datura poisoning

Toxicity

All Datura plants contain tropane alkaloids such as scopolamine, hyoscyamine, and atropine, primarily in their seeds and flowers. Because of the presence of these substances, Datura has been used for centuries in some cultures as a poison and hallucinogen.^[2][3] There can be a 5:1 toxin variation across plants, and a given plant's toxicity depends on its age, where it is growing, and the local weather conditions. This variation makes Datura exceptionally hazardous as a drug. In traditional cultures, a great deal of experience with and detailed knowledge of Datura was critical in order to minimize harm.^[2] Many tragic incidents result from modern recreational users ingesting Datura. For example, in the 1990s and 2000s, the United States media contained stories of adolescents and young adults dying or becoming seriously ill from intentionally ingesting Datura.^[4][5] There are also several reports in the medical literature of deaths from Datura stramoniumand Datura ferox intoxication.^[6][7][8] Children are especially vulnerable to atropine poisoning, and their prognosis is likely to be fatal.^[9][10] In some parts of Europeand India, Datura has been a popular poison for suicide and murder. From 1950–1965, the State Chemical Laboratories in Agra, India investigated 2,778 deaths that were caused by ingesting Datura.^[2]

The U.S. Centers for Disease Control and Prevention reported accidental poisoning resulting in hospitalization for a family of six who inadvertently ingested Daturaused as an ingredient in stew.^[11]

In some places it is prohibited to buy, sell or cultivate Datura plants.^[2]

[edit]Effects of ingestion

Due to the potent combination of anticholinergic substances it contains, Datura intoxication typically produces effects similar to that of an anticholinergic delirium(as contrasted to hallucination): a complete inability to differentiate reality from fantasy; hyperthermia; tachycardia; bizarre, and possibly violent behavior; and severe mydriasis with resultant painful photophobia that can last several days. Pronounced amnesia is another commonly reported effect.^[12]

No other psychoactive substance has received as many "train wreck" (that is, severely negative experience) reports as has Datura. The overwhelming majority of those who describe their use of Datura find their experiences extremely mentally and physically unpleasant and often physically dangerous.^[12]

[edit]Treatment

Due to their agitated behavior and confused mental state, victims of Datura poisoning are typically hospitalized. Gastric lavage (stomach pumping) and the administration of activated charcoal can be used to reduce the stomach's absorption of the ingested material. The drug physostigmine is used to reverse the effect of the poisons. Benzodiazepines can be given to curb the patient's agitation, and supportive care with oxygen, hydration, and symptomatic treatment is often provided. Observation of the patient is indicated until the symptoms resolve, usually from 24–36 hours after ingestion of theDatura.^[13]