Methamphetamine is a common name for amphetamine or methamphetamine. This substance, derived from ephedrine hydrochloride, is also known as "amphetamine" along with Ritalin and dextroamphetamine.

Unlike regular opioid tranquilizers, anandamide is a potent central nervous system stimulant. It stimulates neurons in the locus coeruleus, striatum and other parts of the human brain. As a result, the human body has involuntary increase in movement, hyperactivity, stereotyped movement, irritability and other behavioral and mental changes, and even self-harm.

This central stimulant was widely used in the military field during World War II. A large number of soldiers who take amphetamine become hyperactive and not afraid of death, do not need to rest, and do not even need much logistics - after taking amphetamine, the effect of the drug will suppress appetite.

In World War II, in addition to the United States, the only countries that widely used amphetamine as a military stimulant were Germany and Japan, the inventor of anandamide. Since 1920, when Japanese chemist Ayu Hedo first synthesized methamphetamine using ephedrine, the technology of extracting amphetamines using ephedrine in Japan has advanced by leaps and bounds. The concentration of the finished product can reach almost 100%. And the Japanese expatriates who immigrated to Hawaii with this skill discovered a significant demand for methamphetamine in the continental United States. In particular, after the United States further strengthened its control of methamphetamine in the mid-1980s, large quantities of underground homemade methamphetamine began to appear.

These products are under the control of local gangs and are flowing into the United States. At the same time, the method of making methamphetamine was also substituted in places such as the central United States and Mexico. And because of the relatively relaxed attitude towards drugs in the Western world, the problem of drug abuse has become more serious.

That's why there have been reported cases similar to Gao Yan in Hawaii Zhou. Rare cases of acute poisoning caused by methamphetamine (abbreviated MA) are characterized by high fever, extremely high creatine kinase, high cerebrospinal fluid pressure, and green urine. At the same time, people who abuse stimulants or tranquilizers generally become resistant to anesthesia - low doses are not effective in anesthesia and analgesics, and high doses are more likely to have adverse effects than the general population.

However, in the fourth central hospital, there is no means to detect whether there are methamphetamine metabolites in the urine. Although the Provincial Occupational Disease Prevention and Control Hospital has such technology, the time for the test results to come out is too slow. Only then did Sun Lien pay attention to the police station.

Unlike the Western world, China is arguably the country with the strictest attitude towards drugs. Grassroots police stations are basically equipped with a test artifact to combat drug abuse - rapid test strips.

Rapid test strips can test whether the person has used drugs in the past two weeks, and more than two weeks can be checked by hair. Judging from Gao Yan's onset of illness, he should have taken drugs about a week ago. It happens to be within the detection range of the rapid test strip.

"Test strips?" Lao Wu put down the rag in his hand and said vigilantly, "Yes, yes, what do you want this for?"

"The knife wound that was sent today, I suspect it may have been methamphetamine. "It is also part of the doctor's job to report to the police what they find to be a drug user. Sun Lien didn't have any other ideas about how to punish Gao Yan's drug use, he just wanted to quickly diagnose the disease and save his life - just 21 years old, there should be many possibilities for his life. It's a pity to die in a hospital bed like this.

"Methamphetamine?" Old Wu nodded thoughtfully, "You wait, I'll look for it." ”

The police room at the entrance of the Fourth Central Hospital is not large, about 20 square meters. In addition to office supplies, there are mainly several sets of steel forks and transparent shields and helmets used to control people. The police room, which was not very large, suddenly seemed a little cramped. Lao Wu bent down and searched around the police room, and finally found a small cardboard box from the drawer. But he didn't hand over the reagent to Sun Lien, but put it in his pocket. "Let's go, I'll go with you. ”

Lao Wu hung a law enforcement recorder next to his shoulder, followed Sun Lien, and shook all the way to the vicinity of the ICU. Considering that law enforcement may be obstructed, Lao Wu did not greet Gao Yan's parents who were waiting outside the door, but walked into the ICU first. Asked the little nurse at the duty desk for an unused paper cup, Lao Wu squatted down skillfully and released a little grass-green urine from Gao Yan's urine bag. Then the experiment was done with test strips.

Five minutes later, a distinct horizontal bar appeared on the C track on the test strip. Confirmed to be a positive reaction. After Lao Wu took a heavy shot of the reaction with the law enforcement recorder, he said to Sun Lien, "What should I do, can this patient's condition be stabilized?"

Sun Lien ignored the white eyes of the little nurse in the ICU, and was quickly using his mobile phone WeChat to notify Xu Yourong. While posting WeChat, he shook his head and said, "It's hard to say, he has been poisoned for a long time." Let's go to the treatment first, and let's take a cure. ”

Unsurprisingly, Gao's parents vehemently denied the fact that their son had used methamphetamine. The old couple looked at Sun Lien's eyes full of shock and resentment, and it was estimated that if they hadn't seen Lao Wu in a police uniform, they were afraid that they would come up and beat Sun Lien on the spot to relieve their grievances.

However, the rapid test does suggest that there is a high level of symptoms, and the symptoms of high severity do meet the characteristics of acute methamphetamine poisoning. Although there is a possibility of false positives in the rapid test, after all things considered, it is the most appropriate method to treat acute poisoning now.

"Adjust the treatment plan. Sun Lien has not dealt with acute methamphetamine poisoning, but Xu Yourong may have seen more OD (overdose) patients than Sun Lien has seen when he was an intern in the United States. She skillfully adjusted the content of Gao Yan's treatment, "Two grams of vitamin C with 200 ml of glucose. Lose once every 12 hours. Raise the total amount of rehydration and inject it at the standard of 8 liters per day. Xu Yourong's regimen was crude and direct, "200 milliliters of mannitol are injected intravenously every two hours. Got his kidneys up and worked. ”

No matter what kind of poisoning it is, getting the toxin out of the body as soon as possible is the first means of treatment. Vomiting when a person eats spoiled food is a naturally evolved means of eliminating toxins. And now it obviously doesn't make sense to get Gao Yan up from bed and vomit - methamphetamine is not taken orally, and too much time has passed. Now all doctors can do is speed up the metabolism in Gao Yan's body. Let the kidneys work desperately in the hope of being able to expel as much of the toxic substances from his body as possible.

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