Is Acupuncture Safe in Patients with Morphine Hypersensitivity?

Acupuncture is a well recognised method of providing pain relief. The case of a known morphine-sensitive patient is reported, who apparently suffered a hypersensitivity reaction (nausea, headache and lethargy) to a single treatment with acupuncture, possibly due to the increased release of endogenous opioid peptides. It is suggested that acupuncture should either be avoided or administered with caution in patients known to be sensitive to morphine or opiate derivatives.

Designer Drugs of Abuse

Designer drugs of abuse represent a major health risk to those who use them. The toxic effects of these agents are very dangerous when they are correctly identified, but they are especially dangerous because they are often misidentified by emergency room personnel. The three groups of designer drugs are the opiates, amphetamine derivatives and phencyclidine derivatives. Amphetamine derivatives such as MDMA and MDA can cause fatal sequelae including hyperthermia, hypertension, and seizures. No specific antidote exists for these agents. Therefore, their widespread use in certain areas is a major concern. The opiate derivatives M PPP, MPTP and the fentanyl analogues produce a wide range of toxic effects. These agents are much more potent than heroin, and are sometimes sold as heroin unknowingly to the user. The results have been catastrophic, with many fatalities. Arylhexylamines such as phencyclidine and ketamine are becoming more popular as agents of abuse. These drugs may result in fatal toxicity resulting from cardiac arrest, hypertensive emergency, or status epilepticus. Familiarity with the signs and symptoms of toxicity from the designer drugs will expedite the care of these patients.