Transcript Identifying DUID - Summit Healthy Futures

Drug Classifications
Depressants – Alcohol, Marijuana,GHB (roofies),
Heroin
Stimulants – Ecstasy, Methamphetamine,
Cocaine
Hallucinogens – LSD, Psycobillin
Dissociative Anesthetics – Ketamine, PCP, DXM
Narcotic Analgesics – pain relievers
Inhalants
CNS Depressants
• Alcohol, Zanax, Prozac, GHB
• Slows the operation of the brain and CNS
CNS Stimulants
• Cocaine, Amphetamines, Methamphetamine,
Ritalin
• Speed up the brain
Hallucinogens
• Organic and synthetic substances: Peyote, LSD,
MDMA (Ecstasy)
• Impair ability to perceive reality
Dissociative Anesthetic
• PCP, Ketamine, Dextromethorphan
• May cause symptoms similar to Depressants,
Stimulants or Hallucinogens
Narcotic Analgesics
• Derivatives of opium – morphine, heroin,
codeine
• Pain relievers
Inhalants
• Any chemical in a gaseous state that may be
inhaled
• Household items that can be purchased
without a prescription
Pupil Observations
• Dilation
• Constriction
Depressants
Stimulants
Hallucinogens
Dissociative
Anesthetics
Narcotic
Analgesics
Inhalants
Cannabis
HGN
Present
None
None
Present
None
Present
None
VGN
Present*
None
None
Present
None
Present*
None
LOC
Present
None
None
Present
None
Present
Present
Dilated
Dilated
Normal
Constricted
Normal²
Dilated³
Pupil Normal¹
Size
*= High dose for that individual
1 = Soma, Quaaludes, and some anti-depressants dilate pupils
2 = Normal, but may be dilated
3 = Dilated, but may be normal
CNS Depressants
• To be classified as a depressant, a drug must
depress the activity of an individual’s brain
and the CNS
• Initially affects speech, coordination, mobility
• With increase in dosage (more than
theraputic) impairment of heartbeat, body
temperature, and breathing may occur
• Category includes alcohol, anti-anxiety
tranquilizers, anti-psychotic tranquilizers,
antidepressants, barbituates, non-barbituates,
or combination drugs
• People look and act much like EtOH
• Most common: Valium, Prozac, Xanax, Soma
(prescription meds)
• Rohypnol (Flunitrazepam), Gamma Hydroxy
Butyrate (GHB)
• Most commonly taken orally, may be inhaled,
very rarely injected
• If inhaled, will cause irritation to the nasal
tissue
• Injection sites will be noticeably swollen,
possibly ulcerated
• Liquid depressants require a larger gauge
needle for injection
• Person will look like a drunk, talk like a drunk,
walk like a drunk, but may not smell like a
drunk
• General indicators
– Wide variety of emotional effects (euphoria, depression, laughing or
crying for no apparent reason)
– Reduced ability to divide attention
– Disoriented
– Sluggish
– Thick, slurred speech
– Drunk-like behavior
– Fumbling
– Relaxed inhibitions
– Slowed reflexes
– Uncoordinated
– Drowsiness
– Gait ataxia (rubber legged)
Duration of Effects
• Four categories based on onset properties:
– Very rapid (surgical anesthesia)
– 4 hours or less
– 6 to 8 hours
– 8 to 14 hours
Type/Example
Duration
Barbituates
1 to 16 hours
Tranquilizers
4 to 8 hours
GHB
3 to 5 hours
Rohypnol
Peak 1 to 2 hours
Peak 8-12 hours
Overdose Symptoms
• Not limited to:
– Shallow breathing
– Cold/clammy skin
– Dilated pupils
– Rapid/weak pulse
Medical
• These conditions may mimic CNS Depressant
– Extreme fatigue
– Very recent head injuries
– Diabetic reactions
– Hypotension (low blood pressure)
– Inner ear disorders
– Severe depression
CNS Stimulants
• Relieve fatigue, aid in weight reduction,
reduce need for sleep, increase energy and
confidence
• “uppers”
• As stimulants “wear off” users can exhibit
signs and symptoms of depressants due to
“crashing”
• Most commonly abused: cocaine,
amphetamines and methamphetamines
• Amphetamines are usually pill form, legally
manufactured for medical use
• Ephedrine and Pseudoephedrine (diet
supplements, antihistamines, decongestants)
when taken in excess may impair
• Ritalin, Adderall, Dexedrine (ADD and ADHD
meds)
Ingestion
• Cocaine may be inhaled, injected, or smoked
• Amphetamines usually taken orally
• Methamphetamines may be snorted, smoked,
injected, or taken orally
• Other pills usually taken orally, but may be
crushed and inhaled
• General indicators
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Restlessness
Body tremors
Excited
Euphoric
Talkative
Exaggerated reflexes
Anxiety
Grinding teeth
Redness in nasal area
Runny nose
Loss of appetite
Increased alertness
Dry mouth
Irritability
Duration varies widely. Dosage amount, age, weight,
tolerance, and other variables dictate length of impairment
Drug
Duration
Cocaine
5 to 10 minutes (smoked)
45 to 90 minutes (injected)
30 to 90 minutes (snorted)
Amphetamines
4 to 8 hours
Methamphetamines
12 hours
Ritalin, Adderall, Dexedrine
Varies with form, strength and time
release
Overdose Signs and Symptoms
• Not limited to
– Possible increase in heart rate or intensity
– Convulsions
– Increased body temperature
– Hallucinations
Hallucinogens
• Affect perceptions, sensations, thinking, selfawareness and emotional state
• Naturally occuring : Peyote, psilocybin
mushrooms, Jimson Weed, Morning Glory
Seeds, Bufo Alvarius (toad)
• Synthetically manufactured: Lysergic Acid
Diethylamide (LSD),
Methylenedioxymethamphetamine (MDMA,
Ecstasy)
Effects
• Effects depend on the personality and
expectations of the subject as well as the
surroundings in which the drug is taken
• Usually intensifies the mood of the user
• May uncover emotional or psychological
issues in the user
• General indicators
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Hallucinations
Paranoia
Nausea
Perspiring
Dazed appearance
Flashbacks
Body tremors
Uncoordinated
Disoriented
Memory loss
Synesthesia
Difficulty in speech
Duration
Type/ Example
Duration
LSD
10 to 12 hours
(peaking between 4 and 6 hours)
Ecstasy (MDMA)
1 to 3 hours
Psilocin
2 to 3 hours
Mescaline/Peyote
Up to 12 hours
Dissociative Anesthetic (DA)
• Includes Phenyl Cyclohexyl Piperidine (PCP),
its analogs, dextromethorphan (DXM)
• Effects or symptoms are sometimes similar to
hallucinogens, stimulant, and/or depressants
Identification
• PCP is the most common, originally
intravenous anesthetic, discontinued for
human use in 1967 due to side effects
• Ketamine is an analog of PCP, still used in
pediatric and animal surgery
• DXM found in over-the-counter anti-tussive
cold medications
Effects
• May cut off or distort the brain’s perception of
the rest of the body’s senses
• Increased pain threshold
• General Indicators
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Perspiring
Blank stare
Cyclic behavior
Chemical odor
Increased pain threshold
Incomplete verbal responses
Warm to the touch
Repetitive speech
Hallucinations
Confused
Possibly violent or combative
“moon walking”
Duration
Type/ Example
Duration
PCP
4 to 6 hours
Ketamine
30 to 45 minutes (injected)
45 to 60 minutes (snorted)
1 to 2 hours (orally)
DXM
3 to 6 hours
Overdose Symptoms
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Bizzare, violent, self destructive behavior
Deep coma lasting up to 12 hours
Seizures and convulsions
Death due to respiratory depression
May trigger heart attack
Eyes open with blank stare
Permanent psychosis