Downers and Dual Recovery How do depressant drugs affect mental health?

Downers and Dual RecoveryDowners and Dual Recovery

How do depressant drugs affect How do depressant drugs affect mental health?mental health?

What comes to mind when you What comes to mind when you hear “Downers” ?hear “Downers” ?

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

ALCOHOLALCOHOL

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

Original “Palm Pilot”Original “Palm Pilot”


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


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


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


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

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

HEROINHEROIN

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


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

BENZODIAZEPINES BENZODIAZEPINES

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

Common Motives Common Motives for Use of for Use of

DepressantsDepressants

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 USECONSEQUENCES OF USE

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


Dual diagnosis Dual diagnosis groupsgroups

Increased structureIncreased structure RehabilitationRehabilitation Self-help groupsSelf-help groups Individual therapyIndividual therapy


Motivational Motivational strategiesstrategies

Family support and Family support and problem solvingproblem solving

Keeping hope aliveKeeping hope alive

Thank you for coming!Thank you for coming!

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Downers and Dual Recovery How do depressant drugs affect mental health?