drugs & alcohol tuesday afternoon
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Drugs of Abuse
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Agenda
! What are the commondrugs of abuse?
! How are they used?! How can I detect use?! What problems do they
cause?
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Introduction
! Audience experience! Range of use/abuse
" Casual use" Misuse of medications" Abuse" Dependency
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Drug Use Facts in U.S.
! 22 million engage in binge drinking! 15.9 million currently use illicit
drugs
! 12 million currently use marijuana! 1.7 million currently use cocaine! 12.9 million have five or more
drinks per occasion, five or moretimes per month
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Drug Use Facts in U.S.
! About 100,000 deaths in the United Statesare related to alcohol consumption.
! Illicit drug abuse and related acquiredimmunodeficiency syndrome (AIDS) deathsaccount for at least another 12,000 deaths.
!In 1995, the economic cost of alcohol anddrug abuse was $276 billion. Thisrepresents more than $1,000 for everyman, woman, and child in the United States
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Drug Abuse (DSM IV)! Recurrent use resulting in a failure to
fulfill major role obligations at work,school, etc.;
! Recurrent use in potentially hazardoussituations;
! Recurrent legal problems related touse;
! Continued use despite persistentproblems of a social or interpersonalnature, caused or exacerbated by theuse of the substance.
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Drug Dependence (DSM IV)! Increased tolerance;! Development of withdrawal;! Taking larger amounts over longer
period than intended, developstolerance;
! Desire and/or inability to stop;! Excessive time spent in using
substances;! Interferes with normal daily activities;! Continued use despite consequences.
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Continuum Of Use
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Common Drugs Of Abuse! Alcohol! Marijuana! Cocaine / Crack! Hallucinogens (LSD, mushrooms,
etc.)! Medications
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Drug Classifications
! Alcohol! Cannabis! Stimulants! Depressants! Narcotics! Hallucinogens! Steroids
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Alcohol
! Not the most abused drug in theUS
! Effects executive function of forebrain
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Alcohol
! Ethyl Alcohol is chemical name! Liquid distilled from fruits, grain
and vegetables! Effects are intoxication, sensory
alteration, and anxiety reduction! Symptoms are staggering,
slurred speech, loss of coordination
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Alcohol
! Withdrawal includes" Sweating" Tremors" Altered Perceptions" Delirium Tremens (which can be
fatal) can cause psychosis, fearand hallucinations
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Alcohol
! Indications of Misuse" Confusion" Disorientation" Poor coordination" Involuntary release of urine or
feces" Sleepiness" Respiratory Depression" Death
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What is Marijuana
! The agent that effects change istetrahyocannabinol (THC)
! Usually called pot
! Produced from hemp plants
! Hashish is a resinous byproduct
! Marijuana is the tobacco like substance! Also known as cannabis
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What is Cannabis (Marijuana)
! Effects are:
" Euphoria followed by relaxation
" Impaired memory" Poor concentration
" Loss of coordination
" Vivid enhancement of most senses
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Cannabis
! Symptoms you may recognize
" Insomnia" Increased appetite (munchies)" Hyperactivity" Sensory exaggeration
" Mood exaggerations" The smell
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Cannabis (Marijuana)
! Withdrawal effects:
" Insomnia
" Hyperactivity
" Decreased appetite
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Stimulants
! Amphetamines
! Benzedrine
! Butyl Nitrite
! Dextroamphetamine
! Cocaine
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Stimulant Actions
! Used to increase alertness
! Relieve Fatigue
! Abusive and addictively desiredcharacteristics are euphoria, power,or relief from feeling down, or useof other medications which are
downers
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Stimulant Physiological Effects
! Average dosage brings
" Increased heart and respiratoryeffects
" Elevated blood pressure
" Dilated pupils
" Decreased appetite
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Stimulant Physiological Effects
! Overdose or long term consistentuse brings
" Rapid irregular heartbeat
" Blurred vision
" Dizziness
" Restlessness
" Anxiety
" Paranoia
" Death
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Stimulants: Indications of abuse
! Excessive activity or talkativeness! Irritability! Argumentativeness! High blood pressure! Increased pulse! Dilated pupils! Long periods without sleep! Euphoria
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Cocaine! Classified as a narcotic (although it isnt)! Causes increased alertness, ending with
psychosis if used for lengthy periods! Increases heart and respiratory rates,
increased BP, dilated pupils, perspiration,feelings of restlessness.
! Users go long periods without sleep and/oreating, are usually very talkative, irritable,and argumentative.
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Depressants
! Barbiturates
! Methaqualone
! Tranquilizers
! Chloral Hydrate
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Depressants
! Used medicinally to relieve anxiety,irritability, and tension.
! Tolerance develops very fast
! Intoxicant symptoms are similar toalcohol
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Depressants: PhysiologicalEffects
! Nothing bothers them
! Slurred speech
! Relaxed muscles
! Large doses = respiratorydepression, coma and death
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Depressants: Overdose Effects! Shallow respiration
! Clammy skin
! Dilated pupils
! Weak and rapid pulse
! Coma
! Death
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Depressants: Withdrawal
! Anxiety! Insomnia! Muscle tremors! Loss of appetite! Convulsions upon cessation of use! Delirium! Death
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Narcotics/Opiates
! Heroin! Morphine! Opium! Codeine! Oxycontin! Hydrocodone, Hydromorphone! Meperidine! Methadone (synthetic)
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Opiates
! Under classification of Narcotics! Used to relieve pain! Heroin is the morphine derivative
most commonly abused! Initial reactions are nausea and
vomiting! Then causes a euphoric high
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Opiate Withdrawal
! Watery eyes! Runny nose! Yawning! Cramps, Diarrhea! Loss of appetite! Chills and sweating! Piloerection (chicken skin)
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Opiates: Symptoms of Use
! Euphoria! Drowsiness! Respiratory depression! Pin Point Pupils
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Hallucinogens
! Phencyclidine (PCP)! LSD! Mescaline! Peyote! Psilocybin! Ecstasy and other designer drugs
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Hallucinogens
! LSD is most commonly abused hallucinogen! Hallucinogens produce behavioral changes
that are dramatic and of many dimensions! Effects are rapidly changing feelings,
sometimes violent and erratic behavior,hallucinations, illusions, paranoia, etc.
! There are no documented withdrawalsymptoms. Behavioral characteristicsnoted above fade with time.
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Hallucinogens - PCP! Use for long periods can lead to:
" Memory loss" Difficulties with speech and thinking" Depression" Weight loss" Mood Disorders" Symptoms can persist up to a year after stopping PCP
use.
! PCP has sedative effects! Interactions with other central nervous system
depressants, such as alcohol andbenzodiazepines, can lead to coma or accidentaloverdose .
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Steroids! Abused to improve performance in sports.! Attempt to increase their muscle size and/or
reduce their body fat.! Anabolic steroid abuse has been associated
with adverse side effects, such as acne andbreast development in men
! There are others that are life threatening, suchas heart attacks and liver cancer.
! Most are reversible if the abuser stops takingthe drugs, but some are permanent.
! Roid rage
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Newer Trends InAdolescent Drug Use
! Ecstasy! GHB! Rohypnol! Ketamine! Embalming Fluid
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Dealing With Addiction
! Do not fail to confront the obviousresults or consequences of substanceabuse with your employees and theirsupervisors;
! Expect resistance and denial, butconfront and educate in spite of theresistance;
! Offer help through SEAP referral, andstress the need for follow through.
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Short and Long TermProblems of Addiction
! Trauma! Psychiatric Instability! Intoxication! Acute Withdrawal! Drug Seeking! Loss of employment! Homelessness! Legal Involvement and/or Avoidance! Other medical conditions
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Drug Use Facts
! Of all workplace drug users whotest positive, 52% are daily users
! Employees who test positive fordrugs are:
" 60% more likely to responsible foraccidents,
" use 1/3 more sick leave" have many more unexcused absences.
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Scope of the Problem of Addiction
Nationally,! About 35% to 45% of emergency room
visits are in one form or another relatedto substance abuse or dependency;
! About 50% of traumas are related tosubstance abuse or dependency;
! About 47% of psychiatric admissionshave co-existing substance abuse ordependency disorders;
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Levels Of Care! Detoxification! Inpatient! Residential (halfway house)
! Partial hospitalization! Intensive outpatient program! Traditional outpatient
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Defense Mechanisms! In psychoanalysis, any of a
variety of unconsciouspersonality reactions which theego uses to protect theconscious mind from threateningfeelings and perceptions .
! They include projection, reactionformation, displacement, sublimation,and isolation.
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! Denial: an ego defense mechanism thatoperates unconsciously to resolveemotional conflict, and to allay anxiety byrefusing to perceive the more unpleasantaspects of external reality
" Denial by employee I dont have aproblem; feels persecuted; blamessupervisors for having it in for him/her
" Denial by supervisor - Hes a goodworker, and he promised me hellimprove his performance
Problems In Referral
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Problems in Referral
! Audience participation
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