Three Wasatch Front teen-agers were admitted into intensive care at Pioneer Valley Hospital on Saturday night after ingesting seeds of jimson weed, a flowering poisonous plant common in Utah. The boys -- Kevin Simmons, 17, and Paul Butterfield, 13, both from West Valley City, and an unidentified 13-year-old from Bountiful -- are recuperating. They remained in the hospital Monday night in stable condition.
The teens broke open the thistle-like pods of the Datura stramonium plant -- also known as loco weed and Sacred Datura -- and swallowed the seeds inside. Within half an hour they started hallucinating, the effect they were told to expect from friends. What they weren't counting on was a trip to Pioneer Valley Hospital, said Kevin's mother, Sherrie Simmons. ``They had heard about this weed growing in the neighborhood, that they could eat the seeds and it would get them high,'' Sherrie Simmons said, adding that the plant was growing in her neighbor's yard.
The plant, featured on the book cover of artist Georgia O'Keeffe's 100 Flower Paintings, has white trumpet-like blossoms and blue-green spineless leaves. Paul Butterfield returned home with the other boy, and Kevin Simmons went into a downstairs room of his house. The Simmons and Butterfield parents noticed the youths were acting strangely, and soon it became apparent they were hallucinating. ``He couldn't even walk,'' said Paul's mother, Cheri Butterfield. ``He looked at me like he was scared to death.''
The boys confessed they had swallowed some seeds and were taken to the hospital. All three were admitted into the emergency room with rapid heart rates ranging from 110 to 140 beats per minute, irregular breathing, muscle twitches, dilated pupils and severe hallucinations, said Pioneer Valley doctor Peter Taillac. ``When they start having hallucinations, they get scared and the whole thing intensifies and it can be serious, it can cause seizures and it could cause death if enough is taken,'' said Doug Rollins, medical director of the Utah Poison Control Center.
``We're probably only seeing the tip of the iceberg. This is evidently a popular thing among high school students because they can get these plants everywhere. They need to know that there is a consequence of doing this, just like taking any other drug.'' Sherrie Simmons agreed. ``These kids know it's out there, they just don't know how poisonous it is. We've got to let others know what it's done to these three boys. If people have this plant on their property, they need to remove it.''
History shows more than a few lives have been taken by this plant, said Zell McGee, a professor of medicine and pathology at University of Utah and an expert on Datura stramonium. -- Five teens in Tasmania ingested the plant and all but one drowned in 6 inches of water after hallucinations convinced them they were fish. -- A federal disease control publication several years ago described how a woman and her husband died after she mistook a jar of the seeds for spice and sprinkled them on their salad. -- The name jimson weed is actually a contraction for Jamestown, Va., and derives from an incident where British soldiers guarding colonists noticed Indians eating loco weed and tried it and died. -- A Harvard anthropologist has described how voodoo doctors in Haiti used the plant to lower people's metabolisms so much they were believed to be dead and were buried alive. The doctors then would dig those people up, give them an antidote and awaken them to show their voodoo power -- bringing dead people back to life. The doctors then would give those people lower doses of poison to stifle their level of awareness. That left them in a stuporous, zombie-like state, and they were subsequently forced into slavery. ``In short, don't mess with this plant,'' McGee said. ``As a drug, it is too dangerous.'' © Copyright 1998, The Salt Lake Tribune
PRICE -- Three Wasatch Front teen-agers hospitalized last weekend after taking seeds of the jimson weed are not the only ones who have landed in the emergency room suffering from the physical and mental effects of the seeds.
In the past two weeks, a dozen teen-agers in Price have been to the hospital, two of them in intensive care, after becoming intoxicated from consuming parts of the plant. ``This is a really a big concern to us,'' Castleview Hospital nursing supervisor Bonnie Cook said Tuesday. ``It is really dumb and can be fatal. The problem is they don't know the dosage they are taking. At least with the common stupid drugs some kids take, there is a dosage.'' The three Wasatch Front teens who were admitted into the intensive-care unit at Pioneer Valley Hospital last weekend are out of ICU and were in stable condition at the hospital Tuesday night, said hospital spokeswoman Dawn Booth. A check of other Utah emergency rooms revealed only one other case of jimson-weed overdose, that of a 14-year-old admitted for two days at Primary Children's Medical Center in Salt Lake City in October 1997. Cook believes at least one of the Price teens ate the seeds from the plant's pods because they were found after the teenager's stomach was pumped. Signs of a jimson-weed overdose, according to Cook, include a red face, dry mouth, dilated pupils and hallucinations. ``They are red as a beet, dry as a bone, blind as a bat and mad as a hatter,'' she said. The biggest danger to a person from ingesting the plant is that the heart rate can increase to 110 to 150 beats per minute. ``It can lead to a fast heart rate, coma and sometimes death,'' said Cook. Once doctors verify the plant's presence in a patient through a urine test, the stomach is pumped. Sometimes people become so agitated that sedatives are needed to calm them down, said Cook. ``We had to restrain one boy because he kept trying to bite everyone around him,'' said Cook. ``Frequently they wake up and can't remember anything they did, which is sometimes a good thing. Hearing that you tried to bite someone would tend to be embarrassing.'' Cook said if parents notice their children staggering around, breathing fast, with dilated pupils and displaying strange, combative behavior, they should take them to a hospital emergency room immediately.
The plant is commonly called by several different names, including moon flower, angel's trumpet, loco weed, and datura. It grows in sandy soil, has large bluish-green leaves and produces a large white trumpet-shaped blossom this time of year. It has been used by some American Indian medicine men during ceremonies.Tribune reporter Norma Wagner contributed to this story. © Copyright 1998, The Salt Lake Tribune
Epidemiologic Notes and Reports Jimson Weed Poisoning -- Texas, New
York, and California, 1994 Ingestion of Jimson weed (Datura
stramonium), which contains the anticholinergics atropine and
scopolamine, can cause serious illness or death. Sporadic incidents
of intentional misuse have been reported throughout the United
States, and clusters of poisonings have occurred among adolescents
unaware of its potential adverse effects. This report describes
incidents of Jimson weed poisoning that occurred in Texas, New York,
and California during June-November 1994.
Texas
On June 19, 1994, the El Paso City-County Health and
Environmental District was notified of two male adolescents (aged 16
and 17 years) who had died from D. stramonium intoxication. On June
18, the decedents and two other male adolescents had consumed tea
brewed from a mixture of roots from a Jimson weed plant and alcoholic
beverages, then fell asleep on the ground in the desert. Family and
police found the decedents the following afternoon. The other two
adolescents reported drinking only small amounts of the tea: one
experienced hallucinations; the other had no signs or symptoms.
Neither was treated, nor were biologic specimens collected. Screening
of a toxicologic postmortem blood sample from one decedent detected
atropine (55 ng/mL) and a blood alcohol concentration (BAC) of 0.03
g/dL (in Texas, intoxication is defined as a BAC greater than or
equal to 0.1 g/dL). Analysis of the tea identified atropine,
ethanol, and scopolamine.
New York
On the morning of October 9, 1994, an 18-year-old man from Long
Island was brought to an emergency department (ED) by his mother
after she found him in his bedroom unclothed and hallucinating.
Reports from friends indicated he had ingested 50 Jimson weed seeds
and had used controlled substances (i.e., cocaine, "ecstacy," and
marijuana) at a party the previous night. On evaluation, the patient
was hallucinating and had fully dilated pupils, dry mouth, and
decreased bowel sounds. He became progressively agitated and was
sedated with intravenous diazepam and alprazolam. Hallucinations
continued for 36 hours. On October 11, he was discharged for
psychiatric counseling. He had a history of chronic substance abuse.
During October 8-November 15, a regional poison-control center was
contacted about this case and for information about 13 other
identified cases of Jimson weed intoxication. The mean age of the 14
patients was 16.8 years (range: 14-21 years), and eight were male. In
the five incidents for which quantity of Jimson weed exposure was
reported, ingestion ranged from 30 to 50 seeds per person.
Manifestations included visual hallucinations (12 persons), mydriasis
(10), tachycardia (six), dry mouth (five), agitation (four), nausea
and vomiting (four), incoherence (three), disorientation (three),
auditory hallucinations (two), combativeness (two), decreased bowel
sounds (two), slurred speech (two), urinary retention (one), and
hypertension (one). Four patients were treated and released from EDs,
six were hospitalized, three were admitted to an intensive-care unit
(ICU), and one refused medical care. Five of these patients were
treated with activated charcoal, one was administered gastric lavage,
and none received physostigmine.
California
On October 22, 1994, two male and four female adolescents (aged
15-17 years) with a history of drinking Jimson weed tea were
transported to an ED. Two persons were discharged from the ED; four
were admitted to the ICU because of symptoms that included headache,
fatigue, disorientation, fixed or sluggish dilated pupils,
tachycardia (heart rates greater than 120 beats per minute), and
hallucinations. These four patients were monitored with
electrocardiograms, treated with physostigmine and activated
charcoal, and discharged on October 23. The Los Angeles County
Forestry Division reported that fires in the Los Angeles area may
have promoted regrowth of Jimson weed in defoliated areas.
Reported by: DM Perrotta, PhD, Bur of Epidemiology, Environmental
Epidemiologist, Texas Dept of Health; LN Nickey, MD, El Paso
City-County Health and Environmental District, El Paso. M Raid, T
Caraccio, PharmD, HC Mofenson, MD, Winthrop Univ Hospital, Long
Island Regional Poison Control Center, New York; C Waters, Injury
Control Program, D Morse, MD, State Epidemiologist, New York State
Dept of Health. AM Osorio, MD, S Hoshiko, MPH, Div of Environmental
and Occupational Disease Control, GW Rutherford, III, MD, State
Epidemiologist, California State Dept of Health Svcs. Div of
Environmental Hazards and Health Effects, National Center for
Environmental Health, CDC.
Editorial Note: D. stramonium grows throughout the United States
and, historically, was used by American Indians for medicinal and
religious purposes. All parts of the Jimson weed plant are poisonous,
containing the alkaloids atropine, hyoscyamine, and scopolamine.
Jimson weed--also known as thorn apple, angel's trumpet, and
Jamestown weed (because the first record of physical symptoms
following ingestion occurred in Jamestown, Virginia, in 1676 [1])--is
a member of the nightshade family. The toxicity of Jimson weed varies
by year, between plants, and among different leaves on the same
plant. Although all parts of the plant are toxic, the highest
concentrations of anticholinergic occur in the seeds (equivalent to
0.1 mg of atropine per seed). The estimated lethal doses of atropine
and scopolamine in adults are greater than or equal to 10 mg and
greater than 2-4 mg, respectively (1,2).
Symptoms of Jimson weed toxicity usually occur within 30-60 minutes
after ingestion and may continue for 24-48 hours because the
alkaloids delay gastrointestinal motility. Ingestion of Jimson weed
manifests as classic atropine poisoning. Initial manifestations
include dry mucous membranes, thirst, difficulty swallowing and
speaking, blurred vision, and photophobia, and may be followed by
hyperthermia, confusion, agitation, combative behavior,
hallucinations typically involving insects, urinary retention,
seizures, and coma (3). Treatment consists of supportive care,
gastrointestinal decontamination (i.e., emesis and/or activated
charcoal), and physostigmine in severe cases (4).
In 1993, a total of 94,725 poisonings associated with toxic plants
was reported in the United States. Although most cases of
Jimson weed poisoning in the United States occur sporadically,
increased incidence or clustering of cases may follow press and
broadcast reports that heighten interest in--but do not emphasize the
adverse effects of--Jimson weed ingestion. In 1993, the American
Association of Poison Control Centers Toxic Exposure Surveillance
System received 318 reports of Jimson weed exposure. Although the
total number of reported exposures to Jimson weed did not rank among
the 20 most frequently reported exposures to poisonous plants (5),
telephone calls to poison-control centers about Jimson weed
poisoning are more likely than those about other hallucinogens to
prompt a need for medical care (6). Poisoning associated with Jimson
weed can be prevented through education of health-care providers and
by press and broadcast reports to the public that emphasize the
health hazards of Jimson weed ingestion, but that reduce access to
the plant by omitting detailed descriptions and drawings and
photographs.
References
1. Shervette RE, Schydlower M, Lampe RM, Fearnow RG. Jimson "loco"
weed abuse in adolescents. Pediatrics 1979;63:520-3.
2. Hooper RG, Conner CS, Rumack BH. Acute poisoning from
over-the-counter sleep preparations. Journal of the American College
of Emergency Physicians 1979;8:98-100.
3. Rumack BH. Anticholinergic poisonings: treatment with
physostigmine. Pediatrics 1973;52: 449-51.
4. Vanderhoff ST, Mosser KH. Jimson weed toxicity: management of
anticholinergic plant ingestion. Am Fam Physician 1992;46:526-30.
5. Litovitz TL, Clark LR, Soloway RA. The 1993 annual report of the
American Association of Poison Control Centers Toxic Exposure
Surveillance System. Am J Emerg Med 1994;12:546-84.
6. Klein-Schwartz W, Oderda GM. Jimson weed intoxication in
adolescents and young adults. Am J Dis Child 1984;138:737-9.
On October 18, 1983, after a husband and wife ate a meal of hamburger
prepared at home, the husband collapsed, and the wife telephoned for
an ambulance to take him to a local hospital. When the ambulance
arrived, the wife also became unconscious. Examination of the home
showed no carbon monoxide source. Within 24 hours, the couple regained
consciousness and explained the circumstances of their illness.
In preparing the hamburger, the wife added what she thought was
seasoning but later realized was seeds of Angels' Trumpets (Datura
suaveolens) that had been drying above the stove for planting the next
year. After removing most of the seeds from the cooked meat, the
husband and wife ate one hamburger patty each. Less than 1 hour later,
both began to hallucinate. Other symptoms were tachycardia and severe
diarrhea. Both recovered and were discharged after 3 days of
hospitalization. Reported in Canada Diseases Weekly Report 1984;10:45.
Editorial Note:
There are several species of Datura, and all are
poisonous, containing high levels (0.25%-0.7%) of anticholinergic
alkaloids, such as atropine, hyoscyamine, and scopolamine. Three
species are widely distributed in North America, but only one, D.
suaveolens, is cultivated as an ornamental flower. Poisoning through
the accidental mixing of seeds into food has been previously but not
recently reported (1). "Locoweed" teas made from other Datura species
have been used intentionally to produce hallucinatory effects (2).
Typical findings in Datura poisoning include pupillary dilation,
flushing, fever, amnesia, urinary retention, decreased salivation,
and, in contrast to the cases reported here, decreased intestinal
motility. In more severe poisoning, active hallucinations, extreme
agitation, cardiac arrhythmias, convulsions, delirium, stupor, or coma
may occur. Physostigmine, a reversible antiacetylcholinesterase agent,
may be useful in treating patients with central and peripheral
manifestations of anticholinergic crisis.
References
1.Riemann H, ed. Food-borne infections and intoxications. 1st ed.
New York: Academic Press, 1969.
2.Goldfrank LR, ed. Toxicologic emergencies: a comprehensive
handbook in problem solving. New York: Appleton-Century-Crofts, 1982.