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Substance Abuse and Substance Abuse and its Deadly its Deadly
ConsequencesConsequences
Nick van Terheyden, MDNick van Terheyden, MD
Latest InfoLatest Info
Binge Drinking Slows Teenage BrainsBinge Drinking Slows Teenage Brains Less Brian MatterLess Brian Matter Decreased learningDecreased learning Permanent destruction of White Brain Permanent destruction of White Brain
MatterMatter
Drug MythsDrug Myths I am stronger than the drugI am stronger than the drug
– I can control what others cannotI can control what others cannot
Drugs make me more creative/social Drugs make me more creative/social etc.etc.
Life is better stoned.Life is better stoned. Drugs do no permanent harm.Drugs do no permanent harm. What I do in my own time is my own What I do in my own time is my own
businessbusiness Doctors/counselors/authorities are liars.Doctors/counselors/authorities are liars. *** is *** is wayway safer than alcohol. safer than alcohol. I know a guy/girl who’s been doing this I know a guy/girl who’s been doing this
for years and s/he’s for years and s/he’s finefine……
Drug Stats IDrug Stats I
The illegal drug industry ranks The illegal drug industry ranks in size with Mobil Oil as the U.S. in size with Mobil Oil as the U.S. second largest business-only second largest business-only Exxon is larger.Exxon is larger.
Drugs and alcohol cost Drugs and alcohol cost taxpayers nearly $276 billion taxpayers nearly $276 billion dollars a year in preventable dollars a year in preventable health care costs, extra law health care costs, extra law enforcement, auto crashes, enforcement, auto crashes, crime, and lost productivity.crime, and lost productivity.
Drug Stats IIDrug Stats II
In 1999, an estimated 14.8 In 1999, an estimated 14.8 million Americans were current million Americans were current illicit drug users.illicit drug users.
There is an average of 1.5 There is an average of 1.5 million emergency room visits million emergency room visits per year because of drug use.per year because of drug use.
Five typical marijuana Five typical marijuana cigarettes have the same cigarettes have the same cancer-causing capability as 112 cancer-causing capability as 112 tobacco cigarettes.tobacco cigarettes.
StatisticsStatistics
America has only 5% of the world population but America has only 5% of the world population but consumes 60% of ALL illegal drugs produced in the worldconsumes 60% of ALL illegal drugs produced in the world
Each year, a typical young person in the United States is Each year, a typical young person in the United States is inundated with more than 1,000 commercials for beer inundated with more than 1,000 commercials for beer and wine coolers in addition to several thousand fictional and wine coolers in addition to several thousand fictional drinking incidents on television. drinking incidents on television.
Alcohol is involved in 50% of all driving fatalities.Alcohol is involved in 50% of all driving fatalities. Almost half of Americans ages 12 and older reported Almost half of Americans ages 12 and older reported
being current drinkers of alcohol. This translates into being current drinkers of alcohol. This translates into 105 million people.105 million people.
In the next 30 days, 17% of all 7In the next 30 days, 17% of all 7thth graders will use graders will use alcohol. 25% of all 9-12alcohol. 25% of all 9-12thth graders will use enough to be graders will use enough to be defined as heavy drinkers.defined as heavy drinkers.
Every 40 minutes, a kid is arrested for drunk drivingEvery 40 minutes, a kid is arrested for drunk driving
Narcotics (Opioids)Narcotics (Opioids)
HeroinHeroin MorphineMorphine CodeineCodeine HydrocodoneHydrocodone HydromorphHydromorph
oneone
OxycodoneOxycodone MethadoneMethadone MeperidineMeperidine FentanylFentanyl PropoxyphenPropoxyphen
ee
EFFECTSEFFECTS
CNS effectsCNS effects– AnalgesiaAnalgesia– DrowsinessDrowsiness– Mood changesMood changes– EuphoriaEuphoria– respiratory depressionrespiratory depression
vomitingvomiting slows gastrointestinal motilityslows gastrointestinal motility No good correlation between No good correlation between
blood concentrations and blood concentrations and lethalitylethality
CocaineCocaine
COCAINECOCAINE Popular recreation drugPopular recreation drug brain becomes tolerant which brain becomes tolerant which
results in the need for more and results in the need for more and moremore– HeadacheHeadache– ExhaustionExhaustion– ShakingShaking– Blurred visionBlurred vision– NauseaNausea– ImpotenceImpotence
Cocaine - Pharmacologic EffectsCocaine - Pharmacologic Effects
CNS stimulationCNS stimulation– euphoriaeuphoria
– hyperactivityhyperactivity
– restlessnessrestlessness
elevation of blood pressure and heart rateelevation of blood pressure and heart rate hyperthermiahyperthermia dilatation of pupils of eyesdilatation of pupils of eyes nausea and vomitingnausea and vomiting Cardiac arrhythmiasCardiac arrhythmias
Cocaine affects the BrainCocaine affects the Brain
……study of K. Little et al; study of K. Little et al; Am J Psychiatry on post Am J Psychiatry on post mortem brain tissue of mortem brain tissue of chronic users – chronic users – dopamine transporter dopamine transporter proteins (VMAT2) proteins (VMAT2) reducedreduced
Ken CaminitiKen Caminiti
Recovering AlcoholicRecovering Alcoholic 4 failed drug tests since 4 failed drug tests since
2002 for cocaine possession2002 for cocaine possession Died from massive heart Died from massive heart
attack @ age 41, Oct. 2004.attack @ age 41, Oct. 2004. ““When asked how someone When asked how someone
so fit and disciplined in his so fit and disciplined in his sport could be so reckless sport could be so reckless with alcohol and drugs, with alcohol and drugs, Caminiti shook his head and Caminiti shook his head and said “I just don’t said “I just don’t understand…” understand…” sports illustrated, October 18, 2004sports illustrated, October 18, 2004
CrackCrack
CRACK MIXTURE OF BAKING CRACK MIXTURE OF BAKING SODA AND COCAINESODA AND COCAINE
smoked in glass water pipesmoked in glass water pipe HyperactivityHyperactivity ParanoiaParanoia powerful chemical powerful chemical
dependence occurs dependence occurs
Psychedelics And Psychedelics And HallucinogensHallucinogens
PeyotePeyote MescalineMescaline LSD LYSERGIC ACID LSD LYSERGIC ACID
DIETHYLAMIDE “Trips” Trigger DIETHYLAMIDE “Trips” Trigger Panic, Depression, Confusion, Panic, Depression, Confusion, Fear Of Insanity, Distorted Fear Of Insanity, Distorted Thoughts And PerceptionsThoughts And Perceptions
PCP Phencyclidine “Angel Dust” PCP Phencyclidine “Angel Dust” Behaviorally Toxic -Psychotic Behaviorally Toxic -Psychotic Attacks Temporary InsanityAttacks Temporary Insanity
Lysergic Acid Lysergic Acid Diethylamide (LSD)Diethylamide (LSD)
The “High”: The “High”: Visual Visual hallucinationshallucinations
Serious Risks: Serious Risks: Possible Possible “flashbacks”; “flashbacks”; poor judgment poor judgment leading to leading to accidents accidents (crashes, (crashes, jumping off high jumping off high places)places)
Dilated pupilsDilated pupils higher body higher body
temperaturetemperature increased heart rate increased heart rate
and blood pressureand blood pressure SweatingSweating loss of appetiteloss of appetite SleeplessnessSleeplessness dry mouthdry mouth TremorsTremors NumbnessNumbness WeaknessWeakness TremblingTrembling NauseaNausea hallucinationshallucinations
Phencyclidine - Pharmacologic EffectsPhencyclidine - Pharmacologic Effects
hallucinogenhallucinogen slurred speechslurred speech staggering gaitstaggering gait nystagmusnystagmus hyperthermiahyperthermia increased heart rate and blood increased heart rate and blood
pressurepressure hostile and bizarre behaviorhostile and bizarre behavior distorted sensory experiencedistorted sensory experience
““Crystal Crystal Meth”(Methamphetamine) Meth”(Methamphetamine) ((meth, crystal, ice, jib, crank, speed)meth, crystal, ice, jib, crank, speed)
Man made analog of amphetamine. Smokable. Made Man made analog of amphetamine. Smokable. Made in basement labs.in basement labs.
Meth contains a lot of dangerous chemicals.Meth contains a lot of dangerous chemicals. Triggers massive release of dopamine – intense Triggers massive release of dopamine – intense
“rush”“rush” Neurotoxic in animal models – destroys dopamine Neurotoxic in animal models – destroys dopamine
and serotonin neurons - Long term damageand serotonin neurons - Long term damage Predisposition to neurodegenerative diseases later Predisposition to neurodegenerative diseases later
in lifein life EffectsEffects: Anxiety, rapid heart beat, sweating, energy.: Anxiety, rapid heart beat, sweating, energy. Serious RisksSerious Risks: Violence/aggression, hallucinations, : Violence/aggression, hallucinations,
paranoia, heart attack, HIV and other transmittable paranoia, heart attack, HIV and other transmittable diseases, nerve damage, chronic depression, tooth diseases, nerve damage, chronic depression, tooth loss, gum disease.loss, gum disease.
EcstasyEcstasy
MDMA – “E”MDMA – “E” MethylenedioxyamphetamineMethylenedioxyamphetamine Hallucinogen, (euphoria, depression)Hallucinogen, (euphoria, depression) Effects last 4-6 hours, after effects last weeks to monthsEffects last 4-6 hours, after effects last weeks to months Works on serotonin system (mood)Works on serotonin system (mood) May damage neurons permanently after 1 useMay damage neurons permanently after 1 use Addictive potential like very weak cocaineAddictive potential like very weak cocaine Malignant hyperthermiaMalignant hyperthermia chronic paranoid psychosischronic paranoid psychosis cardiac arrestcardiac arrest coagulopathycoagulopathy
EcstasyEcstasy EffectsEffects: Increased energy, nausea, : Increased energy, nausea,
hallucinations, chills, sweating, shaking, hallucinations, chills, sweating, shaking, blurred vision, rapid heart beat, high blurred vision, rapid heart beat, high blood pressure, muscle cramping.blood pressure, muscle cramping.
Serious RisksSerious Risks: Heat stroke, severe : Heat stroke, severe dehydration, possible changes in brain dehydration, possible changes in brain functioning, memory problems, serious functioning, memory problems, serious depression.depression.
Eventually, you “run out” of Serotonin, Eventually, you “run out” of Serotonin, regardless of how much you take.regardless of how much you take.
InhalantsInhalants
Chemicals that produce vapors Chemicals that produce vapors with psychoactive effectswith psychoactive effects
Solvents, aerosols, cleaning Solvents, aerosols, cleaning fluids, and petroleum productsfluids, and petroleum products
Local irritation to nose and Local irritation to nose and upper respiratory tract, upper respiratory tract, nosebleeds, loss of nosebleeds, loss of coordination, loss of appetite coordination, loss of appetite
Decreased breathing and HRDecreased breathing and HR
InhalantsInhalants EffectsEffects:: NauseaNausea SneezingSneezing FatigueFatigue CoughingCoughing nose bleedsnose bleeds rapid pulserapid pulse HeadachesHeadaches involuntary release involuntary release
urination or fecesurination or feces impaired judgmentimpaired judgment
Serious Risks:Serious Risks: Violent behaviorViolent behavior loss of consciousnessloss of consciousness loss of feeling in hands and loss of feeling in hands and
feetfeet Kidney damageKidney damage brain damagebrain damage loss of smellloss of smell Loss of hearingLoss of hearing Loss of memoryLoss of memory Loss of bone marrowLoss of bone marrow hepatitishepatitis
Drug Abuse Related Toxicity
HIV (Human Immunodeficiency Virus) HIV (Human Immunodeficiency Virus) infectioninfection
AIDS (Acquired Immunodeficiency AIDS (Acquired Immunodeficiency Syndrome)Syndrome)
In large cities perhaps 40-50% of IV In large cities perhaps 40-50% of IV drug users test positive for HIV.drug users test positive for HIV.
Sharing of needles and syringes is Sharing of needles and syringes is primarily responsible.primarily responsible.
Hepatitis B - Another blood-borne Hepatitis B - Another blood-borne disease responsible for 100s of deaths disease responsible for 100s of deaths in IV drug abusersin IV drug abusers
All DrugsAll Drugs
All drugs are dangerous!All drugs are dangerous! With many of these drugs, there’s no way for the With many of these drugs, there’s no way for the
user to know:user to know:– who made the drugwho made the drug– what the ingredients arewhat the ingredients are– how much of an ingredient the drug containshow much of an ingredient the drug contains
Because of these unknowns, the drug’s effects Because of these unknowns, the drug’s effects can be very unpredictablecan be very unpredictable
BAC – Blood Alcohol BAC – Blood Alcohol Concentrations. Measured in Concentrations. Measured in grams/100 ml blood.grams/100 ml blood.
..01 – marked increase in sleepiness. Impairs sleep.01 – marked increase in sleepiness. Impairs sleep. .02 – decreased ability to understand commands, esp. .02 – decreased ability to understand commands, esp.
radio.radio. .03 risk of fatal MVA 1.5x normal.03 risk of fatal MVA 1.5x normal .05 – too impaired to operate a vehicle. 24 hour .05 – too impaired to operate a vehicle. 24 hour
suspension. Poor speed/distance perception. Poor suspension. Poor speed/distance perception. Poor problem solving skills. Fatal MVA 2 x normal.problem solving skills. Fatal MVA 2 x normal.
.08 – “legally” impaired. Fatal MVA 4 x normal..08 – “legally” impaired. Fatal MVA 4 x normal. .1-.19 – neurologic impairment, reaction time, ataxia...1-.19 – neurologic impairment, reaction time, ataxia.. .2-.3 – severe impairment.2-.3 – severe impairment .4 – hypothermia, stage 1 anesthesia, aspiration.4 – hypothermia, stage 1 anesthesia, aspiration .5-.8 – onset of coma, death.5-.8 – onset of coma, death
Ethanol (Alcohol)Ethanol (Alcohol)
CNS depressionCNS depression– impaired judgementimpaired judgement– depressed learned social and cultural depressed learned social and cultural
inhibitionsinhibitions– impaired self evaluationimpaired self evaluation– euphoriaeuphoria– memory loss memory loss – shortened attention spanshortened attention span
blurred visionblurred vision nystagmusnystagmus impaired hearingimpaired hearing reduced muscle coordinationreduced muscle coordination
December 1999December 1999
The car in which Jacqueline was in was hit by another car that was driven by a 17-year old male student on his way home after drinking a couple of hard packs with his friends
She Suffered 60% BurnsShe Suffered 60% Burns
Jacqueline was caught in the burning car and her body was heavily burnt during around 45 seconds. After the accident Jacqueline has needed over 40 operations
Lifelong TreatmentLifelong Treatment
Without a left eyelid Jacquie needs eye drops to keep her vision
Marihuana EFFECTSMarihuana EFFECTS
euphoriaeuphoria sleepinesssleepiness impaired short-term memoryimpaired short-term memory impaired balanceimpaired balance altered time perceptionaltered time perception impaired multi-taskingimpaired multi-tasking Hashish extract of cannabis 2 to Hashish extract of cannabis 2 to
10 times more potent than 10 times more potent than marijuanamarijuana