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Downers and Dual RecoveryDowners and Dual Recovery
How do depressant drugs affect How do depressant drugs affect mental health?mental health?
Downers (depressants) are…Downers (depressants) are…
Alcohol, Heroin, Benzodiazapine, ?Alcohol, Heroin, Benzodiazapine, ? All depress the Central All depress the Central
Nervous System (CNS)Nervous System (CNS) RReduce heart rate, breathing educe heart rate, breathing
rate, blood pressurerate, blood pressure Mild doses cause mild Mild doses cause mild
euphoriaeuphoria High doses can cause High doses can cause
depression, drowsiness, depression, drowsiness, confusion, lack of confusion, lack of coordination, irrational behavior coordination, irrational behavior
Effects of AlcoholEffects of Alcohol
Nervous SystemNervous System Alters, kills brain cells; impairs Alters, kills brain cells; impairs
memory, coordination, andmemory, coordination, and judgmentjudgment
Damages nerve connections, Damages nerve connections, causes irreversible damagecauses irreversible damage
Causes blackoutsCauses blackouts - no - no recollection of what was said recollection of what was said and done, but appearing to and done, but appearing to behave normallybehave normally
Effects of AlcoholEffects of Alcohol
Gastrointestinal System Gastrointestinal System irritates the stomach and digestive systemirritates the stomach and digestive system blocks absorption of essential nutrients, blocks absorption of essential nutrients,
contributes to malnutritioncontributes to malnutrition causes Gastritis (stomach lining causes Gastritis (stomach lining
inflammation)inflammation) causes ulcers in the stomach and first part causes ulcers in the stomach and first part
of intestineof intestine contributes to cancer development in lip, contributes to cancer development in lip,
esophagus, stomach, and liveresophagus, stomach, and liver causes Alcoholic Hepatitis, Cirrhosis, and causes Alcoholic Hepatitis, Cirrhosis, and
PancreatitisPancreatitis
Effects of AlcoholEffects of Alcohol
Circulatory SystemCirculatory System causes high blood pressurecauses high blood pressure
causes cardiomyopathy causes cardiomyopathy (deterioration of the heart muscle) (deterioration of the heart muscle)
Skeletal SystemSkeletal System
leeches Calcium from the bones; leeches Calcium from the bones; worsen existing osteoporosis worsen existing osteoporosis
reduces muscle mass reduces muscle mass
Effects of AlcoholEffects of Alcohol
Reproductive SystemReproductive System Men - reduces testosterone in men; Men - reduces testosterone in men;
breast enlargement, shrinking of breast enlargement, shrinking of testicles, impotencetesticles, impotence
Women - causes menstrual Women - causes menstrual irregularities, infertility, loss of sex drive irregularities, infertility, loss of sex drive
Causes Fetal Alcohol Syndrome, or Causes Fetal Alcohol Syndrome, or Fetal Alcohol Effects, if drinking while Fetal Alcohol Effects, if drinking while pregnantpregnant
Effects of AlcoholEffects of Alcohol
Immune SystemImmune System
impedes functioning of impedes functioning of immune system cellsimmune system cells
increases susceptibility to increases susceptibility to infectious diseases and infectious diseases and cancercancer
Alcohol WithdrawalAlcohol Withdrawal
Begins first several days after last useBegins first several days after last use
Causes anxiety, nausea, cravings, sleep Causes anxiety, nausea, cravings, sleep disturbances, difficulty concentrating, disturbances, difficulty concentrating, hallucinationshallucinations, , seizuresseizures, , delirium tremensdelirium tremens
Detoxification should be medically supervisedDetoxification should be medically supervised
Effects of HeroinEffects of Heroin
Euphoric, drowsy, and warm Euphoric, drowsy, and warm (being "high") feeling within (being "high") feeling within seconds of injectionseconds of injection
Slowed breathing, arms and Slowed breathing, arms and legs feeling heavy or weighted, legs feeling heavy or weighted, itchy skin, dry mouth, slowed itchy skin, dry mouth, slowed heartbeat, constricted pupils, heartbeat, constricted pupils, and feeling sickand feeling sick
Desire to sleep after the Desire to sleep after the euphoric effects euphoric effects
Effects of HeroinEffects of Heroin
Changed into morphine-like Changed into morphine-like chemical within the brain, chemical within the brain, which then binds quickly to which then binds quickly to opioid receptorsopioid receptors
Feelings of depression Feelings of depression caused when body's normal caused when body's normal production of brain chemicals production of brain chemicals that produce feelings of that produce feelings of pleasure, are impairedpleasure, are impaired
Heroin WithdrawalHeroin Withdrawal
Begins 6 - 8 hours after Begins 6 - 8 hours after last use, most severe last use, most severe around 48 to 72 hours around 48 to 72 hours after, lasts for about one after, lasts for about one weekweek
Symptoms compared to a Symptoms compared to a bad case of the flu bad case of the flu depending on use historydepending on use history
Elevations in blood Elevations in blood pressure, pulse, respiratory pressure, pulse, respiratory rate and temperaturerate and temperature
Heroin WithdrawalHeroin Withdrawal
Goose bumps, watery eyes, Goose bumps, watery eyes, runny nose, yawning, loss of runny nose, yawning, loss of appetite, tremors, panic, chills, appetite, tremors, panic, chills, nausea, muscle crams, and nausea, muscle crams, and insomniainsomnia
DepressionDepression, so , so deep and deep and overwhelmingoverwhelming, that they are not , that they are not able to make it through the able to make it through the withdrawal processwithdrawal process
Methadone or Buprenorphine Methadone or Buprenorphine treatment used for detoxification treatment used for detoxification at some clinicsat some clinics
Effects of BenzodiazepinesEffects of Benzodiazepines
Versed (3 hrs), Librium (5-25 hrs), Versed (3 hrs), Librium (5-25 hrs), Xanax (6-12 hrs), Klonopin (18-50 hrs), Xanax (6-12 hrs), Klonopin (18-50 hrs), Valium (36-200 hrs), Ativan (10-20 hrs)Valium (36-200 hrs), Ativan (10-20 hrs)
Prescribed for short-term (up to 4 Prescribed for short-term (up to 4 months) relief of Anxiety, Panic months) relief of Anxiety, Panic Disorders, & InsomniaDisorders, & Insomnia
Long-term use problematic due to Long-term use problematic due to development of tolerance and development of tolerance and dependencydependency
Effects of BenzodiazepinesEffects of Benzodiazepines
BenzodiazepinesBenzodiazepines andand TranquilizersTranquilizers belongbelong toto thethe samesame classclass ofof drugs;drugs; Sedative-Sedative-HypnoticsHypnotics
ThereThere isis aa greatgreat potentialpotential forfor crosscross addictionaddiction withwith alcohol,alcohol, ifif tolerancetolerance isis alreadyalready developeddeveloped forfor thethe otherother
Benzodiazepine WithdrawalBenzodiazepine Withdrawal
Lasts 6 weeksLasts 6 weeks
HHigh level of psychological igh level of psychological problems (anxiety, agitation, problems (anxiety, agitation, insomnia, depression)insomnia, depression)
Serious physical problems; Serious physical problems; seizuresseizures
Detoxification should be Detoxification should be medically supervisedmedically supervised
1.1. SocializingSocializing
Feel less anxious around other people Feel less anxious around other people when usingwhen using
Feel pressured by others to useFeel pressured by others to use Helps to feel “normal” and “accepted” Helps to feel “normal” and “accepted”
by others; don’t feel they have a by others; don’t feel they have a mental illness or are different from mental illness or are different from others when usingothers when using
2.2. Self-medicationSelf-medication
(Reduce the effects of) unpleasant (Reduce the effects of) unpleasant symptomssymptoms
Might be temporarily effectiveMight be temporarily effective UUsually unsuccessful in the long runsually unsuccessful in the long run
Most common symptoms people report Most common symptoms people report using substances to self-medicateusing substances to self-medicate
depressiondepression anxietyanxiety sleep problemssleep problems nervousnessnervousness tensiontension hallucinationshallucinations medication side effectsmedication side effects loss of interestloss of interest
3.3. Pleasure enhancementPleasure enhancement
SSubstances are one of the few sources ubstances are one of the few sources of pleasure they experienceof pleasure they experience
Use because they believe it enhances Use because they believe it enhances other enjoyable activities other enjoyable activities
Very tempting to use because they are Very tempting to use because they are easy to get and effects are rapideasy to get and effects are rapid
4.4. Habit or routineHabit or routine
UUsing becomes part of a daily routine if sing becomes part of a daily routine if using for a long period of timeusing for a long period of time
Substance use is second natureSubstance use is second nature Use substances automatically, without Use substances automatically, without
much thought (like brushing teeth)much thought (like brushing teeth)
5.5. Relieving cravings or withdrawal Relieving cravings or withdrawal symptomssymptoms
Cravings for substances developed in Cravings for substances developed in individuals who use larger quantitiesindividuals who use larger quantities
May experience withdrawal symptoms if May experience withdrawal symptoms if they stop using suddenlythey stop using suddenly
UUse primarily motivated by the desire to se primarily motivated by the desire to avoid cravings or withdrawal symptomsavoid cravings or withdrawal symptoms
Consequences of Substance UseConsequences of Substance Use
BehavioralBehavioral Social relationshipsSocial relationships Work or role functioningWork or role functioning Money problemsMoney problems Legal problemsLegal problems Housing instabilityHousing instability DDangerous situationsangerous situations
Consequences of Substance UseConsequences of Substance Use
PhysicalPhysical Symptom relapseSymptom relapse Health problemsHealth problems
Long-Term Consequences (Addiction)Long-Term Consequences (Addiction)
PsychologicalPsychological Giving up important activitiesGiving up important activities Spending large amounts of time Spending large amounts of time
getting or using substancesgetting or using substances Using more of a substance than Using more of a substance than
plannedplanned Repeated attempts to cut down or Repeated attempts to cut down or
quitquit
Long-Term Consequences (Addiction)Long-Term Consequences (Addiction)
PhysicalPhysical ToleranceTolerance CravingsCravings Withdrawal symptomsWithdrawal symptoms
Principles of TreatmentPrinciples of Treatment
Medication adherenceMedication adherence Decreased stressDecreased stress Treatment of both Treatment of both
mental illness and mental illness and substance abusesubstance abuse
Individualized Individualized treatmenttreatment
CollaborationCollaboration
Principles of TreatmentPrinciples of Treatment
Dual diagnosis Dual diagnosis groupsgroups
Increased structureIncreased structure RehabilitationRehabilitation Self-help groupsSelf-help groups Individual therapyIndividual therapy
Principles of TreatmentPrinciples of Treatment
Motivational Motivational strategiesstrategies
Family support and Family support and problem solvingproblem solving
Keeping hope aliveKeeping hope alive
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