Keep him awake or talking!
March 5, 2018 11:03 PM   Subscribe

I'm watching a show and there's a moment when a character is given too much heroin. Other characters seem very insistent to keep him from sleeping and talking, thinking about it I've seen that in other movies, be it drugs or alcohol. Is this something that's just a trope? Or is there any actual value to keeping people up/cogent if there having chemical issues?
posted by Carillon to Health & Fitness (8 answers total)
My main thought is that if there's enough adulterants in someones blood stream as to incapacitate them, I can't seem talking being enough to overcome that. On the other hand, maybe there's some value into keeping the brain active or something such as to mitigate really negative effects.
posted by Carillon at 11:14 PM on March 5, 2018

Not sure about drugs/alcohol, but this is a line of thinking often used with concussions and it's a myth. You should make sure the person doesn't have any concerning symptoms before falling asleep, because if they are asleep you can't monitor them, but sleep after a concussion in and of itself doesn't do anything bad. I think you do want to make sure the person can wake up periodically though. I remember after I got in a car accident, a doctor woke me up at the hospital abruptly and it was merely to make sure I could be woken up. I suspect that might be why people do this when someone is very drunk or high - you can't tell the difference between being asleep and slipping into a coma. But I'm sure people also erroneously think this stops the onset of comas.
posted by AppleTurnover at 11:24 PM on March 5, 2018 [9 favorites]

I worked at an addiction treatment center 40 years ago and "stay with me" was standard first aid for staff while waiting for EMTs simply because it's easier to access the condition (e.g., get details re drug use) of a conscience person.
posted by she's not there at 1:32 AM on March 6, 2018 [8 favorites]

When people go to sleep their core body temperature drops by about 1 degree Centigrade. That can be problematic if somebody is at risk of hypothermia - which is often true of somebody who has taken an overdose and collapsed somewhere.

If somebody has taken an overdose then at least one - but possible several - people caring for them are going to want to know exactly what they took and when. So much better if they are conscious for that too.

There are, of course, are also great advantages of depicting things like that from a dramatic people of view - writers can can maintain tension, deploy all their wound effects and their actors best moans- and have the character whisper key pieces of information into the ear of their rescuer (always!). The fact that it is supported by some medical practice only is all the excuse needed.
posted by rongorongo at 2:54 AM on March 6, 2018

It's long been a standard part of steer lore on how to handle an OD. There's two obvious advantages - if someone is up, it becomes immediately obvious if they stop breathing. And they're less likely to choke to death if they vomit while sleeping on their back. Depressed breathing leading to death is one of the most common ways that a heroin overdose will kill you, so being able to intervene with CPR immediately if it occurs is important. And too much alcohol or heroin can both leading to vomiting while asleep.
posted by Candleman at 4:22 AM on March 6, 2018 [4 favorites]

Heroin overdoses kill by suppressing respiratory function. So, they stop breathing. Keeping them awake means you can easily assess their breathing. If you allow them to become unconscious, they can stop breathing and you don't realize it.
posted by eleslie at 6:01 AM on March 6, 2018 [3 favorites]

One more point to add is that first aid is often a "shunt and dump" business: the casualty will get initial treatment from somebody who is local but not very qualified - they then get handed to the paramedics who have considerably more resources and experience . They might then go to a local hospital emergency ward - and perhaps even be moved to a bigger hospital for specialist treatment. Everybody in that chain wants to be able to do their thing and pass on the patient as quickly as possible and nobody wants to be the gooseberry left with a corpse.

On first aider training, I've heard the mnemonic "Dr ABC" a few times as a reminder of what to do in what order: Danger (anything preventing you for approaching the causality), Response (can you speak to them?), D+R - Doctor - call one, A - if no response then check airway, B if airway OK then check breathing, C - if breathing then check circulation. In most cases things get only get as far as "R" - and once you have a dialogue going then you keep the patient talking. You might have other things you can be doing to help them - but you keep them talking to provide reassurance to them and assurance to yourself that they are still with you.
posted by rongorongo at 10:38 AM on March 6, 2018

Another theory in addition to those above

Keeping a person awake also means that blood flow is increased. Increased blood flow will mean the drug will be removed from the system at a faster rate than when asleep. Its a small change but when we are talking overdose anything helps.
posted by Takeyourtime at 10:12 AM on April 11, 2018

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