Telecommunicator Orientation to Street Drugs and Excited Delirium

Durham Police Department CITAnd

Durham County EMS

Synthetic Drugs

• Cannabinoids – K-2 or Spice – Versions of synthetic marijuana

• Cathinones – “Bath Salts” – mimic the effects of cocaine or meth

• These products are not intended for human consumption but labeled and marketed to allude to being used as a drug

Why are they dangerous

• No consistent way of manufacturing chemicals

• Many are more potent

• Individual behavioral reactions are unpredictable

• Long term treatment plans are wisely untested

Bath Salts

• Sold as crystalline powder with the names like: Red Dove, Vanilla Sky, White lightening

• Can cause severe paranoia, violent behavior, and hallucinations

• Symptoms may last 2 days

• Long term psychiatric care may be required

Herbal Incense

• Sold as incense with names like spice, K2, Mojo, G-Four

• Inconsistency in product can lead to differences in reactions

• Can cause anxiety, paranoia, confusion

Signs and Symptoms of Synthetic Drug Use

• Altered mental status – speaking in inappropriate language, making animal like sounds

• Rapid heart rate• Sweating profusely• Very aggressive / Threatening Violence• Removing clothes to point of nudity• Elevated Body temperature

Video of Synthetic Drug Use

• http://www.youtube.com/watch?v=Wh_nZiuFC4o&feature=related

• http://www.youtube.com/watch?v=HfEepVOQrpE

Warning!!!

• May present with one or two signs and symptoms at first

• Their condition will worsen over time

• Be aware of the key words that will indicate the person is suffering from Excited Delirium or Synthetic Drug Overdose

WARNING SIGNS / Key Words!!!!

• “He is taking off his clothes”• “He is Agitated”• “He is talking out of his head”• “He pacing back and forth”• “He is wanting to fight everybody”• “I think he took something”• “He is hearing voices / He is seeing things”• “He is sweating a lot”

Excited Delirium Videos

• http://www.youtube.com/watch?v=DWbQ3xOazNU

• http://www.youtube.com/watch?v=4FljTDZR1G4

Excited Delirium

• Excited Delirium is a controversial term used to explain deaths of individuals in police custody, in which the person being arrested, detained, or restrained is highly agitated and may be under the influence of stimulants. [1]

Excited Delirium- A Neurology Definition – Dr. Deborah Mash - University of Miami

• “Someone who is disproportionately large, extremely agitated, threatening violence, talking in-coherently, tearing off clothes, and it takes four to five officers to get the attention of that individual and bring him out of harms way – that’s excited delirium!”

What Causes Excited Delirium??• The use of Stimulant Drugs Over a Period of

Time, specifically Cocaine, Methamphetamine, and Synthetic Stimulant Drug

• The use of Alcohol with these Stimulant Drugs

• Combined with Obesity, ethnicity, and often unknown underlying heart disease

Recognizing Excited Delirium• Unbelievable strength • Imperviousness to pain • Ability to offer effective resistance against

multiple officers over an extended period of time • Hyperthermia (temperatures can spike to

between 105-113°F) • Sweating • Shedding clothes or nudity • Bizarre and violent behavior • Aggression • Hyperactivity

Call Take/Dispatch Role

• When Warning Signs/Key Words present the information should be clearly documented and provided to responders

• Dispatch Crisis Intervention Team/Mental Health trained responders when possible

• Consider dual response policy for PD/EMS

Special Note: Impervious Pain• More Officers the better – due to the usual

techniques to control the person may be ineffective – Taser, Baton, Pepper Spray

• Due to the lack of response to usual Law Enforcement Techniques, One officer will be overwhelmed in a short period of time.

• This can cause injuries or death to both the Officer and the person consuming the drug

Treatment of Excited Delirium• EMS and Law Enforcement response will focus

first on crew, officer, and patient safety• We will treat immediate life threats – CPR,

Oxygen, Airway• The person will receive medications to help

sedate and calm them both psychiatrically and physically.

• They will also receive IV Fluids and Heart monitoring to rule out their heart has not been damaged by the drugs

Treatment at the Hospital

• Both immediate and long term treatments focus on preserving body function, while detoxifying and allowing metabolic functions to return to a somewhat normal state.

• The major organs affected by the drugs are Kidneys, Liver, Heart, and Brain.

QUESTIONS??