Overamping or Speed “Overdose”

-This document was made in colaboration between the DOPE Project, North Carolina Harm Reduction Coalition and the National Harm Reduction Coalition.



“You take that one shot all of a sudden you go damn, I shouldn’t have done that, you did one too many and you just crossed the line...all of a sudden, paranoid, everybody’s looking at you, you’re in a fishbowl...it lasts 12 terrible hours…and the shadow people are watching, everyone’s just on that side of the door looking at you, the cops have binoculars three stories away, everything’s got recorders.” –Rick

Practicing Harm Reduction, for ourselves and with our friends

“There’s one appropriate response no matter how people are reacting and that’s to treat that other person who’s having a crisis with compassion and treat them with kindness no matter what, that’s the always the appropriate response.” –Jesse

The suggestions in this guide are intended as just that: suggestions. We all have our own ways of doing things, and our own experiences with the drug, the high, and practicing harm reduction. The goal of this booklet is to get us all to take the issue of overamping seriously and to bring attention to it as much as other kinds of “overdoses,” and also to recognize all the smart things people already do to keep themselves and their friends safe. Overamping can be harmful — either physically, mentally or both — and the intention of this guide to help us think of ways to lessen that harm.

What is overamping?

Overamping is the term we use to describe what one might consider an “overdose” on speed. Overamping means a lot of things to a lot of people. Sometimes it is physical, when our bodies don’t feel right. Other times it is psychological, like paranoia, anxiety or psychosis — or a mixture of the two. It’s complicated because sometimes one person will consider something overamping, and the other person actually considers it just part of the high, or maybe even enjoys a feeling that someone else hates. There are many different definitions of overamping, but we’ve tried to simplify it down to some common elements.

Overamping can happen for a lot of different reasons: you’ve been up for too long (sleep deprivation), your body is worn down from not eating or drinking enough water, you’re in a weird or uncomfortable environment or with people that are sketching you out, you did “that one hit too many,” you mixed some other drugs with your speed that have sent you into a bad place — whatever the reason, it can be dangerous and scary to feel overamped.

Is overamping an overdose?

Most of the time, when we hear the word overdose, we think of heroin, someone in a heavy nod, turning blue, not breathing. A lot of times people say “you can’t overdose on speed,” but then other people say, “I don’t know, I’ve passed out, or felt like I was gonna have a heart attack…is that an overdose?” The problem is actually with the word itself. “Overdose” isn’t really the best word to describe what happens when tweak turns bad…so we call it OVERAMPING.

Even the term “overdose” makes it sound like taking too much is the problem. With speed (unlike some drugs like heroin) it is much more unpredictable, overamping might happen regardless of how much or little you use, or how long you’ve been using. It might happen on the third day of a run when your body is getting run down, or when you get high with some people that make you feel weird.

Do people die from overamping/speed overdoses?

In San Francisco, there are around 35-45 speed-related deaths per year (2005-2009 Medical Examiner’s reports). We don’t know exactly what the causes of death are; sometimes they are listed as “drug-related deaths,” other times they are listed as “accidental deaths” where drugs were involved. In some cases, people died of things like firearm injuries, but they tested positive for speed. What we do know, is that sometimes speed can cause fatal harm.

This information in this guide is to help prevent deaths from speed, but also the other stuff that happens when you overamp — when we feel paranoid, anxious, or have unpleasant, scary psychosis.

What are the psychological symptoms of overamping?

• Extreme anxiety

• Panic

• Extreme paranoia

• Hallucinations

• Extreme agitation

• Increased aggressiveness

• Agitation, restlessness, irritability

• Hypervigilance (being super aware of your environment, sounds, people, etc.)

• Enhanced sensory awareness

• Suspiciousness

What is psychosis?

According to the National Institutes of Health, “Psychosis is a loss of contact with reality that usually includes false beliefs about what is taking place or who one is (delusions) and seeing or hearing things that aren’t there (hallucinations).”

Some ways to recognize psychosis: abnormal displays of affection, confusion, depression, occasionally suicidal thoughts, disorganized thought and/or speech, mania, delusions, illusions, hallucinations, unfounded fear or

• Hallucinations, or false perceptions, may be associated with any of the five senses.

• Delusions are false or exaggerated personal beliefs.

Some common delusions include:

• Delusions of persecution: You feel threatened and believe that others intend to harm you in some way. For example, you think that the CIA intends to kill you.

• Delusions of grandeur: You have an exaggerated feeling of importance, power or knowledge. For example, you might think that you’re in control of the state or that you’re the Messiah.

• Delusions of reference: You believe that unrelated events or happenings are somehow connected to you, usually in a negative way. For example, you might be watching TV and think the news broadcaster is trying to get a message to you.

• Delusions of being controlled: You believe certain objects or persons have control over you. For example, you might think the president of the United States has control over your behavior.

• Somatic delusions: You believe your or parts of your body

Paranoia is extreme suspicion of others, their actions or perceived intentions. For example, you see a duck on the river and think the police have placed a camera in the duck to watch you.

• Obsessions (repetitive thoughts) and compulsions (repetitive behaviors) can be manifestations of long-term speed use. You can perform repetitive behaviors such as cleaning, assembling and disassembling objects or washing hands several times in a 15-minute period. Other repetitive behaviors include formication (experiencing imaginary bugs), grinding of teeth, and pulling out hair.

What to do if you feel like you’re overamping or you’re with someone who might need help?

First, figure out what is needed, MEDICAL ASSISTANCE, or SUPPORT and REST?

FOR OVERHEATING

Overheating, or “hyperthermia” can be deadly. If you notice someone overheating get them to slow down and stop agitated movements and try to cool down with ice packs, mist and fan techniques. Make sure they are drinking water or a sports drink with electrolytes so they don’t dehydrate. Place cool, wet cloths under the armpits on back of knees, and/or on the forehead. Open a window for fresh air.

Hot, dry skin is a typical sign of hyperthermia. The skin may become red and hot as blood vessels dilate in an attempt to get rid of excess heat, sometimes leading to swollen lips. An inability to cool the body through perspiration causes the skin to feel dry.

Other signs and symptoms vary depending on the cause. The dehydration associated with overheating can produce nausea, vomiting, headaches and low blood pressure. This can lead to fainting or dizziness, especially if the person stands suddenly.

In the case of severe heat stroke, the person may become confused or hostile, and may seem intoxicated. Heart rate and breathing will increase as blood pressure drops and the heart attempts to supply enough oxygen to the body. The decrease in blood pressure can then cause blood vessels to contract, resulting in a pale or bluish skin color in advanced cases of heat stroke. Eventually, as body organs begin to fail, unconsciousness and death will result.

When the body temperature reaches about 40° C/104° F, or if the person is unconscious or showing signs of confusion, hyperthermia is considered a medical emergency that requires treatment in a proper medical facility. Call 911. In a hospital, more aggressive cooling measures are available, including intravenous hydration, gastric lavage (pumping the stomach) with iced saline, and even

FOR POSSIBLE STROKES

Strokes are caused by a blood clot that blocks or plugs a blood vessel or artery in the brain or a blood vessel in the brain that breaks and bleeds into the brain.

The SYMPTOMS OF STROKE are distinct because they happen quickly:

• Sudden numbness or weakness of the face, arm or leg (especially on one side of the body)

• Sudden confusion, trouble speaking or understanding speech

• Sudden trouble seeing in one or both eyes

• Sudden trouble walking, dizziness, loss of balance or coordination

• Sudden severe headache with no known cause



WHAT SHOULD YOU DO FOR A STROKE?

If you believe someone is having a stroke — if he or she suddenly loses the ability to speak, or move an arm or leg on one side, or experiences facial paralysis on one side — call 911 immediately.

• High blood pressure

• Heart disease

• Smoking

• Diabetes

• High cholesterol

Even if you don’t want to stop or cut down on speed use, a good thing to do would be to see your doctor to make sure you don’t have high blood pressure, high cholesterol, heart disease or other physical issues that could increase your risk for a stroke.

FOR SEIZURES

What is a seizure?

The brain is full of electrical activity. It is how the brain ‘talks” to the rest of the body. If there is abnormal or excess electrical activity in a part of the brain it can cause a misfire and result in a seizure or convulsion.

Seizures fall into two general groups: general and partial. A partial seizure affects small parts of the brain. A general seizure affects the whole brain and can cause loss of consciousness and/or convulsions. This is the type that most people think of when the word “seizure” is mentioned.

Some typical signs and symptoms of a general seizure are:

• Drooling or frothing at the mouth

• Grunting and snorting

• Tingling or twitching in one part of the body

• Loss of bladder or bowel control

• Sudden falling

• Loss of consciousness

• Temporary absence of breathing

• Entire body stiffening

• Uncontrollable muscle spasms with twitching and jerking limbs

• Head or eye deviation (fixed in one direction)

• Aura before the seizure which may be described as sudden fear or anxiety, a feeling of nausea, change in vision, dizziness, or an obnoxious smell (not as common with drug-related seizures).

• Skin color may be very red or bluish.

WHAT TO DO IF SOMEONE HAS A SEIZURE:

• DO remain calm, be a good observer. Speak calmly and softly to the person.

• DO help the person into a lying position and put something soft under the head.

• DO turn the person to one side (if possible) to allow saliva to drain from the mouth. (If not possible during the seizure, do so once the seizure has stopped).

• DO remove glasses; loosen ties, collars and tight clothing.

• DO protect the head and body by clearing the area of hard or sharp objects.

• DO NOT force anything into the person’s mouth or between their teeth. This is an old myth — people cannot swallow their own tongues. You can harm yourself trying to put things in their mouth, and you can also break their teeth or cause other harms to the person.

• DO NOT try to restrain the person. You cannot stop the seizure.

After the seizure:

• DO arrange to have someone stay nearby until the person is fully awake.

• DO clear the airway of saliva and /or vomit.

• DO allow the person to rest. Most people will sleep soundly for a period of time following the seizure.

• DO NOT offer any food or drink until the person is fully awake.

Call 911 if:

• The seizure lasts for more than 5 minutes

• The person has one seizure right after another

• The person appears to be injured

• The person does not regain consciousness

• This is a first-time seizure

• The person’s color remains poor

• The person does not start breathing within one minute after the seizure has stopped (Start CPR)

FOR HEART ATTACK/CARDIAC ARREST

“I’ve known several people that have died of cardiac arrest due to speed…it’s important to help people recognize what those events are when they’re happening because they can look like a lot of other things.” –Jesse

Even though a heart attack may be related to drugs, it will still look similar to the heart attacks that might not be drug-related. So keep an eye out for the same symptoms, although sometimes it may be tricky to figure out what is from the drug (sweating, for example) and what may be the signs of a heart attack. Things to look out for:

• Uncomfortable pressure, fullness, squeezing, or pain in the center of the chest. These symptoms can range from mild to severe, and they may come and go.

• Discomfort in other areas, such as the neck, arms, jaw, back, or stomach.

• Shortness of breath, lightheadedness, nausea, or breaking out in a cold sweat.

Women may get chest pain or discomfort, but in many cases, it’s not the most obvious symptom. Instead, women are more likely than men to have these symptoms:

• Unusual fatigue

• Nausea or indigestion

• Dizziness or lightheadedness

• Abdominal discomfort that may feel like indigestion

• Discomfort described as pressure/tightness or an ache in the neck, shoulder or upper back

If the person has lost consciousness and you notice that they are not breathing, call 911 and begin CPR if you are trained. Time is very important with heart attacks, so help your buddy!

How to deal with the psychological aspects of overamping?

If you are confident that the problem is not medical in nature (seizure, stroke, heart attack, overheating), but that you or your friend is experiencing anxiety or other psychological symptoms of overamping there are things you can do as well.

Here are some things that some fellow tweakers have tried, and they worked! You may have your own methods of relaxing or getting yourself out of a bad space. Do whatever works, and share your strategies with friends.

• Drink water or a sports drink; eat some food

• Try to sleep

• Switch how you’re doing your speed; sometimes if you’re shooting, switching to smoking can help

• Change your environment or the people you’re with

• Take a benzo (small dose, like an Ativan)

• Do breathing or meditation exercises

• Create physical contact, like massaging yourself or having someone else do it for you

• Go walking, walking, walking — walk it off!

• Take a warm shower

• Get some fresh air