Nicotine Overdose

Nicotine Overdose Is On the Rise

Nicotine overdose occurs when someone has ingested too much nicotine. That can happen in a variety of forms, from skin contact to eating cigarettes and many other forms in between. The CDC reports that nicotine poisoning is on the rise, noting there has been an increase in the report of nicotine poisoning symptoms to poison centers over the last several years. The Canadian Medical Association Journal (CMAJ) noted that the report of nicotine poisoning symptoms that were related to the use of e-cigarettes increased by 300 percent from 2012 to 2014 in the United States.

Threshold for nicotine poisoning

In a nutshell, it doesn’t take much for nicotine poisoning symptoms to occur, and research shows that fatalities from a nicotine overdose can occur with as little as 10 ml of liquid nicotine.

Generally the size and weight of the individual will determine how much someone can ingest before nicotine poisoning occurs. The Archives of Toxicology reported that 50 to 60 milligrams of nicotine will lead to nicotine overdose in a 150 pound human. The California Poison Control System says overdose can occur from liquid nicotine in the amount of 5 ml./kg.

But even a teaspoon of liquid nicotine such as the kind used in e-cigarettes could lead to nicotine poisoning symptoms in children. That form of overdose would be from ingesting the liquid nicotine as a liquid as opposed to vaping it.

The CMAJ reported in their study that more than half of the accidental nicotine poisoning cases reported to poison control centers in 2014 involved children younger than the age of six. The JMT notes that liquid nicotine such as that found in vaping products and e-cigarettes was more likely to cause nicotine overdose than other products such as cigarettes and chew tobacco.

The Archives of Toxicology launched a review of today’s literature to examine how much is too much for nicotine overdose to occur. They concluded that ingesting 5 to 6 cigarettes whole in an adult would lead to fatal nicotine overdose, and 10 ml of diluted nicotine liquid like the kind you find in e-cigarettes could be the magic number for fatalities in adults.

Causes of nicotine poisoning

Simply put, nicotine overdose occurs when you have too much nicotine in your system. Smoking too much, eating cigarettes directly, or intentionally consuming too much liquid nicotine will lead to nicotine poisoning symptoms and even death.

Fatalities arising from nicotine overdose do happen, and nicotine overdose is even used in suicide attempts. It would take a lot of cigarettes in a short amount of time for a nicotine overdose to occur from smoking alone, but ingesting cigarettes by eating them or through liquid nicotine can lead to poisoning symptoms.

Prevention Medicine Reports noted in 2016 that four adults and two children died in the United States died of nicotine overdose by ingesting liquid nicotine intentionally. Children are attracted to the pretty smells and tastes of the various flavors found in vaping products containing liquid nicotine. Web MD says that “the majority” of nicotine poisoning cases today are caused through the direct ingestion of liquid nicotine.

But at the same time, there are other ways to contract nicotine poisoning. A disease known as Green Tobacco Sickness occurs in tobacco farmers exposed to nicotine. Nicotine is found in the leaves of tobacco plants, and when the plants are wet, harvesters in contact with the plants can experience a tobacco saturation.

The National Agricultural Safety Database reported on the story of Juan, who began working with wet tobacco leaves early in the morning and by lunchtime was experiencing nicotine poisoning symptoms that was diagnosed as Green Tobacco Sickness. Nicotine contact on your skin can even lead to nicotine overdose or nicotine poisoning.

Symptoms of nicotine poisoning

There are two stages of nicotine poisoning according to Web MD. Symptoms can begin as soon as 15 minutes within coming into contact of nicotine, but can also take up to an hour for nicotine poisoning symptoms to begin. A mild overdose will only last for one or two hours, but a severe overdose can last as long as 24 hours.

In the first stage of nicotine overdose, general unwellness symptoms are the norm.

  • Queasy feeling, nausea
  • Mouth watering
  • Cardiac symptoms such as faster heart rate and increased blood pressure
  • Shortness of breath, faster breathing with heavy breath
  • Pale
  • Dizziness
  • Confusion
  • Stomach problems including pain and/or vomiting
  • Sweating
  • Tremors
The second stage of nicotine poisoning symptoms shows the body slowing down. These symptoms can crop up within half an hour to four hours after the consumption of nicotine.

  • Slower breathing with shallow breath, could lead to complete respiratory failure
  • Heart rate slows down and blood pressure drops
  • Weakness and lethargy, slow response to stimulus and muscle problems
  • Seizures
  • Diarrhea
  • Coma
  • Paralysis

Treatment for nicotine poisoning

There is no one size fits all formula for treating a nicotine overdose, but that does not mean that you can’t treat it. The management of symptoms is generally how emergency rooms conduct their treatment of nicotine poisoning symptoms. Canada EM in Medical Concepts reports that activated charcoal is often used to treat nicotine poisoning.

Inducing vomiting without medical supervision is also not advised. Drinking water and hydrating patients in emergency rooms are also common treatments for nicotine overdose, but generally the symptoms will be treated as the overall treatment for nicotine overdose.

What to Do for Nicotine Poisoning

It’s important for anyone that suspects nicotine poisoning to get help immediately, particularly if a large amount has been consumed. Web MD suggests that for severe nicotine poisoning symptoms such as respiratory failure, seizures, or coma, call 911. Drinking water is also advised, but inducing vomiting is not a good idea in someone experiencing nicotine overdose.
Prevention

The easiest way to prevent nicotine overdose is to not consume too much nicotine. But to prevent it from happening in the home to someone else, simply keeping any form of nicotine out of reach of children is the best way to prevent it from happening to you. Even discarding the products after use in a way that children and pets can not see them is a good idea to avoid nicotine poisoning.

Outlook

The Archives of Toxicology notes that prognosis is good in mild cases of nicotine overdose, with nicotine poisoning symptoms easing as soon as a few hours after ingestion and severe cases showing symptoms for as long as 24 hours.

The same review notes that severe symptoms for a significant amount of nicotine poisoning can lead to paralysis, coma, and death. However most nicotine overdoses will result in a good prognosis and complete recovery if medical attention is sought immediately.

Conclusion

Nicotine overdose is a serious condition, and becoming a serious problem with its increase in the United States and across the world due to an increase in vaping and use of e-cigarettes. A little common sense prevails for those using vaping products for nicotine consumption. An ounce of prevention is a worth a pound of cure. Keeping vaping products out of sight and out of reach of curious children and pets will go a long way towards decreasing your risk for nicotine overdose.

REFERENCES

1. Hawley, Alana. Medical Concept: Nicotine Toxicity, a New Trend in Toxicology. Medical Concepts. Retrieved from: https://canadiem.org/medical-concept-nicotine-toxicity-a-new-trend-in-toxicology/

2. Mayer, Bernd. (2014) How much nicotine kills a human? Tracing back the generally accepted lethal dose to dubious self-experiments in the nineteenth century. Archives of Toxicology 88 (1) pages 5 – 7. Retrieved from: https://link.springer.com/article/10.1007%2Fs00204-013-1127-0

3. Miller, Adam. (2014). Nicotine Poisoning Increase Due to E-Cigarettes. Canadian Medical Association Journal. 186 (10). Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4081231/

4. My, Hua and Prue Talbot. (2016). Potential Health Effects of Electronic Cigarettes: A systematic review of case reports. Prevention Medicine Reports (4). Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4929082/

5. CDC Newsroom. New CDC Study Finds Dramatic Increase in E-Cigarette Related Calls to Poison Centers. Retrieved from: https://www.cdc.gov/media/releases/2014/p0403-e-cigarette-poison.html

6. Quandt, Sara and Arcury, Thomas (2001). Learning abut Green Tobacco Sickness: Juan’s Experience. Wake Forest University School of Medicine. Archives National Agricultural Safety Database. Retrieved from: https://web.archive.org/web/20090621190312/http://www.nasdonline.org/docs/d001501-d001600/d001591/d001591.html

7. Symptoma. Nicotine Poisoning. Retrieved from: https://www.symptoma.com/en/info/nicotine-poisoning

8. Mayer, B. (2014). How much nicotine kills a human? “Tracing back the generally accepted lethal dose to dubious self-experiments in the nineteenth century.” Archives of Toxicology. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3880486/

9. Cantrell, L. (2005). Nicotine Poisoning. California Poison Control System. Retrieved from: https://calpoison.org/news/nicotine-poisoning

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