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Young AM, Livingston M, Vickers-Smith R, Cooper HLF. Emergence of wasp dope in rural Appalachian Kentucky. Addiction 2021; 116:1901-1907. [PMID: 33063438 PMCID: PMC8046840 DOI: 10.1111/add.15291] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/28/2020] [Accepted: 10/02/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIMS Recent reports have highlighted the emergence of 'wasp dope' as an issue of concern, but epidemiological evidence is lacking. Wasp dope is a crystalline substance created by electrifying pyrethroid-containing insecticides (e.g. wasp sprays) that may give users a methamphetamine-like 'rush'. This paper describes wasp dope use and correlates of use in a sample of people who use drugs (PWUD) in Appalachian Kentucky, a region that has been an epicenter of opioid use and related harms in the United States. METHODS Respondent-driven sampling and targeted street outreach were used to recruit PWUD. Eligibility criteria included being aged at least 18 years, residing in one of five Appalachian Kentucky counties, and having either used opioids or injected any drug to get high in the prior 30 days. Interviewer-administered surveys queried participants' (n = 278) recent (past 6 months) wasp dope use, other substance use and demographic characteristics. Prevalence ratios (PR) were estimated using generalized estimating equations assuming a Poisson outcome distribution in a cross-sectional analysis. RESULTS Recent wasp dope use was reported by 16.1% of participants. Men and people who recently experienced homelessness and transportation difficulties were twice or more as likely to have used wasp dope compared with their counterparts [PR = 2.08, 95% confidence interval (CI) = 1.11, 3.87, PR = 2.78, 95% CI = 1.64, 4.72 and PR = 2.01, 95% CI = 1.06-3.81, respectively]. While wasp dope use was associated with injection drug use and using opioids and other substances to get high in unadjusted analyses, the factor most strongly associated with wasp dope use was methamphetamine use (PR = 17.23, 95% CI = 2.57, 115.61), specifically methamphetamine injection (PR = 4.47, 95% CI = 1.56, 12.78). CONCLUSIONS Among people who use drugs in rural Kentucky, USA, more than one in six people surveyed reported using wasp dope in the past 6 months, nearing the percentage using cocaine/crack (20%) and fentanyl/carfentanil (25%). Wasp dope use was higher among men and strongly associated with homelessness, transportation access, methamphetamine use and injection drug use.
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Affiliation(s)
- April M Young
- Department of Epidemiology, University of Kentucky College of Public Health, Lexington, Kentucky,Center on Drug and Alcohol Research, Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, Kentucky
| | - Melvin Livingston
- Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, Atlanta, Georgia
| | - Rachel Vickers-Smith
- Department of Epidemiology, University of Kentucky College of Public Health, Lexington, Kentucky,Center on Drug and Alcohol Research, Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, Kentucky,School of Nursing, University of Louisville, Louisville, Kentucky
| | - Hannah LF Cooper
- Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, Atlanta, Georgia
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Zheng S, Zhang S, Hong S, Lou Q. Severe dyspnea and uncontrolled seizures following meperfluthrin poisoning: a case report. BMC Pediatr 2021; 21:51. [PMID: 33494742 PMCID: PMC7829090 DOI: 10.1186/s12887-021-02509-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 01/17/2021] [Indexed: 11/10/2022] Open
Abstract
Background Meperfluthrin is a novel sanitary cyhalothrin insecticide invented in China and has increasingly been used to produce liquid mosquito repellents. Oral meperfluthrin poisoning in human has rarely been reported. Here, we reported a case of meperfluthrin poisoning by ingestion of a meperfluthrin-based liquid mosquito repellent in a 16-month-old infant. Case presentation A 16-month-old boy with a history of accident ingestion of meperfluthrin was admitted to our hospital’s emergency department. He exhibited severe dyspnea, and lung radiograph showed multiple patchy and cord-like high-density shadows bilaterally in a short time. He also suffered 35 min of seizures which were finally controlled by the intravenous infusion of propofol. He was diagnosed with meperfluthrin poisoning, status epilepticus and severe pneumonia. After treated with methylprednisolone, aerosolized beclomethasone dipropionate, anti-infection, and some critical supportive therapy, the patient was in good health and showed no symptoms during 12 months of follow-up. Conclusions Meperfluthrin poisoning is rare. Oral meperfluthrin poisoning shows neurotoxic effects and pulmonary toxicity. Controlling seizures rapidly and ensuring an adequate oxygen supply are critical to the successful treatment.
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Affiliation(s)
- Shengkun Zheng
- Department of Emergency, Xiamen Children's Hospital, 92-98 N Yibin road, Huli District, Xiamen, 361006, Fujian province, China
| | - Shengxin Zhang
- Department of Pediatric Intensive Care Unit, Xiamen Children's Hospital, 92-98 N Yibin road, Huli District, Xiamen, 361006, Fujian province, China
| | - Shaoxian Hong
- Department of Pediatric Intensive Care Unit, Xiamen Children's Hospital, 92-98 N Yibin road, Huli District, Xiamen, 361006, Fujian province, China
| | - Qing Lou
- Department of Emergency, Xiamen Children's Hospital, 92-98 N Yibin road, Huli District, Xiamen, 361006, Fujian province, China.
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Abstract
Phenol (carbolic acid) is one of the oldest antiseptic agents. Apart from being used in many commercially available products, in rural India, it is often used in the household to prevent snake infestation. We hereby present four cases of acute carbolic acid poisoning which we saw over the last monsoon. The cases highlight the multiple routes of absorption of carbolic acid as well as its multi-organ complications which often necessitate intensive care of local therapy decreases systemic phenol absorption from cutaneous exposure and may help in reducing severity.
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Affiliation(s)
- Prabhas Prasun Giri
- Department of Pediatrics and PICU, Institute of Child Health, Department of Paediatric Nephrology, Kolkata, West Bengal, India
| | - Rajiv Sinha
- Department of Pediatrics and PICU, Institute of Child Health, Department of Paediatric Nephrology, Kolkata, West Bengal, India
| | - Shalini Sikka
- Department of Pediatrics and PICU, AMRI Hospital, Kolkata, West Bengal, India
| | - Saumen Meur
- Department of Pediatrics and PICU, AMRI Hospital, Kolkata, West Bengal, India
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Senthilkumaran S, Menezes RG, Balamurugan N, Thirumalaikolundusubramanian P. Prallethrin poisoning that taxes the brain. J Anaesthesiol Clin Pharmacol 2014; 30:116-7. [PMID: 24574614 PMCID: PMC3927277 DOI: 10.4103/0970-9185.125726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Subramanian Senthilkumaran
- Department of Emergency and Critical Care Medicine, Sri Gokulam Hospitals and Research Institute, Salem, Tamil Nadu, India
| | - Ritesh G Menezes
- Department of Forensic Medicine and Toxicology, ESIC-Medical College and PGIMSR, Bangalore, India
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Abstract
Intravenous self-injection of phenol resulting in multi-organ failure is reported. The case is discussed, because of the unique nature of exposure to phenol and rapid involvement of multiple organ systems including the central nervous,pulmonary, renal and hematological systems.
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Affiliation(s)
- Supradip Ghosh
- Department of Critical Care Medicine, Fortis-Escorts Hospital, Neelam Bata Road, NIT, Faridabad, Haryana, India
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Miller MA, Menowsky M. Human intravenous injection of β-cyfluthrin with minimal toxic effects. Am J Emerg Med 2014; 32:113.e1-2. [DOI: 10.1016/j.ajem.2013.08.045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Accepted: 08/22/2013] [Indexed: 11/30/2022] Open
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Pyrethroid as a Substance of Abuse. Case Rep Psychiatry 2014; 2014:169294. [PMID: 25431720 PMCID: PMC4241337 DOI: 10.1155/2014/169294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 10/20/2014] [Accepted: 10/25/2014] [Indexed: 11/20/2022] Open
Abstract
This is a case of a 22-year-old Hispanic male with a history of bipolar disorder and methamphetamine dependence who was admitted after presenting with suicidal ideations by slashing his throat with a machete. The patient had been smoking and inhaling “processed” pyrethroid for about eight weeks as an inexpensive methamphetamine substitute. He reported experiencing a “rush” similar to methamphetamine after using pyrethroid from liquid insecticide that had been heated (electrocuted) or sprayed on hot metal sheets until it crystallized. The patient presented with no significant physical markings or findings but claimed to have his suicidal ideations precipitated by concerns of ill effects of pyrethroid on his health. He also had positive urine drug screen for methamphetamine, which he admitted to using on the day of admission. We conclude that it is important for physicians to maintain a high level of suspicion for alternate and uncommon substances of abuse as well as risks for suicidal tendencies in these patients.
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Panwar M, Usha G, Kumath M. Status epilepticus: An association with pyrethroid poisoning. Indian J Crit Care Med 2013; 17:119-20. [PMID: 23983421 PMCID: PMC3752865 DOI: 10.4103/0972-5229.114825] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This report describes a 35 year old male who presented with seizures after consuming 4-5 bottles of “ALL-OUT” a commercial composition of pyrethroid used as insecticides. Our case report supports authors reporting an association of pyrethroid poisoning with status epilepticus.
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Affiliation(s)
- Mamta Panwar
- Department of Anaesthesiology, VMMC and Safdarjung Hospital, New Delhi, India
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Giampreti A, Lampati L, Chidini G, Rocchi L, Rolandi L, Lonati D, Petrolini VM, Vecchio S, Locatelli CA, Manzo L. Recurrent tonic–clonic seizures and coma due to ingestion of Type I pyrethroids in a 19-month-old patient. Clin Toxicol (Phila) 2013; 51:497-500. [DOI: 10.3109/15563650.2013.808747] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Vale A, Bradberry S, Proudfoot A. Clinical Toxicology of Insecticides. MAMMALIAN TOXICOLOGY OF INSECTICIDES 2012. [DOI: 10.1039/9781849733007-00312] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Some insects compete for our food, some damage construction materials and some are important disease vectors in humans and animals. Hence, it is not surprising that chemicals (insecticides) have been developed that kill insects and other arthropods. More recently introduced insecticides, such as the neonicotinoids, have been produced with the intent that humans and animals will not be harmed by their appropriate use. This chapter reviews the clinical features and management of exposure to organophosphorus (OP) and carbamate insecticides, neonicotinoids, phosphides and pyrethroids. In the developing world where the ambient temperature is often high and personal protection equipment often not worn, poisoning particularly from OP and carbamate insecticides is common in an occupational setting, though more severe cases are due to deliberate ingestion of these pesticides. Both of these insecticides produce the cholinergic syndrome. The neonicotinoids, a major new class of insecticide, were introduced on the basis that they were highly specific for subtypes of nicotinic receptors that occur only in insect tissues. However, deliberate ingestion of substantial amounts of a neonicotinoid has resulted in features similar to those found in nicotine (and OP and carbamate) poisoning, though the solvent in some formulations may have contributed to their toxicity. Phosphides interact with moisture in air (or with water or acid) to liberate phosphine, which is the active pesticide. Inhalation of phosphine, however, is a much less frequent cause of human poisoning than ingestion of a metal phosphide, though the toxicity by the oral route is also due to phosphine liberated by contact of the phosphide with gut fluids. It is then absorbed through the alimentary mucosa and distributed to tissues where it depresses mitochondrial respiration by inhibiting cytochrome c oxidase and other enzymes. Dermal exposure to pyrethroids may result in paraesthesiae, but systemic toxicity usually only occurs after ingestion, when irritation of the gastrointestinal tract and CNS toxicity, predominantly coma and convulsions, result.
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Affiliation(s)
- Allister Vale
- National Poisons Information Service (Birmingham Unit) City Hospital, Birmingham UK. *
- West Midlands Poisons Unit City Hospital, Birmingham UK
- School of Biosciences and College of Medical and Dental Sciences University of Birmingham, Birmingham UK
| | - Sally Bradberry
- National Poisons Information Service (Birmingham Unit) City Hospital, Birmingham UK. *
- West Midlands Poisons Unit City Hospital, Birmingham UK
- School of Biosciences and College of Medical and Dental Sciences University of Birmingham, Birmingham UK
| | - Alex Proudfoot
- National Poisons Information Service (Birmingham Unit) City Hospital, Birmingham UK. *
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