Transcript PowerPoint 簡報

1. The financial loss because of drug abuse in HK last
year was__________________
4.3 billion dollars (0.3% of the gross domestic production)
2. What are the two most commonly abused chemicals?
Alcohol and cigarettes (smoking)
3. What are ‘Anaesthetics’ and ‘Analgesics’?
Anaesthetics are drugs that make the body unable to feel pain.
while analgesics are painkillers
Substance Abuse
Chemical Abuse?
Drug Abuse?
物質濫用
化學劑濫用?
藥物濫用?
 A pandemic problem – occurs in developed,
developing and under-developed
countries
 Abuse of psychotropic drugs is most
common
Psychotropic Drug Seizure in
Different Regions in 1990 and 1998
Region
1990
1998
(% Global Seizure)
East & South Asia*
22
41
Europe#
20
38
North America
14
18
*The amount of psychotropic substances seized reached 31.6 tones in 2000.
# The rise occurred mainly in Eastern Europe
(Source: United Nations Commission in Narcotic Drugs)
We do not use ‘drugs’, why should we study
“Drug abuse”?
 Drug abuse is an important social problem:
•
•
•
Causes heavy financial loss in society
Rapid increase in drug abusers recently
Related to organized crime or triad society activities
 Scientific issues:
•
•
•
How do drugs affect behaviour?
What are the effects of drug abuse?
Why do some people use drugs?
•
Do abusers idsplay any abnormal signs of habits?
Number of People Arrested for Drug Offences
major offences
minor offences
19
90
19
91
19
92
19
93
19
94
19
95
19
96
19
97
19
98
19
99
20
00
12000
10000
8000
6000
4000
2000
0
Year
6000
30
5000
25
4000
20
3000
15
數
人
2000
10
1000
5
0
0
1995
1996
1997
1998
1999
2000
濫用精神藥物者人數 Number of psychotropic substance abusers
濫用精神藥物者佔同年被呈報並備有藥物種類資料的人數百分比
% of psychotropic substance abusers among all individuals with type of
drug reported in that year
資料來源 : 藥物濫用資料中央檔案室
Source: Central Registry of Drug Abuse
Percentage
35
百分比
7000
No. of persons
濫用精神藥物者 (一九九五至二零零零年)
Psychotropic substance abusers (1995-2000)
Reasons for drug use
Reason
Percentage
Peer influence /to identify with peers
45.7
Avoid discomfort of its absence
45.7
Curiosity
27.5
To seek euphoria or sensory satisfaction
23.2
Relief of boredom/depression/anxiety
21.4
For self-medication
4.3
Under influence of the partner
1.4
Other reasons
2.5
資料來源: 藥物濫用資料中央檔案室
Source: Central Registry of Drug Abuse
什麼是藥物?
What is a drug?
A chemical used in the diagnosis, prevention or
treatment of diseases
A chemical used in the treatment of diseases
用作診斷、預防及治療疾病的化學劑
用作治療疾病的化學劑
All drugs should be used with extreme care
所有藥物必需小心使用
Adverse Effects of Drugs
藥物的不良作用
 Side (Undesirable) effects [副作用]
 Overdose toxicity [過量毒性 (過量性中毒)]
 Allergic reaction(s) [過敏性反應]
 Tolerance [耐藥性增加]
 Addiction [成癮]
Path Leading to Addiction (成癮)
 Experimental use
試探性使用
 Social use 社交性使用
 Episodic abuse 偶發性使用

 Tolerance
耐藥性增加
 Addiction 成癮
True or False ?
1. Drugs can be divided into ‘Hard’ and
‘Soft’ drugs???
No. All drugs have undesirable effects!
2. ‘Soft’ drugs will not cause addiction???
No. Misuse of any drug is harmful &
dangerous.
Possession of a ‘restricted’ drug/chemical,
in any form, is illegal
What are Club/Party Drugs?
 Mood/mind-altering
substances used by some teens and
young adults who attend rave parties, nightclubs,
karaoke clubs, etc
 Said to increase stamina (ability to endure physical and
mental strain) and intoxicating highs that are said to
deepen the rave or trance (hypnotic state) experience
 Some commonly abused club drugs in HK are:
MDMA (Ecstasy), Rohypnol, GHB & Ketamine.
 They exert their effects by acting on the brain
 Some of them are highly addictive
How Are Psychoactive Substances Taken?
 Sleeping pills & Amphetamines
Mouth  Stomach/Intestine  Blood  Brain
 Heroin
Injection  Blood  Brain
 Cocaine, Marijuana & Organic solvents
Inhaling or Sniffing  Nose  Respiratory
tract /Lungs  Blood  Brain
Note: Regardless of the routes, they all enter the brain and affect
brain functions and alter behaviour
1. Which of the following drugs would affect
behaviour: aspirin, Panadol, antibiotics
and heroin?
Heroin
2. Heroin alters behaviour by affecting ______
(an organ).
Brain
The ‘Central nervous system consists of
________ and ____________.
The brain and spinal cord
Central Nervous System
Brain
Controls all activities in our body
(like the CPU of a computer)
Structures: Brain & Spinal cord
Functions:
Brain: controls thinking &
behaviour
Spinal cord: Transmit signals
from the brain to other
parts and back
Spinal
cord
Frontal lobe:
Brain Function
cognition, judgment,
speech, thinking,
writing, etc
Temporal lobe::
memory, speech,
etc
Spinal cord:
convey motor &
sensory messages
Different areas perform different functions
Parietal lobe:
movement,
reasoning, memory,
etc.
Occipital lobe:
vision, etc
Cerebellum:
modulate motor
activities, etc
Neuron (Nerve cell)
 Neurons are building blocks of the nervous system
 There are 1-10 billion in the brain
 Neurons have many shapes
 They are specialized cells that transmit (carry)
signals in the nervous system (from one neuron
to another)
神經細胞
Neurons 神經細胞
Pre-synaptic neuron
突觸前細胞
細胞核
Nucleus
軸索(突)
Axon
Synaptic cleft
突觸裂隙
突觸後細胞
Post-synaptic neuron
Note: Neurons are not in direct contact with one
another
Psychotropic drugs 精神科藥物的分類
1. Narcotic analgesics (heroin, morphine)
止(鎮)痛藥 (鴉片類)
2. Depressants (benzodiazepines; ketamine)
鎮靜(抑制)藥 (十字架、氯胺酮)
3. Stimulants (amphetamines, caffeine)
興奮藥 (安非他明、咖啡因等)
4. Hallucinogens (marijuana; LSD)
幻覺藥 (大麻、黑芝麻 [LSD] 等)
5. Anti-psychotics (clozapines; haloperidol)*
治療精神病藥
*Rarely abused
Commonly Abused Drugs by Persons
of All Ages in HK (2001)
Drug
Heroin (海洛英)
Ketamine (氯胺酮)
Ecstasy (忘我)
Cannabis (大麻 )
Ice (冰)
Percent*
71.8
15.7
14.5
6.3
5.4
Total > 100% as some abusers use more than one type of drug
•Source: Central Registry of Drug Abuse 48th Report (2001),
Narcotics Division
Commonly Abused Drugs by Persons
Under 21 in HK (2001)
Drug
Ecstasy (忘我 )
Ketamine (氯胺酮)
Cannabis (大麻 )
Heroin (海洛英)
Ice (冰)
Percent*
56.6
56.4
14.3
14.2
10.6
*Total > 100% as some abusers use more than one type of drug
Source: Central Registry of Drug Abuse 48th Report (2001), Narcotics
Division
Sources of Drugs in Hong Kong
Heroin: Golden Triangle Mainland China*  HK
MDMA (Ecstasy): Europe  HK
Methylamphetamine (Ice): Mainland China*  HK
Cannabis: Golden Triangle & Cambodia 
Mainland China*  HK
Cocaine: South America  HK
Benzodiazepines (sleeping pills) & ketamine: Local
dispensary operators, medicine brokers &
unscrupulous medical practitioners
*Mainly through Guangdong Province
After a cup of black coffee or strong tea, you
feel awake and more alert. The major
chemical that causes these effects is_______.
Caffeine (咖啡因)
To heroin abusers, what are 『港紙』and
『美金 』?
???????? Will tell you later!
Narcotics analgesics (Opiates)
 They are pain-killers
 4 major forms: heroin (海洛英), morphine (嗎啡), opium
(鴉片) & codeine (可待因, cough syrup)
 Heroin is a white or brownish powder
 Heroin (diacetylmorphine) most potent and highly
addictive
Street heroins are diluted with sugar, starch, powdered
milk, quinine, caffeine, antipyrine, theophylline,
carbetapetane, acetaminophen (必理痛) or even
with strychnine or other poisonous substances
麻醉止(鎮)痛劑
Narcotics analgesics (Opiates)
 Heroin is usually injected, sniffed/snorted or smoked.
Effects: Intravenous injection > intramuscular
injection > sniffing or smoking [鼻吸或口吸(追
龍)]
 Street names:
• Heroin : smack, H, skag, junk, 白粉, 粉, 灰,
四仔, 港紙 (純度約15-65%), 美金 (純度約7090%)
• Codeine : MB, 高甸, 止咳水, 囉囉攣
• Methadone: 美沙酮, 蜜瓜汁
Short-term Effects of Heroin Abuse
 Euphoria ("rush")  warm flushing of the skin, a
dry mouth, and heavy extremities
 Clouded mental function
 Respiration depression  Death
 AIDS & hepatitis infection
 Pupil constriction
 Constipation
* Through use of common syringes & needles among addicts
海洛英
Long-term Effects of Heroin Abuse
 Collapsed veins, infection of the heart
lining and valves
 Liver & lung diseases
 Develop tolerance, physical dependence &
addiction
 AIDS and hepatitis*
* Through use of common syringes & needles among addicts
海洛英
Withdrawal Symptoms of Heroin Addiction
 Chills
 Sweating
 Runny nose and eyes
 Abdominal cramps
 Muscle pains
 Insomnia
 Nausea
 Diarrhea
海洛英
斷癮徵狀
1.What happens when you have too much
alcohol?
Drunk and don’t remember anything. WHY???
2. Which of the following is toxic: methyl alcohol
(wood alcohol) or ethyl alcohol?
Methyl alcohol
3. Why is ‘ketamine’[氯胺酮} called a date-rape
drug?
It is colourless, odourless and tasteless drug and can be slipped
into drinks to cause disinhibition in the unwitting victim.
鎮靜(抑制)藥
CNS Depressants
Sedative Hypnotic Compounds
What Are CNS Depressants?
 Chemicals that slow down normal brain
function
 Because of this property, some CNS
depressants are useful in the treatment
of anxiety and sleep disorders
Examples: Alcohol, Inhalants (organic
solvents & cigarette lighter fluid)
Ketamine*, Barbiturates* &
Benzodiazepines*
*Medicinal drugs
Ethyl Alcohol
 A non-selective depressant of the nervous system
 Used in social & recreational occasions
 One of most commonly used chemicals
 Absorbed rapidly in stomach/intestine
 70% is bactericidal (in 1-2 minutes)
 Alcohol content: beers (~5-10%), table wine (915%), spirit (40%)
Methyl alcohol (wood alcohol) is toxic.
酒精 (乙醇)
Do not drive if > 50 mg/100ml (or .05%). WHY?
Effects of Alcohol
  Social activities (short-term)
 Impaired psychomotor performance
 Chronic use  nutrients insufficiency*
 Damage to the CNS  memory loss
 Damage to the liver (fatty liver & liver cirrhosis)
 Death (accidents, respiratory control, etc)
* Loss of appetite & inability to absorb nutrients properly.
What Are Inhalants?
 Volatile substances that produce chemical vapors that
can be inhaled to induce psychoactive, or mindaltering, effects.
 Inhalant (Harmful) chemicals found in household
products:
toluene; methylene chloride; acetone; benzene;
isoamyl nitrate; isobutyl nitrite; butane; propane;
freon*; butane; isopropane etc
*A refrigerant.
溶解劑, 氣油和打火機氣體
How are inhalants used?
 “Sniffing” or “snorting” fumes from
containers
 Spraying aerosols directly into the nose
or mouth
 “Bagging”–sniffing or inhaling fumes
from substances sprayed or
deposited inside a plastic or paper
bag
溶解劑, 氣油和打火機氣體
Short-term Effects of Inhalants
 Low doses:
 Initial excitation  Disinhibition of behaviour*
 Drowsiness, Lightheadedness, & Agitation
 High doses:
 Anaesthesia  Loss of sensation, Loss of
respiratory control  Unconsciousness
 Death
* Inhibition of ‘inhibitory neurons’
溶解劑, 氣油和打火機氣體
Harmful Effects of Some Inhalants
Chemical
Harmful Effects
Amyl/Butyl nitrite  Immune function; death
Benzene
 Immune function; bone marrow injury; risk of
leukemia; death
Butane/Propane
 Heart function; death
Freon
Respiratory obstruction; death
Methylene
chloride
 Oxygen carrying capacity in blood;  heart
beat; death
Nitrous oxide
 Perception, heart function & muscle
coordination; death
Toluene
 Coordination & cognition; brain, liver and
kidney damage; death
Long-term Effects of Inhalants
 Dizziness, drowsiness, slurry speech, lethargy,
depressed reflexes, general muscle
weakness & stupor
 Impaired judgment & functioning in work or
social situations
 Belligerence (Aggressive behaviour)
 Apathy (Lack of interest & enthusiasm)
 Memory loss (permanent)
 Brain, kidney and liver damage  Death
溶解劑, 氣油和打火機氣體
What is ketamine?
 An anaesthetic used primarily for veterinary use
 Street names:‘Special K’, ‘Vitamin K’, ‘Lady K’,
‘Super K’, ‘K’, ‘OK’, ‘KO’
 Liquid (injection); in illicit use ketamine is generally
evaporated to form a powder that is snorted or
compressed into pills
 A ‘Date Rape’ drug (clourless, odourless & tasteless)
氯胺酮/K仔
Effects of ketamine
 Low doses:
 Sociability, euphoria, slurry speech, dry mouth,
respiration, racing heart
 Senses,  judgment, and  coordination (stumbling,
clumsy, or 'robotic' movement  delayed reaction
time, irrationality, violent or aggressive behavior)
 Nausea and/or vomiting (anaesthetic effects)
 Confusion, hallucination (visual, altered body image
& dreamy thinking)
氯胺酮/K仔
Effects of ketamine
 High doses:
 Oxygen supply to muscle and brain  Death
 Pregnancy:
Triggers widespread cell death in the brains of
developing rats
Not yet seen in humans
氯胺酮/K仔
1. Can you name two commonly (mis)used
stimulants?
Caffeine and nicotine (cigarette smoking)
2. Which is more dangerous: taking (smoking)
cocaine or cocaine and drinking alcohol?
Cocaine with alcohol. WHY???
3. Which is more dangerous: taking sleeping
pills with water or sleeping pills with
alcohol?
Sleeping pills with alcohol. Why????
Benzodiazepines苯二氮
類藥物
Types (Brand names) & Street names*
 Chlordiazepoxide [Librium, Librax, 利眠寧] -- 綠豆仔
 Diazepam [Valium, 安定] -- 羅氏五號; 羅氏十號
 Zopiclone, 佐匹克隆 -- 白瓜子
 Flunitrazepam [Rohypnol, 氟硝西泮, 氟硝安定] –
十字架
 Midazolam [Dormicum, 咪達唑侖, 速眠安] -- 藍精靈
Street names mainly derived from the shapes, colours and signs on the tablets
Short-term Effects of
Benzodiazepines
 At low doses:
  some types of behavior (talk more freely and
feel less shy)*
 At high doses:
 Depression and mood swings
 Impaired memory & thinking
 Sedative, psychomotor responses,  anxiety,
 respiration,  blood pressure,  heart rate
& induce sleep
* Inhibition of ‘inhibitory neurons’
Long-term Effects of Benzodiazepines
 Slurred speech, sleep disorders &





disorientation
Impaired memory & thinking
Develop mental diseases
Tolerance, addiction & withdrawal
Liver and kidney damage#
If taken during pregnancy, baby  addictive
# Liver is the major site of metabolism (detoxification) and kidney site of
excretion
What is GHB*?
[G水、迷暈水]
 Short form for gamma hydroxybutyrate
 A naturally occurring compound in human cells
 A colourless, odourless, bitter or slightly salty taste
liquid or in crystal powder form
 Causes changes in behaviour
 A ‘date-rape’ drug*
 An addictive substance
* Precautions: At parties, Never leave your drink unattended and take
bottled drinks only.
Short-term Effects of GHB
Low doses:
 Sense of well-being & relaxation
  Sociability & sense of touch
  Confidence &  inhibition (talk more freely)
 Drowsiness & headache
High doses:
 Confusion, agitation & hallucination
 Stiffening of muscle, disorientation
 Vomiting & convulsion
 Impaired movement & speech
 Unconsciousness, amnesia & respiratory collapse
Long-term Effects of GHB
 Physical and physiological dependence
(Addiction)
 Difficulty in sleeping
 Vertigo (Dizziness [頭暈])
 Worrisome chest pains
G水、迷暈水
Stimulants
Chemicals or drugs that increase
nervous system activity
興奮藥(劑)
Types of CNS Stimulant
 Caffeine (咖啡因; coffee)
 Nicotine (尼古丁; tobacco)
 Amphetamines * [安非他明(命) 類]
 Cocaine * (可卡因)
* Behaviour and mood altering drugs/chemicals
Caffeine
Sources: coffee, tea, cola drinks and chocolates
Effects: Slightly elevates pulse rate (1 cup/day)
Alertness and  Fatigue (1 cup or more)
 Loss of calcium in the urine (5 cups/day)
A possible human teratogen (>6 mg/kg)
 Calorie intake
Affect sleep patterns
Withdrawal: Headaches, gastrointestinal effect & diarrhea
咖啡鹼, 咖啡因
Nicotine (Smoking)
 Sources: Tobacco (1 cigarette contains 1-10 mg nicotine)
 Effects:
  heart rate, bloods pressure and stimulating
heart muscle (small doses)
 Affects respiration & inducing tremors, convulsion,
vomiting (large doses)
 Chronic smoking: emphysema, lung cancer (tobacco
contains tar), spontaneous abortion, etc
尼古丁 (煙草)
Amphetamine & Related Compounds
 3 major types: Amphetamine, Methamphetamine & Ecstasy
 Potency: Ecstasy > Methamphetamine > Amphetamine
 Methamphetamine – White/brownish crystalline powder;
street names: Meth, crystal meth, speed, ice, black
beauties, bennies, dexies, dextroamphetamine, beans,
crank, 冰 etc
 Ecstasy: Tablets/capsules in various shapes and colours;
street names: MDMA, X, ecstasy, Adam, XTC, hug,
beans, 亞 甲 二 氧 基 甲 基 安 非 他 明, 狂 喜, 忘 我
etc
安非他明類
Short-Term Effects of Amphetamine Abuse
  Activity & Attention
  Fatigue & Appetite
  Euphoria (Rush)
  Chills & Sweating
  Heart rate & Blood pressure
 Teeth clenching (involuntary)
 Blurred vision
 High doses  Schizophrenic symptoms
安非他明類
“Ecstasy” and “Ice”
Long-Term Effects of Amphetamine Abuse
 Dependence & Addiction
 Paranoia & Mood Disturbances
 Hallucinations
 Weight loss
 Stroke
 Brain damage
 Liver damage
安非他明類
“Ecstasy” and “Ice”
Cocaine
 A very strong stimulant
 A white powder
 Obtained from coca plant grown in South
America
 Taken by sniffing or injection
 Street names: coco, snow, crack, coke, etc
可卡因, 可可精, 古柯鹼
Effects of Short-term Cocaine Abuse
Low doses:
 Euphoric, energetic, talkative & mentally alert,
especially to sight, sound, and touch
 Loss of appetite & insomnia
 ↑ Temperature, heart rate & blood pressure
High doses:
 Bizarre, erratic & violent behavior
 Cardiac arrest or seizures ⇒ Respiratory arrest
⇒ Death.
可卡因, 可可精, 古柯鹼
Effects of Long-term Cocaine Abuse
 Tolerance & Addiction
 Irritability & Mood disturbance
 Toxic Psychosis
 Auditory hallucinations
 Heart & Kidney failure
可卡因, 可可精, 古柯鹼
Do Not take psychoactive drugs with alcohol!
Why?
1. Psychoactive drugs dissolve readily in alcohol
2. Pass thro’ the blood–brain barrier readily
3. Alcohol

+ psychoactive drugs
Alcohol  heart rate
 entry into the brain
 Overdose  Death
Effect of Multi-drugs
【Depressant + Stimulant】
Much Greater Effects
Brain death (植物人)
Death (死亡)
XXX
No Effect??
Stimulant + Depressant  0 Why?
Stimulant + Depressant  Death Why?
Different psychoactive Drugs:
 Affect different brain areas
 Affect different processes of transmission
Cocaine  Dopamine re-uptake
Benzodiazepines  GABA receptor
Which of the following is a synthetic
hallucinogen: LSD or marijuana [草]?
LSD
Where does the name ‘marijuana’ come from?
From Spanish Maria-Juana (Mary-Jane)
Do drug abusers show some easily recognizable
signs that they are taking drugs?
Yes, they do. Can you name some?
What Are Hallucinogens?
 Sometimes called ‘psychedelics’
 Substances that cause emotions to swing wildly
-- from real-world sensations to assume
unreal, sometimes frightening aspects
 People see images, hear sounds, and feel
sensations that seem real but do not exist
 Examples: LSD, marijuana (marihuana)
mescaline* (from cactus) , psilocybin*(from
magic mushrooms) & ibogaine* (from Star
Jasmine)
* Not common abused drugs in Hong Kong
迷幻藥
LSD
 Short form for ‘lysergic acid diethylamide’
 A synthetic compound
 Most potent hallucinogen
 A clear or white, odorless, water-soluble material
 No accepted medical use
 Taken orally (sometimes inhaled or injected)
 Highly addictive
麥角副酸二乙基 胺
迷幻藥
Short-term Effects of LSD
 Physical effects: numbness; muscle weakness and
trembling; rapid reflexes;  blood pressure,
heart rate, and temperature; impaired motor
skills and coordination; dilated pupils; nausea;
dizziness, loss of appetite, dry mouth, sweating,
and, occasionally, seizures
 Distorted perceptions of vision (unreal colors and
shapes); time (minutes seem like hours) &
distance
迷幻藥
Long-term Effects of LSD
 Tolerance (needs larger doses to produce similar effects)
 Mental disorders
1. Psychosis - the disorganization of a person's capacity to
recognize reality, think rationally, or communicate
with others
2. Hallucination – experiencing episodes of spontaneous,
repeated, sometimes continuous recurrences of some
of the sensory distortions originally produced by
LSD.
 Higher risk of spontaneous abortion and congenital
abnormalities in babies born to women who
regularly used LSD during pregnancy
迷幻藥
What is Marijuana?
 Grey mixture of dried, shredded leaves,
stems, seeds and flowers of hemp plant
 Hashish – a stronger form of marijuana
 A psychoactive substance
 Highly addictive
大麻、草
Short-term Effects of Marijuana
 Distorted perception (sights, sounds,
time & touch)
 Trouble with thinking & problemsolving ability
 Loss of coordination
  Heart rate & anxiety
大麻、草
Long-term Effects of Marijuana
 Tolerance and addiction
 Problem with memory and learning
 Breathing problems: emphysema & lung cancer
 Damage to the immune system
 May lead addict to other psychoactive substances
 Harmful to fetus if taken during pregnancy
大麻、草
Can you tell if a friend is using club drugs?

Problems remembering things they recently
said or did (Amnesia)

Loss of appetite &  body weight

Loss of muscle coordination, dizziness, fainting

Depression

Confusion

Sleep problems

Chills or sweating (for no medical reasons)

Slurred speech
Effects of Psychoactive Drug Abuse
 Addiction & Withdrawal
 Affects heart, kidney & liver functions
 Affects brain function
by interfering with neuronal transmission
 May cause Death (死亡)
 Impurities
 Overdose [Concentrations vary]
 Poly-drug use
Ways to say “No”
 Avoid places where drug-uses are likely
 Keep ‘suspected’ abusers at arm’s length
 When offered drugs:
 Say “No” decisively, and tell them the
harmful effects of drugs
 Change the subject or excuse yourself and
leave the place
 Accept the offer, and tell them that you
would like showing it to your
teachers/social worker at school/friends
 Other means……..
Highest penalties for drug-related crimes
Hong Kong:
Life imprisonment
Confiscation of properties
Mainland:
Death
Confiscation of properties