe in young people at different levels of intoxication. Note that some of the indicators appear in more than one category. For example, excitability can be a feature of intoxication with both depressants and stimulants, depending on the dosage. This means that simply knowing the effects of different drug types may not necessarily help identify which drug has been consumed.

Indicators of intoxication by their effect on the central nervous system (CNS)

Depressants

Decreased activity of CNS
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Examples:
  • Alcohol
  • Benzodiazepin es (e.g. Valium, Serapax, Rohypnol, Temazepam)
  • Opiates (heroin, morphine, codeine, methadone)
  • Inhalants – can also be hallucinogenic (solvents, aerosols, petrol, glue)
  • Marijuana (also an hallucinogen)
  • Barbiturates
Likely effect at lower doses:
  • Relaxation, feeling of wellbeing
  • Feel less inhibited
Likely effect at moderate doses:
  • More intense moods
  • Excitable
  • Euphoria or depressed
  • Quick to anger
  • Impulsiveness
  • Loss of co-ordination
  • Slowed reflexes and reaction time
  • Impaired attention
Likely effect at higher doses:
  • Slurring of speech
  • Unsteady on feet
  • Light-headed
  • Drowsiness
  • Blurred vision
  • Nausea/vomiting
  • Unconsciousness and possible death if overdose
Duration:
  • Tranquillisers - 12-24 hours
  • Opiates - 4-24 hours
  • Cannabis - 5 hours
  • Inhalants/ solvents - 6 hours
  • Alcohol - dose-related, liver metabolises one drink per hour

Note: Some depressant drugs tend to produce such deep relaxation that exaggerated sociability, impulsivity and aggression are not likely (e.g. tranquilisers, opiates).

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Stimulants

Increased activity of CNS

Examples:
  • Amphetamines (speed)
  • Caffeine
  • Cocaine
  • MDMA (Ecstasy)
Effect:
  • Arousal, alertness
  • Excitability
  • Boost in energy
  • Hyperactivity
  • Talkative
  • Euphoria
  • Feel less inhibited
  • Overconfidence
  • Insomnia
  • Dehydration (potentially fatal)
  • Anxiety, agitation
  • Delusions/ hallucinations
Duration:
  • Caffeine - 2-24 hours
  • Speed - 4-8 hours
  • Cocaine - 4 hours
  • Ecstasy - 6 hours
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Hallucinogens

Disturbance of perception

Examples:
  • PCP
  • LSD (acid or trips)
  • Marijuana (also depressant)
  • Inhalants (also depressant)
  • Mescaline (peyote cactus)
  • Psilocybin (magic mushrooms)
  • MDA (adam)
Effect:
  • Impaired co-ordination
  • Impaired attention
  • Visual and auditory hallucinations
  • Altered time perception
  • Religious-like experiences
  • Anxiety from 'bad trips'
Duration:

Most varieties - 6-12 hours

Source: Modified version of table, included in the ARRTS student handbook, Provide Alcohol and/or Other Drug Withdrawal Services (2001).

Note: Nicotine is not included, as most users have high tolerance, and intoxication is not readily discernible.

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