An Invitation to HealthAn Invitation to HealthChapter 10Chapter 10

Drug Use, Misuse, and AbuseDrug Use, Misuse, and Abuse

Dr. Lana Zinger.

©2004 Wadsworth Publishing Co.

Drug TerminologyDrug Terminology

DrugDrug: any substance that alters the user’s any substance that alters the user’s ability to function, ability to function, Including over-the-counter drugs, prescription Including over-the-counter drugs, prescription medications, medications, and illegal substances.and illegal substances.Drug MisuseDrug Misuse: the intentional or inappropriate the intentional or inappropriate use of over-the-counter or prescribed use of over-the-counter or prescribed medications.medications.Drug AbuseDrug Abuse: excessive drug use that’s excessive drug use that’s inconsistent with accepted medical practice.inconsistent with accepted medical practice.

ToxicityToxicity: the dosage level at which a drug the dosage level at which a drug becomes poisonous to the body, causing either becomes poisonous to the body, causing either temporary or permanent damage.temporary or permanent damage.

Routes of Administration of Routes of Administration of DrugsDrugs

Drug-Drug InteractionsDrug-Drug Interactions

SynergisticSynergisticAdditiveAdditive

PotentiatingPotentiating AntagonisticAntagonistic

Commonly Misused Commonly Misused Over-The-Counter (OTC) DrugsOver-The-Counter (OTC) Drugs

AspirinAspirin Nonsteroidal Anti-Nonsteroidal Anti-

Inflammatory Inflammatory DrugsDrugs IbuprofenIbuprofen

Nasal SpraysNasal Sprays LaxativesLaxatives Eye DropsEye Drops Sleep AidsSleep Aids Cough SyrupCough Syrup

Prescription DrugsPrescription DrugsPotential ComplicationsPotential Complications

NonadherenceNonadherenceRecurrent infections, serious medical

complications, and emergency hospital treatment.

Physical Side EffectsPhysical Side EffectsHeart failure, heart attack, seizures, kidney and

liver failure, severe blood disorders, birth defects, blindness, memory problems, and allergic

reactions.

Psychological Side EffectsPsychological Side EffectsDepressive symptoms vs. agitation and anxiety.

Drug InteractionsDrug InteractionsOTC drugs, prescription drugs, alcohol, vitamins

and minerals, and food components.

Drug InteractionsDrug Interactions

Substance Use TerminologySubstance Use Terminology

ADDICTIONADDICTIONADDICTIONADDICTION The habitual use of substances, such as alcohol, psychoactive drugs, and nicotine, and also to compulsive behaviors, such as overeating.

The habitual use of substances, such as alcohol, psychoactive drugs, and nicotine, and also to compulsive behaviors, such as overeating.

DRUGDRUGABUSEABUSEDRUGDRUGABUSEABUSE

The use of chemical substances that results in physical, mental, emotional, or social impairment. The use of chemical substances that results in physical, mental, emotional, or social impairment.

DRUG DRUG MISUSEMISUSE

DRUG DRUG MISUSEMISUSE

The occasionally inappropriate or unintentional use of a medication.

The occasionally inappropriate or unintentional use of a medication.

PHYSICALPHYSICALDEPENDENCEDEPENDENCE

PHYSICALPHYSICALDEPENDENCEDEPENDENCE

When a person develops tolerance to the effects of a drug and needs larger and larger doses to achieve intoxication or another desired effect.

When a person develops tolerance to the effects of a drug and needs larger and larger doses to achieve intoxication or another desired effect.

PSYCHOLOGICALPSYCHOLOGICALDEPENDENCEDEPENDENCE

PSYCHOLOGICALPSYCHOLOGICALDEPENDENCEDEPENDENCE

A state in which individuals crave drugs to satisfy some personality or emotional need.

A state in which individuals crave drugs to satisfy some personality or emotional need.

Warning Signs Of A Warning Signs Of A Substance Use DisorderSubstance Use Disorder

An Abrupt Change In AttitudeAn Abrupt Change In AttitudeMood SwingsMood Swings

A Decline In PerformanceA Decline In PerformanceIncreased SensitivityIncreased Sensitivity

SecrecySecrecyPhysical ChangesPhysical ChangesMoney ProblemsMoney Problems

Changes in AppearanceChanges in AppearanceDefiance of RestrictionsDefiance of Restrictions

Changes in RelationshipsChanges in Relationships

What Causes Drug Dependence What Causes Drug Dependence and Abuse?and Abuse?

The Biology of DependenceThe Biology of Dependence Dopamine, glutamine, GABA, and norepinephrine.

The Psychology of VulnerabilityThe Psychology of Vulnerability Difficulty controlling impulses, a lack of values

that may constrain drug use, low self-esteem, feelings of powerlessness, denial, and depression or anxiety.

Early InfluencesEarly Influences Lower socioeconomic backgrounds, family

instability, a lack of realistic, rewarding alternatives and role models, and increased hopelessness.

Teen Drug UseTeen Drug Use Early use of tobacco and alcohol is linked with a

greater likelihood of marijuana use, which in turn increases the likelihood of other illegal drug use.

Dopamine Levels For Dopamine Levels For CocaineCocaine

Factors Influencing Student Factors Influencing Student Drug UseDrug Use

Race/EthnicityRace/Ethnicity

Perception of RiskPerception of RiskSexual IdentitySexual Identity

EnvironmentEnvironment Alcohol UseAlcohol Use

Common Drugs Of AbuseCommon Drugs Of Abuse

CannabiCannabiss

Club Drugs/ Club Drugs/ Designer Designer Drugs Drugs

StimulantsStimulants DepressaDepressantsnts

HallucinogHallucinogensens

InhalanInhalantsts

MarijuaMarijuanana

MDMA, MDMA, MDA, MDEAMDA, MDEA

RohypnolRohypnol

GHBGHB

AmphetamiAmphetaminesnes

CocaineCocaine

Tobacco/ Tobacco/ NicotineNicotine

AlcoholAlcohol

BarbituatBarbituateses

TranquiliTranquilizerszers

NarcoticsNarcotics/ Opioids/ Opioids

PCPPCP

LSDLSD

MescalineMescaline

SolventsSolvents, ,

AerosolAerosolss

NitratesNitrates

Nitrous Nitrous OxideOxide

CannabisCannabisMarijuana and HashishMarijuana and Hashish

The FactsThe Facts Marijuana is the most widely used illegal drug Marijuana is the most widely used illegal drug

in the United States (~12 million Americans).in the United States (~12 million Americans). Marijuana is a drug derived from the cannabis Marijuana is a drug derived from the cannabis

plant that contains the active ingredient THC.plant that contains the active ingredient THC. How Users FeelHow Users Feel

A mild sense of euphoria, a sense of slowed A mild sense of euphoria, a sense of slowed time, a dreamy type of self-absorption, and time, a dreamy type of self-absorption, and some impairment in thinking and some impairment in thinking and communicating.communicating.

The euphoria peaks within a half hour and The euphoria peaks within a half hour and usually lasts about three hours.usually lasts about three hours.

Potential for Potential for marijuana withdrawal syndromemarijuana withdrawal syndrome..

Some Bodily Effects of Some Bodily Effects of MarijuanaMarijuana

Do Students Want Marijuana Do Students Want Marijuana Legalized?Legalized?

Club Drugs (Designer Club Drugs (Designer Drugs)Drugs)

AlcoholAlcohol LSD LSD (acid)(acid)

MDMA MDMA (ecstasy)(ecstasy)

AmphetaminesAmphetamines

KetamineKetamine(Special K)(Special K)

FentanylFentanyl RohypnolRohypnol

GHBGHB

GBLGBL

Meth-Meth-amphetamineamphetamine

Club DrugsClub DrugsEcstasyEcstasy

The FactsThe Facts Ecstasy is the common street name for Ecstasy is the common street name for

methylenedioxymethamphetamine (MDMA).methylenedioxymethamphetamine (MDMA). MDMA belongs to a family of drugs called MDMA belongs to a family of drugs called

enactogensenactogens.. How Users FeelHow Users Feel

MDMA is a mood elevator which produces a MDMA is a mood elevator which produces a relaxed, euphoric state, but does not produce relaxed, euphoric state, but does not produce hallucinations.hallucinations.

The effects of MDMA begin in 45 minutes and The effects of MDMA begin in 45 minutes and last for 2 to 4 hours.last for 2 to 4 hours.

Club DrugsClub DrugsThe Risks of EcstasyThe Risks of Ecstasy

Psychological DifficultiesPsychological Difficulties Confusion, depression (neurotoxicity), sleep Confusion, depression (neurotoxicity), sleep

problems, drug cravings, severe anxiety, and problems, drug cravings, severe anxiety, and paranoia.paranoia.

Physical Symptoms/Side EffectsPhysical Symptoms/Side Effects Muscle tension, involuntary teeth clenching, Muscle tension, involuntary teeth clenching,

nausea, blurred vision, rapid eye movement, nausea, blurred vision, rapid eye movement, faintness, chills, sweating, and increased heart faintness, chills, sweating, and increased heart rate and blood pressure.rate and blood pressure.

Hyperthermia and hepatitis.Hyperthermia and hepatitis. Psychological DependencePsychological Dependence

Club DrugsClub DrugsGHB/GBLGHB/GBL

The FactsThe Facts GHB stimulates the release of human GHB stimulates the release of human

growth hormone, but has no known effects growth hormone, but has no known effects on muscle growth.on muscle growth.

When GLB, an industrial solvent, is When GLB, an industrial solvent, is ingested it is converted to GHB.ingested it is converted to GHB.

How Users FeelHow Users Feel Smaller doses induce euphoria and enhance

sex due to a rise in dopamine in the brain. Larger doses can cause individuals to pass

out and possibly fall into a coma.

Club DrugsClub DrugsThe Risks of GHB/GBLThe Risks of GHB/GBL

Side EffectsSide Effects Nausea, amnesia, hallucinations, decreased Nausea, amnesia, hallucinations, decreased

heart rate, convulsions, and sometimes heart rate, convulsions, and sometimes blackouts/coma.blackouts/coma.

Long Term Side EffectsLong Term Side Effects Withdrawal reaction including rapid heartbeat, Withdrawal reaction including rapid heartbeat,

tremor, insomnia, anxiety, and occasionally tremor, insomnia, anxiety, and occasionally hallucinations that last a few days to a week.hallucinations that last a few days to a week.

The danger is greatest when GHB is mixed with The danger is greatest when GHB is mixed with alcohol or opiates.alcohol or opiates.

Club DrugsClub DrugsKetamine (K)Ketamine (K)

The FactsThe Facts Ketamine is an anesthetic used by veterinarians.Ketamine is an anesthetic used by veterinarians. K blocks chemical messengers in the brain that K blocks chemical messengers in the brain that

carry sensory input thereby leading to carry sensory input thereby leading to hallucinations.hallucinations.

Side EffectsSide Effects At high doses, K can cause delirium, amnesia,

impaired motor function, high blood pressure, depression, and potentially fatal respiratory problems.

StimulantsStimulantsAmphetamines & MethamphetamineAmphetamines & Methamphetamine

The FactsThe Facts Amphetamines trigger the release of Amphetamines trigger the release of

epinephrine (adrenaline) which stimulates the epinephrine (adrenaline) which stimulates the central nervous system.central nervous system.

Methamphetamine is a powerful addictive Methamphetamine is a powerful addictive stimulant.stimulant.

Meth remains in the central nervous system and Meth remains in the central nervous system and the body, producing prolonged stimulant effects.the body, producing prolonged stimulant effects.

How Users FeelHow Users Feel Amphetamines produce a state of hyper-

alertness and energy. High doses make users feel wired: talkative,

excited, restless, irritable, anxious, and moody. Meth produces long-lasting toxic effects,

including psychosis, violence, seizures, and cardiovascular abnormalities.

StimulantsStimulantsAmphetamines & MethamphetamineAmphetamines & Methamphetamine Side EffectsSide Effects

Bingeing and crashing.Bingeing and crashing. Feelings of grandiosity, anxiety, tension, Feelings of grandiosity, anxiety, tension,

anger, agitation, paranoia, and impaired anger, agitation, paranoia, and impaired judgment.judgment.

Increased heart rate and blood pressure.Increased heart rate and blood pressure.

Long Term Side EffectsLong Term Side Effects Malnutrition, skin disorders, ulcers, Malnutrition, skin disorders, ulcers,

insomnia, depression, vitamin deficiencies, insomnia, depression, vitamin deficiencies, sexual dysfunction and impaired sexual dysfunction and impaired concentration or memory, and, in some concentration or memory, and, in some cases, brain damage.cases, brain damage.

CocaineCocaine An estimated 5 million people in the United An estimated 5 million people in the United

States use cocaine.States use cocaine. Cocaine is a white crystalline powder extracted Cocaine is a white crystalline powder extracted

from the leaves of the South American coca plant.from the leaves of the South American coca plant. Routes of AdministrationRoutes of Administration::

Smoked (freebasing/crack)Smoked (freebasing/crack) Sniffed/SnortedSniffed/Snorted Injected (speedballing)Injected (speedballing)

How Users FeelHow Users Feel Cocaine stimulates the central nervous system

producing feelings of soaring well-being and boundless energy.

After a brief period of euphoria, users slump into depression.

Forms of CocaineForms of Cocaine

Some Effects Of Cocaine On Some Effects Of Cocaine On The BodyThe Body

DepressantsDepressantsBenzodiazepines and BarbituratesBenzodiazepines and Barbiturates

The FactsThe Facts Benzodiazepines are sedative-hypnotics.Benzodiazepines are sedative-hypnotics. Commonly prescribed for tension, muscular Commonly prescribed for tension, muscular

strain, sleep problems, anxiety, panic attacks, strain, sleep problems, anxiety, panic attacks, anesthesia, and in the treatment of alcohol anesthesia, and in the treatment of alcohol withdrawal.withdrawal.

Rohypnol – date rape drug.Rohypnol – date rape drug. How Users FeelHow Users Feel

Low doses reduce or relieve tension, but may Low doses reduce or relieve tension, but may cause rapid mood changes, impaired cause rapid mood changes, impaired judgment, and impaired social and judgment, and impaired social and occupational functioning.occupational functioning.

High doses produce slurred speech, High doses produce slurred speech, drowsiness, and stupor.drowsiness, and stupor.

DepressantsDepressantsBenzodiazepines and BarbituratesBenzodiazepines and Barbiturates

Side EffectsSide Effects Physical and psychological Physical and psychological

dependence within two to four weeks.dependence within two to four weeks. Cross-tolerance.Cross-tolerance. Mood and behavior changes, slurred Mood and behavior changes, slurred

speech, poor coordination, unsteady speech, poor coordination, unsteady gait, involuntary eye movements, gait, involuntary eye movements, impaired attention or memory, and impaired attention or memory, and stupor and coma.stupor and coma.

Synergistic effect when used in Synergistic effect when used in combination with alcohol.combination with alcohol.

DepressantsDepressantsOpioids and Nonopioid Synthetic Opioids and Nonopioid Synthetic

DrugsDrugsOpiumOpium ““Mother drug”; A base compound for all Mother drug”; A base compound for all

natural narcotics. Creates euphoria and natural narcotics. Creates euphoria and escape from reality.escape from reality.

MorphiMorphinene

Main alkaloid found in opium; used medically Main alkaloid found in opium; used medically to kill pain and sedate. Ten times stronger to kill pain and sedate. Ten times stronger than opium.than opium.

HeroinHeroin Narcotic drug derived from morphine that is Narcotic drug derived from morphine that is 35 times stronger than morphine. Skin-35 times stronger than morphine. Skin-popping vs. mainlining.popping vs. mainlining.

CodeinCodeinee

A natural derivative of opium used as a A natural derivative of opium used as a cough suppressant or mild painkiller.cough suppressant or mild painkiller.

DilaudiDilaudidd

Semisynthetic derivative of morphine, Semisynthetic derivative of morphine, legitimately used as a cough suppressant and legitimately used as a cough suppressant and an analgesic for treating severe pain. an analgesic for treating severe pain.

PercodPercodanan

A semi-synthetic cough-suppressing and A semi-synthetic cough-suppressing and analgesic medication which is more potent analgesic medication which is more potent than codeine.than codeine.

DemerDemerolol

Short-acting synthetic narcotic used as an Short-acting synthetic narcotic used as an analgesic or a painkiller; usually injected.analgesic or a painkiller; usually injected.

DepressantsDepressantsOpioids and Nonopioid Synthetic DrugsOpioids and Nonopioid Synthetic Drugs

How Users FeelHow Users Feel All opioids relax the user, and impart All opioids relax the user, and impart

feelings of euphoria and provide pain feelings of euphoria and provide pain relief.relief.

Side EffectsSide Effects Addiction, lethargy, weight loss, loss of Addiction, lethargy, weight loss, loss of

sex drive, anxiety, insomnia and sex drive, anxiety, insomnia and restlessness.restlessness.

Overdose causes shock, coma, and Overdose causes shock, coma, and depressed respiration.depressed respiration.

Long Term Injection of OpioidsLong Term Injection of Opioids: infections : infections of the heart lining and valves, skin of the heart lining and valves, skin absesses, and lung congestion.absesses, and lung congestion.

Methadone MaintenanceMethadone Maintenance

HallucinogensHallucinogens

Natural Natural Sources of Sources of HallucinogensHallucinogens

Morning glories, jimsonweed, Morning glories, jimsonweed, nutmeg, mace, peyote cactus, and nutmeg, mace, peyote cactus, and psychodelic mushroomspsychodelic mushrooms

Synthesized Synthesized HallucinogensHallucinogens LSDLSD PCPPCP

LSDLSD: lysergic acid : lysergic acid diethylamide-24; a psychedelic diethylamide-24; a psychedelic drug that produces distorted drug that produces distorted reality. reality. PCPPCP: an anesthetic that blocks : an anesthetic that blocks nerve receptors from pain and nerve receptors from pain and temperature without producing temperature without producing numbness; angel dust.numbness; angel dust.

DefinitionDefinition: a group of mind-altering drugs that affect the brain and nervous system bringing about changes in thought,self-awareness, emotion and sensation.

InhalantsInhalants

ExamplesExamples Model airplane glue, gasoline, paint Model airplane glue, gasoline, paint thinner, transmission fluid, lighter thinner, transmission fluid, lighter fluid, liquid shoe polish, and fluid, liquid shoe polish, and fingernail polish remover.fingernail polish remover.

Potential Potential Side EffectsSide Effects

Gastroenteritis, depressed muscle Gastroenteritis, depressed muscle tone, damage to the liver and tone, damage to the liver and kidneys, nervous system kidneys, nervous system dysfunction, and bone marrow dysfunction, and bone marrow disorders.disorders.

DefinitionDefinition: drugs that produce vapors that cause psychoactiveEffects when inhaled or sniffed.

Treating Drug Treating Drug Dependence and AbuseDependence and Abuse

Recognize the reality of the Recognize the reality of the problem.problem.

Consult a physician, Consult a physician, counseling center, or local counseling center, or local mental health clinic.mental health clinic.

Intervention modalitiesIntervention modalities:: Medical careMedical care MedicationMedication DetoxificationDetoxification Individual psychotherapyIndividual psychotherapy Marital and family Marital and family

therapytherapy Behavior modificationBehavior modification 12-step programs12-step programs