Signs and symptoms
Signs and symptoms of an overdose vary depending on the drug or exposure to toxins. The symptoms can often be divided into differing toxidromes. This can help one determine what class of drug or toxin is causing the difficulties. Symptoms of opioid overdoses include slow breathing, heart rate and pulse. Opioid overdoses can also cause pinpoint pupils, and blue lips and nails due to low levels of oxygen in the blood. A person experiencing an opioid overdose might also have muscle spasms, seizures and decreased consciousness. A person experiencing an opiate overdose usually will not wake up even if their name is called or if they are shaken vigorously. Causes
The drugs or toxins that are most frequently involved in overdose and death (grouped by ICD-10):

Added flavoring
Masking undesired taste may impair judgement of the potency, which is a factor in overdosing. For example, lean is usually created as a drinkable mixture, the cough syrup is combined with soft drinks, especially fruit-flavored drinks such as Sprite, Mountain Dew or Fanta, and is typically served in a foam cup. A hard candy, usually a Jolly Rancher, may be added to give the mixture a sweeter flavor. Diagnosis
The substance that has been taken may often be determined by asking the person. However, if they will not, or cannot, due to an altered level of consciousness, provide this information, a search of the home or questioning of friends and family may be helpful. Examination for toxidromes, drug testing, or laboratory test may be helpful.
Volkmanns contracture is a permanent flexion contracture of the hand at the wrist, resulting in a claw-like deformity of the hand and fingers. Passive extension of fingers is restricted and painful. Causes
Any fracture in the elbow region or upper arm may lead to Volkmanns ischemic contracture, but it is especially associated with supracondylar fracture of the humerus. It is also caused by fractures of the forearm bones if they cause bleeding from the major blood vessels of the forearm.The condition may be caused by obstruction on the brachial artery near the elbow, possibly from improper use of a tourniquet, improper use of a plaster cast, or compartment syndrome. Pathophysiology
Volkmanns contracture results from acute ischaemia and necrosis of the muscle fibres of the flexor group of muscles of the forearm, especially the flexor digitorum profundus and flexor pollicis longus. The muscles become fibrotic and shortened. Prevention
Prevention of the condition requires restoration of blood flow after injury and reduction of compartmental pressure on the muscles. Any splints, bandages, or other devices that might be obstructing circulation must be removed.A fasciotomy may be required to reduce pressure in the muscle compartment. Treatment
If contracture occurs, surgery to release the fixed tissues may help with the deformity and function of the hand. History
It is named after Richard von Volkmann (1830–1889), the 19th century German doctor who first described it, in a paper on "non-Infective Ischemic conditions of various fascial compartments in the extremities".