DRUG ABUSE

History

• Drugs have been used in religious and healing ceremonies in ancient cultures

• Cocaine was in Coca Cola until 1927• Coca leaves were chewed by the guides over

the Andes in Peru• Most everyone has taken drugs, aspirin,

antibiotics, tylenol• 18 million people have used marijuana• 32 million have tried cocaine

– 4-5 million use it regularly

Drugs

• Drugs that work on the central nervous system to alter moods or perceptions are called psychoactive drugs

• For this lecture, drugs refer to a non food substance that is deliberately taken to produce some physiological or psychological effect

Process of Addiction

• Exposure – Introduction to the drug

• Compulsion – More energy, money, time spent getting the drug– Normal life disintegrates– Always searching for the high feeling

• Loss of control– Want the drug to avoid withdrawal

Terms

• Tolerance– Body become accustomed to the drug– Need larger doses to get the same effect

• Cross tolerance– Become tolerant to other drugs

• Alcoholics need higher doses of anesthetic drugs

• Dependence– Become so accustomed to the drug you can’t live

without it– May be psychological or physical dependence

Terms

• Psychological dependence– Do not become physically ill during withdrawal– You need the drug for your sense of well being

• Physical dependency– Go through withdrawal syndrome (nausea,

vomiting even seizures)– Body cells have become reliant on the drug and

continued use of the drug is necessary• Addiction– Indicates either a psychological or physical

dependence– Unable to control craving for the drug

Terms

• Withdrawal syndrome– Reflects the body’s attempt to regain normality

without the drug– Ranges from irritability, depression to seizures

and death

Why Take Drugs?

• Individual factors– Genetic predisposition

• Alcohol dependence

– Personality traits, attitudes and beliefs• Kids easily bored• Rebellious• Resist authority

– Low interpersonal skills and self esteem

Why Take Drugs

• Environmental factors– Home and family

• Parents model behavior that kids follow• Antisocial behavior at home

– School• Kids have hard time fitting in at school• Poor grades

– Peers• If you have friends who use drugs increases the chance

that you will too

Narcotics

• Used for pain relief• Morphine, opium, heroin, demerol, codeine,

methadone• Resembles endorphins body produces• Reduce pain• Mood changes• Euphoria• Unable to think clearly

Heroin

Narcotics

• High potential for dependency and addiction• Easily develop tolerance• Psychological and physical dependence• Withdrawal symptoms last 48-72 hours– Flu symptoms– Runny nose– Sweats– Nausea, vomiting– Muscle and bone pain

Narcotics

• By the 7-10 day withdrawal complete• Must treat the psychological addiction• May use methadone to ease withdrawal

symptoms

Depressants

• Central nervous system depressants• Decrease overall activity of nerves, muscles

and heart• Common depressants– Alcohol– Quaaludes– Barbiturates– Valium– Rophynol – date rape drug

• 10 times stronger then valium• Can last up to 8 hours

Depressants

• Valium is the most prescribed tranquilizer, 45 million prescriptions/yr

• Depressants– Decrease anxiety– Mood changes– Drowsiness

• Many depressants are initially medically prescribed and addiction follows

• May quickly develop an addiction and a tolerance– May tolerate up to 15 times the normal dose

• Both psychological and physical addiction

Depressants

• Withdrawal must be done under MDs care– Nervousness– Trembling– Weakness– Seizures– Hallucinations

• Barbiturate overdose combined with alcohol is a common way to commit suicide

Stimulants

• Caffeine– Coffee– Tea– Cocoa– Cola– No doz– Chocolate– Anacin

Stimulants

• Caffeine– Increased alertness– Stimulates heart rate and respiratory rate– High doses cause nervousness, irritability

• Ephedra– OTC herbal stimulant– Weight loss pills– Many have died taking ephedra overdose

Stimulants

• Amphetamines– Pep pills, uppers– Quickly develop a tolerance– Found in diet pills– Students, truck drivers use them to stay awake– When the drug wears off you suddenly fall asleep– Avoid the experimental stage and use it for a

specific reason which increases the chance for addiction

– Depression occurs during withdrawal– Must deal with psychological addiction

Stimulants

• Methamphetamines– Ice, crystal meth– Produced in illegal labs, kitchens

• Can be made with OTC cold medications, fertilizers, battery acid, and hydrogen peroxide

– Effects felt in first 7 seconds after smoked, injected, pills or snorted

– Effects last several hours– Chronic use

• Wt loss• Infections

– Psychological addiction– Withdrawal see fatigue, depression

Stimulants

• Cocaine– Originally from Andes to relieve fatigue– In the US by 1880s– Very addictive

• Can be – Snorted– Injected– Free based

• Effects do not last long– Repeat dose in 5-30 min especially for heavy

users

Stimulants

• Cocaine physical effects– Destroys users nose– Euphoria, impaired judgment– Seizures– Aneurysm due to high blood pressure

Cocaine

• Feels like bugs under your skin• Severe lung damage with heavy use• Heart attacks• Strokes• Life threatening arrhythmias• Decreased appetite, malnutrition• Acute paranoia

Stimulants

• Crack cocaine– Very addictive

• Only 50% able to kick the habit

– Cheap– Combines cocaine with baking soda and heated in

a pipe and vapors inhaled into the lungs– May be combined with heroin or

methamphetamine and given IV a speedball– Feel effects in 10 seconds and gone in 6 min

Stimulants

• Cocaine– Pregnancy• Devastating effects on fetus• Low IQ scores• Deficit in language skills

• Withdrawal symptoms include depression and lethargy, beware of suicide

• Psychological dependence

Hallucinogens

• Psychedelic drugs• Very popular in the 1960s• Generally do not cause physical dependence

but may cause psychological dependence

Hallucinogens

• LSD– Made in home labs– May be placed on blotter paper and then put into

the mouth– Physical symptoms include• Dizziness• Weakness• Visual disorders

Hallucinogens

• LSD– Psychological symptoms• Mood changes• Depersonalization• Alteration in the relationship between self and

external reality, known as an altered state of consciousness

– symptoms start within minutes of ingestion and last 6-9 hours

Hallucinogens

• LSD– “bad trips” caused by impurities in the

drug– Flashbacks may occur five years after the

initial bad trip

LSD

Hallucinogens

• PCP– Angel dust– Used as a large animal anesthetic– Lasts 4-6 hours– Low dose• Euphoria• Numbness• Slurred speech• Hostile behavior

Hallucinogens

• PCP– Large dose• Psychotic behavior• Violence• Seizures• Coma• Paranoia• Aggressive behavior• Unable to feel pain• Cardiovascular collapse• Damage to respiratory centers

Hallucinogens

• Designer Drugs–Made in illegal labs, uncontrolled,

dangerous– Produces a peaceful feeling–MDMA (ecstasy)• Illegal since 1985• Part of the club scene• About 8.1 million Americans have tried it• Affects serotonin and dopamine a neural

transmitters

Hallucinogens

• Designer Drugs– Ecstasy• Leads to Parkinsonian symptoms, trembling,

shaking with movement• High body temperatures up to 110 degrees

resulting in death• May lead to chronic depression• Strong psychological addiction occurs

Ecstasy

Marijuana

• 5000 year old history• Used as a pain reliever before aspirin• Euphoria, heightened sensory experience• THC active ingredient, fat soluble and may

stay in body tissue for a month• High probability of psychological

dependence, low probability of physical dependence

• Used for glaucoma, chemotherapy and AIDS patients

Marijuana

• Long term effects– Chronic abuse leads to amotivational syndrome– Chronic bronchitis and damage to lungs– Lung cancer• 400 chemicals in marijuana linked to lung

cancer– Lower testosterone levels and abnormalities in

sperm count– Alters menstrual cycle, low birth weight infants– Damages the immune system

Inhalants

• Huffing, sniffing, wanging• Found in about 1000 products – Correction fluid– Air fresheners– Sprays used to clean electronic keyboards

• Cheap, easy to obtain• Produces euphoria,• Depresses the central nervous system• Slows the heart rate and can kill you

Inhalants

• Signs to look for in abuse– Paint stains on clothing– Sores around the mouth– Chemical odor on the breath– Drunk, dazed appearance– Anxiety, excitability, irritability– Highest use in 7th and 8th grade

Prevention of Drug Use

• Education at the grade school level• Eliminate the demand for the drug• Early detection • Chronic users are very difficult to treat

Drug Testing

• Approx 70% of companies use drug testing• Tests 90% accurate• Drugs commonly tested– Amphetamines– Barbiturates– Valium– Marijuana– Opiates– PCP

Drug Treatment

• Relapse rate very high• Multiple dependencies – Addicted to multiple drugs and alcohol

• Counseling options– Most common is individual therapy– Group therapy – Family therapy– Crisis intervention– Detoxification– Chemotherapy (antibuse, methadone)