Intoxication

altered mental status (agitation, sedation, confusion)

bizarre, atypical, aggressive or belligerent behaviour

slurred speech

motor incoordination and unsteady stumbling gait (ataxia)

tremor or seizures

characteristic odour (e.g., alcohol, glue or solvent odour)

pinpoint or markedly dilated pupils

involuntary horizontal eye movements (nystagmus)

unusual heart rate (rapid or slow)

unusual respiratory rate (rapid or slow)

unusual blood pressure (high or low)

red eyes (conjunctival injection), typical of marijuana use

cyanosis

profuse sweating The presence of one or more of these symptoms in isolation does not necessarily imply that a person has been using a substance. It is important to keep an open mind and not jump to conclusions. For example, a confused or disoriented person with slurred speech may be a diabetic patient with hypoglycemia rather than a person with alcohol intoxication. While it is desirable to identify the substance that is causing a person’s symptoms, this is not always possible, either because the patient is unresponsive or because they do not know the identity of the substance to which they have been exposed. It is not necessary to have a comprehensive knowledge of drugs in order to render first aid to an intoxicated person. What is important is that the patient is carefully assessed, basic life support is initiated if indicated, and the individual is transported to medical aid without delay.