Presenting features include somnolence, stupor, psychomotor retardation, slurred speech, mood changes (euphoria followed by dysphoria), respiratory depression, and impaired memory and attention. The intensity of these symptoms is related to the amount of opioids consumed, and in severe intoxication, coma may occur. These symptoms are not better accounted by the presence of another medical condition or presence of intoxication or withdrawal of another substance.

in which stage of intoxication does an individual become aggressive

For the actual treatment of aggressive behavior, medication is an effective tool. For inpatients, the quality of the nurse-patient relationship appears to be the most significant determinant Sober Living Scholarships in Texas of whether patients decide to take their medications (Irwin, 2006). Therefore, nurses have an important part to play in prevention, risk assessment, and treatment of aggressive behavior.

Management of opioid intoxication in the emergency setting

These factors lead to development of intoxication at relatively lower doses of the substances. Some prescription medications sometimes have a high risk of dependence (opioids and benzodiazepines). One may need to differentiate from symptoms of frailty syndrome, which manifests as memory problems, incontinence, falls, and limitations of functioning. Sometimes, interactions of the medications may also result in features of substance intoxication.[24] A few points to consider while managing elderly patients with substance intoxication in emergency settings are presented in Table 8.

The assessment of patients with opioid intoxication aims at ensuring safety of the patient and prevention of irreversible harm to the patient. In cases of opioid intoxication/overdose, information is generally obtained from friends or family members of the patients. Information on the presence of pills or injection paraphernalia where the patient was found can be a helpful guide to understanding the consumption of opioids by the patient.


The more alcohol a person consumes the more intoxicated and impaired they become. Any person who enters this state has lost consciousness and could be at risk of further complications, including death. It is essential to distinguish falling asleep after drinking from entering an alcohol-induced coma. The former is common, as alcohol causes drowsiness, while the latter is serious and requires immediate medical attention.

in which stage of intoxication does an individual become aggressive

In Singapore, out of 253 homicide offenders, 141 individuals (56%) were suffering from AUD and 121 offenders (48%) drank alcohol within 24 h preceding their criminal offense (Yeo et al., 2019). In the Brazilian city of Diadem, limiting the hours of alcoholic sales in bars to 11 p.m. Significantly declined the crime rate to 9 homicides per month (Duailibi et al., 2007). Chervyakov et al. (2002) reported that 4 in every 5 Russians convicted of murder were intoxicated with alcohol during the murderous act.

Understanding Anger and Aggression

It was initially reported that women are less likely to engage in binge drinking patterns than men (Bobrova et al., 2010). However, in the recent years, data from the United States indicate that the binge-drinking rate in adult women (age 21–49 years) has been rising (Hasin et al., 2019; Sarah and Keyes, 2020). Evidence suggests that there is a little convergence in the pattern of binge drinking in men and women.

  • Researchers have also linked impulsive alcohol-related behavior to genetic involvement, with the presence of the serotonin 2B receptor gene (HTR2B) playing a role in impulsive and aggressive behaviors while under the influence of alcohol.
  • Thereafter, details of intoxication with specific substances are discussed, namely, alcohol, cannabis, opioids, benzodiazepines, and other substances.
  • A person in the Severe Impairment Stage can also become numb and insensitive to pain.
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