OVERAMPING GUIDE 1 Overamping or speed “overdose”

OVERAMPING GUIDE 1
Overamping
or speed “overdose”
“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.
“When I would mix speed with something else, even
just pot...I would be like “whooooaaaaa”...That’s very
unpleasant...your self esteem is just being pounded on
by the negative thoughts in your own animal brain that
under normal circumstances you can keep kind of in
control...and suddenly you’re being bombarded.” –Robert
“When you overdose on
heroin or OC [Oxycodone]
or something...you’re kind
of in a blacked-out state,
but when you over-stimulate
yourself with speed, you’re
conscious during the whole
thing...My feeling about
working with people in speed
psychosis is...to help them not
hurt themselves, realizing at
some point they’re helping
themselves.” –IsaacOVERAMPING GUIDE 2
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
physical symptoms
of overamping?
• Nausea and/or vomiting
• Falling asleep/passing out
(but still breathing)
• Chest pain or a tightening in
the chest
• High temperature/sweating
profusely, often with chills
• Fast heart rate, racing pulse
• Irregular breathing or
shortness of breath
• Seizure/convulsions
• Stroke
• Limb jerking or rigidity
• Feeling paralyzed but you are
awake
• Severe headache
• Hypertension (elevated blood
pressure)
• Teeth grinding
• Insomnia or decreased need
for sleep
• Tremors
What are the psychological symptoms
of overamping?
• Extreme anxiety
• Panic
• Extreme paranoia
• Hallucinations
• Extreme agitation
• Increased aggressiveness
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 ofreference: 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 are changing or being
distorted. Like you believe your brain is rotting.
“My three overampings have been the most terrifying
experiences in my life. I literally have seen demons...Anything
physical that happened to me overamping pales in comparison
to the psychological. There’s been several times physically
where I know I’ve been close to having a stroke if not having a
mild stroke. But...these psych breaks that I’ve had…I still have
to take antipsychotic and anti-depressants for something that
happened almost four years ago.” –David
• Agitation, restlessness,
irritability
• Hypervigilance (being super
aware of your environment,
sounds, people, etc.)
• Enhanced sensory awareness
• Suspiciousness
• 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.OVERAMPING GUIDE 3
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?
If the problem is primarily with the body, these are some things you can do:
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
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.
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 hemodialysis to cool
the blood.
In addition to speed/stimulant
use, you are more at risk for a stroke
if you also have these things:
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.
(Continued on next page.)OVERAMPING GUIDE 4
FOR SEIZURES (Continued)
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!OVERAMPING GUIDE 5
CALLING 911/DEALING WITH THE POLICE AND EMS:
Calling 911 can be lifesaving; it can
also be a pretty unpleasant experience.
Sometimes the first responders,
whether they are police, fire or the
ambulance can be great, other times
they can be rude at best. There are
lots of legitimate fears about calling
911, like getting arrested, having
neighbors or landlords know your
business, potential loss of benefits
or housing if drug use is disclosed
— and on an on. Drug users face a
lot of stigma, which makes us very
reluctant to call for help if we or our
friends are in trouble.
How to deal w/ the psychological aspects of overamping?
The most important thing is to
know your rights. In San Francisco,
our police officers are not supposed
to arrest people if they have called
911 for an overdose or drug-related
emergency. If you feel safe doing so,
remind the officers of this if they start
giving you trouble.
But, police also have a job to
do, so don’t make it easier for them.
Make sure if you do call, not to leave
drugs or paraphernalia around in
plain view. Try to keep the area calm
and quiet, if there are a lot of people
around, tell them to leave if possible
so there’s not a big group when the
cops, fire or ambulance get there.
When you call, stick to the basics
about what is physically happening
to your friend: “My friend is having
chest pains, or possibly a stroke.”
NOT “My friend did a huge hit of
speed and is acting crazy.” Don’t
mention drugs or overdose, just stick
to the symptoms that you see. Give
them the address and hang up.
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 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
“[So I called 911 for this guy], but when they came to my apartment...they saw the speed pipe [and]
said, “Are you doing drugs too?” I said,“I called you because my friend’s sick ...You’ve been here for ten
minutes and you’re just asking me these questions and you haven’t taken his pulse or anything like that.”
It was a really bad experience and if I wasn’t as involved as I am in certain aspects of drug user politics, I
would never call them again. Because I don’t need them getting in my business. I would just do the old
way and drag the person in the hallway and shut the door and hope someone else would call. So that’s
something that needs to be addressed...if we’re going to take speed overdose seriously it has to be a
comprehensive approach with the police services and the drug users on the same page.” –Isaac
DRUG OVERDOSE
PREVENTION EDUCATION