Transcript Uppers, Downers and All Arounders

Uppers, Downers and All
Arounders
Chapter 7
Other Drugs, Other Addictions
Copyright, 2004, CNS Productions,
Inc.
1
Inhalants
• Used for their stupefying, intoxicating and slight
psychedelic effects
• Most widely abused according to popularity are:
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Nitrous oxide
Nitrites
Gasoline
Glue
Spray paint
Aerosol spray
Lacquer thinner
Typewriter correction fluid
TYPES OF INHALANTS
Volatile Solvents (hydrocarbons)
Airplane glue, rubber, or PVC cement
Paint sprays, especially metallic paint
Hairsprays & deodorants
Lighter fluid & dry cleaning fluid
Nail polish remover
Paint remover/thinner
Typewriter correction fluid
Gasoline & fuel gas
Carbon tetrachloride, toluene, butane,
trichloroethylene, N-hexane
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Inc.
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Inhalants
– Readily accessible to children
– Get little attention because of low status of
inhalant abuse as a drug problem
– Practice of inhaling substances goes back to
ancient times
– Modern version is with abuse began in 1700s
with the discovery of nitrous oxide, chloroform
and ether
– After WWII abuse of glue and metallic paints
rose dramatically and continues today
– Responsible for 700 – 1,200 deaths each year
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Inhalants
– Abuse is prevalent among adolescents,
although adults abuse it too
– Internationally, abuse afflicts the young, poor,
and children exposed to chemicals daily,
especially children of cleaners and
shoemakers
– Inhalant of choice for many countries is
gasoline
– More males and females abuse inhalants
– High use among Hispanics and Native
Americans
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Inhalants
• Methods of inhalation
– Sniffing: breathing the substance from a container
directly into lungs
– Huffing: soaking a rag and inhaling from it
– Spraying the inhalant into the nose or mouth
– Balloons or crackers: suing a tool to puncture a
container that releases the inhaler into a balloon and
then is inhaled
• By spraying the pressurized solvent directly into
the mouth, a dangerous amount of pressure is
put into the lungs and can freeze tissue
Methods
of Inhalation
“Sniffing”
“Huffing”
“Bagging”
“Spraying”
“Balloons &
crackers”
Bag over one’s
head
Soaking clothing
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Inhalants
• Volatile solvents:
– Mostly carbon hydrocarbon based
compounds that turn into gas at room
temperature
– Includes, gasoline and its addictives,
kerosene, paints, especially metallic, paint
thinner, nail polish remover, spot removers,
glues and plastic cements, lighter fluid and
variety of aerosols
– Quick acting because they are absorbed
almost immediately, then moves to heart,
brain, liver and other tissues
Inhalants
• Short-term Effects:
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Temporary stimulation
mood elevation
Reduced inhibitions
Reward/reinforcement center is affected like cocaine
does
– Soon depressive effects takes over
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Dizziness
Slurred speech
Unsteady gait
Drowsiness
High does may cause illusions, delusions and hallucinations
Inhalants
• Prolonged inhalation causes
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Delirium with confusion
Psychomotor clumsiness
Emotional instability
Impaired thinking
Coma
• Long-term Effects
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Lack of coordination
Weakness
Disorientation
Loss of weight
Impaired memory
Can cause injury to brain, liver, kidney, bone marrow
and particularly the lungs
Inhalants
• Toulene (methyl benzene)
– Most abused solvent
– Found in glues
– Drying agents
– Solvents
– Thinners,
– Paints
– Inks and cleaning agents
– In one study, 65% of chronic abusers of spray
paint had neurological damage
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Inhalants
• Trichloroethylene:
– Common solvent found in typewriter
corrections fluids, paints, metal degreasers
and spot removers
– Causes overall depressive effects and some
hallucinations
• N-Hexane & methyl butyl ketone (MBK)
– Used in glues and adhesives and diluents for
plastics and rubber
– Recovery from brain damage can take three
years
Inhalants
• Alkanes;
– Methane, ethane, butane and propane
• Gasoline sniffing is common on some
Native American reservations
– Effects include insomnia, tremors, anorexia,
and sometimes paralysis
– When leaded gas is inhaled, symptoms
include hallucinations, convulsions, and
chronic irreversible effects of lead poisoning
• Alcohol inhalants include ethanol,
methanol, isopropanol
Inhalants
• Warning signs of solvent abuse include:
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Headaches
Chemical order on body, clothes or room
Red, glassy or watery eyes and dilated pupils
Inflamed nose and/or Nosebleed
Rashes around the nose and mouth
Slow, thick or slurred speech
Staggering gait, Disorientation, Lack of coordination
Pains in chest and stomach
Nausea & Fatigue
Shortness of breath
Loss of appetite
Intoxication
Irritability and aggression
Seizure & Coma
Inhalants
• Volatile Nitrites
– Amyl Nitrate (1857)
– Dilate blood vessels so heart and brain
receive more blood
– Effects start in 7-10 seconds and last 30
seconds to 1 minute
– One inhalation there is:
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a feeling of fullness in head,
Rush of mild euphoria
Dizziness
Giddiness
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Inhalants
• Effects wear off, user experiences
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Headaches
Vomiting
Nausea
Chills
• Thought to enhance sexual activity
• Sought by male homosexuals for their euphoric
and psychological effects
• Viagra and methamphetamine combination can
dangerously lower blood pressure
• Tolerance develops rapidly
• Variants sold as room odorizer, tape head
cleaners and sneaker cleaners
Inhalants
• Anesthetics
– Chloroform, Ether, Oxygen and nitrous oxide
– Found to have euphoric effects as wells as anesthetic effects
– Abused by young people, middle class, affluent groups like
doctors, anesthesiologists, hospital workers, and healthcare
professionals
• Nitrous Oxide discovered in 1776
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Immediately used as a recreational drug
Common abused form is whipping crème bottles
Source container is used to fill a balloon then inhaled
7-10 seconds effects begin
Dizziness, giddiness and disorientation
Lasts 2-3 minutes
Long-term exposure can cause central and peripheral nerve
damage and brain cell damage due to lack of oxygen since
nitrous oxide replaces oxygen in blood
Inhalants
• Halothane
– Prescription surgical anesthetic gas (Fluothane)
– Because of limited availability, abuse tends to be with
anesthesiologists and hospital personnel
• Dependence
– DSM-IV-TR classifies inhalant disorders as inhalant
dependence and abuse, intoxication, induced
delirium, dementia, psychotic disorder, mood disorder
and anxiety disorder
• Breaking habit or treating compulsion difficult due to users
being young and immature, combined with cognitive
impairment that hinders comprehension and recovery
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5
SPORTS AND DRUGS
• Three main categories of drugs:
– Therapeutic used for medical problems
– Performance enhancing (ergogenic drugs) that are
mostly banned
– Recreational or mood altering drugs
• History
– Greek Olympic athletes ate large amounts of
mushrooms or meat to improve performance
– 1800s cyclists, swimmers and other athletes used
morphine, opium, cocaine, caffeine, nitroglycerin,
sugar cubes soaked in ether and low doses of
strychnine
– Boxers drank water laced with cocaine between
rounds
SPORTS AND DRUGS
• During Cold War era, Soviet weightlifting team
used steroids in the 1952 Olympics initiating a
“steroid race” for medals
• 1958 steroids were widely abused by athletes
• Commercialization of sports pressured athletes
to improve their performance
• 2001 estimates that 400,000 junior high and
high school students had tried steroids
– High school athletes encouraged to use steroids to
bulk up and then go clean in college
– Anabolic Steroids stunt bone development and
disrupt hormonal function in adolescents
SPORTS AND DRUGS
• Therapeutic Drugs
– Used for medical problems
– Four main groups: Anesthetics, Muscle relaxants,
Anti-inflammatory & Asthma medications
• Anesthetics
– Used to deaden pain
– Topical anesthetics desensitize nerve endings on skin
– Most common are opioids, including:
• Vicodin (most prescribed), Demerol, Morphine, Codeine,
Darvon
– Danger is the drugs block pain without repairing
damage
– Compulsive use and dependence and result
SPORTS AND DRUGS
• Muscle relaxants
– Depresses neural activity within skeletal
muscles
– Used to treat muscle and ligament damage
– Some athletes use relaxants to control anxiety
– Abused occasionally for mental effects
– Benzodiazepines are highly addictive, with
tolerance and tissue dependence
SPORTS AND DRUGS
• Anti-inflammatory drugs
– Controls inflammation and lessen pain
– Nonsteroid = aspirin, ibuprofen, butazoliden
– Corticosteroids = cortisone & prednisone
• High doses cause severe psychosis
• Asthma medications
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Affects 10% of population
Aggravated by heavy exercise
Exercise induced asthma found in 11-23% of athletes
Permission given to use certain asthma medications
Ephedra is banned due it stimulant quality
SPORTS AND DRUGS
• Anabolic-androgenic steroids (AASs)
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Very broad category of drugs
Most are banned by Olympic Committee
Most abused performance enhancing drugs
Derived from male testosterone or are synthesized
Anabolic means “muscle building”
Androgenic means “producing masculine
characteristics.”
– Clinically used to treat:
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testosterone deficiency
Osteoporosis,
Certain types of anemia
Breast cancer
Endometriosis
SPORTS AND DRUGS
• Anabolic-androgenic steroids (AASs)
– Athletes use to:
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Increase body weight
Lean muscle mass
Muscular strength
Increases aggressiveness and confidence
– Patterns of use
• Steroid users may take 20-200 times the clinically
prescribed dose
• Stacking: practice of taking 3 or more kinds of
inject able or oral steroids and alternating cycles of
use and non-use
•,
SPORTS AND DRUGS
• Anabolic-androgenic steroids (AASs)
– Cycling means taking steroids for 4-18 weeks
during intensive training, then stopping for
weeks or months to give body a rest
• 82% who used steroids took 3 or more different
types of steroids
• 30% took 7 or more during training
Anabolic Steroid Effects
Increased muscle mass
Increased confidence &
aggressiveness
Mood elevation
Anger
Tendon & bone damage
Cystic acne
Masculinization of women
Breast enlargement in men
Genital size reduction
Liver cancer
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Inc.
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SPORTS AND DRUGS
• Anabolic-androgenic steroids (AASs)
– Side Effects
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Increased masculinization
Increased muscle mass and muscle tone
Bloated appearance
Long-term use causes suppression of body’s own
natural testosterone
• Long- term use in men causes feminine
characteristics
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Swelling breasts
Nipple changes
Decreased size of sexual organs
Impairment in sexual function
SPORTS AND DRUGS
• Anabolic-androgenic steroids (AASs)
– Side Effects Women
• Gain in muscular development occur with masculinizing
effects, including
• Increased facial hair
• Decreased breast size
• Lowered voice
• Clitoral enlargement
• Mental & emotional effects
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Confidence and aggressiveness
Emotional instability
Rage
Depression
psychosis
SPORTS AND DRUGS
• Anabolic-androgenic steroids (AASs)
– Compulsive use and addiction
• Initially feels a sense of euphoria and wellbeing that
contributes to continued use and compulsive use
– Studies show that steroids increase body mass and
muscle strength when combined with diet and
exercise
– Athletes obtain steroid from
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Black market through gyms, mail order companies or friends
From doctors, veterinarians, or pharmacists
Serious users spend $200-$400 weekly
Some professional athletes spend $20,000-$30,000 year
SPORTS AND DRUGS
• Other drugs used by athletes
– Stimulants like amphetamines, caffeine,
– Ephedra and ephedrine (banned by NFL, IOC, and
NCAA, but not the NBA, NHL or major league
baseball
– Chewing tobacco
– Human growth hormone (HGH)
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Used by athletes to increase muscle strength and growth
Reduces fat
Increases muscle mass, skin thickness and connective tissue
Gigantism and abnormal bone growth reported
Metabolic and endocrine disorders reported
Abuse associated with cardiovascular disease
Decreases life span by up to 20 years
Banned by U.S. Olympic Committee, NCAA
Difficulty to detect because it is found naturally in the body
SPORTS AND DRUGS
• Recreational/mood-altering use of drugs
by athletes
– Peer pressure
– Help to fit in social situations
– Help cope with heavy schedule
– Reduce stress
– Fill up time on long road trips
• Stimulants
– Amphetamines, caffeine and tobacco
SPORTS AND DRUGS
• Recreational/mood-altering use of drugs by
athletes
– Sedatives-hypnotics
• Xanax, Barbiturates, Opioids taken as self-rewards
• Used to unwind after competition
• Counter-act use of stimulants
– Alcohol
– Marijuana (NCAA bans use)
• Testing
– NCAA uses two drug-testing programs
• One for all championships and post season football games
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8
OTHER ADDICTIONS
• Compulsive behaviors
– Gambling, overeating, shopping, sexual
behavior, Internet use and TV watching,
compulsive lying, hair pulling, fire setting
– Impulsive control disorders
• Failure to resist an impulse that is harmful to the
individual or others
• Often starts off as being pleasurable
• Increasing sense of tension or arousal before
actually committing the act
• Often followed by gratification, pleasure, relief
• Then remorse and guilt over the consequences of
the act
OTHER ADDICTIONS
• Compulsive behaviors
– Obsessive compulsive disorders
• Excessive hand washing, checking things,
ordering, and counting
• Repetitive activity whose goal is to reduce anxiety
or distress….not pleasure or gratification
– Addictive behaviors change brain chemistry in
much the same way as psychoactive drugs
– People change their behaviors much like
those who are recovery from alcohol or other
drugs
– Many 12 Step groups are formed around
compulsive behaviors
OTHER ADDICTIONS
• Compulsive behaviors
– Can be triggered by:
• Genetic predisposition,
• Environmental stresses
– Comfort and reassurance or escape provided
by repetitive behaviors
– Increased dopamine levels suggest
biochemical thread
– Twin studies show a connection between
compulsive behaviors and heredity
– Compulsive over-eating shown to be partly
hereditary
OTHER ADDICTIONS
• Compulsive behaviors
• Mid-1990s genetic connections between alcohol,
drug and compulsive behaviors shown
• Genetic predisposition indicated a genetic
marker in the “reward deficiency syndrome” in
severe cases of alcohol, drug and compulsive
behaviors
• Researchers propose that carriers of the A1
allele gene have a deficiency of dopamine
receptors in the reward/reinforcement center
Compulsive Gambling
• Compulsive Gambling
– 125 million Americans gamble and of those,
2.2 million are pathological gamblers, and 5.3
million are problem gamblers
– 1.1 million are teenagers
– Male compulsive gamblers outnumber
females 2 or 3 to 1
– College students have a higher rate of
gambling
– Gamblers anonymous formed in 1957
Gambling, Alcohol
Use, & Drug Use
Among Adolescents
1999
Alcohol use once Past month
Past year
Past year
per month or ever marijuana
pathological pathological or
had alcohol
gambling
use
problem gambling
problems
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Inc.
Past month
other drug
use
9
1. Winning phase
2. Losing phase
3. Desperation phase
4. Giving-up phase
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Inc.
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Slide 7-10 List of the four phases that lead to compulsive gambling.
• In the winning phase, gamblers are confident they can make a living
gambling.
• In the losing phase, they start to chase their losses and gamble poorly.
• In the desperation phase, their debts mount, they gamble foolishly and will
do anything to keep gambling.
• In the giving up phase, they feel they can never win and all they want to do
is stay in action and will do anything to stay there. Mania, depression, and
suicide thoughts are common.
Compulsive Shopping (Oniomania)
• Compulsive Shopping (Oniomania)
– Inability to handle money in a responsible manner is a
hall mark of almost any addict
– Shopping addicts report relief from depression and
subsequent high when buying similar to a cocaine
high
– Both result in a subsequent crash accompanied by
depression and guilt than felt before buying
– More than 400 debtors Anonymous groups in U.S.
– Depression seems a major part of compulsive
shopping
Anorexia
nervosa
Bulimia nervosa
Binge-eating
disorder
(includes
compulsive
overeating)
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Anorexia Nervosa
• Eating Disorders
– Anorexia Nervosa addiction to weight loss, fasting
and control of body size
• Maintains weight by limiting food intake through fasting,
dieting, excessive exercise, use of amphetamines and other
diet pills
• Bulimia symptoms appear in 30-80% of all anorexics
• Have distorted perceptions of their body’s shape and size
• Often feels overweight even when emaciated
• Anorexics have a tendency to be concerned with following
directions and people pleasing
• May be considered to be good girls, model students,
academically talented, but lack self-esteem.
• Refusal to eat gives the anorexic sense of control over their
lives
Anorexia Nervosa
• Semi-starvation strains all the body systems,
especially the heart, liver & brain
– Death rates are 4-20%
• Most severely ill anorexics have to admitted to
the hospital due to:
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Extreme weight loss
Disturbed heart rhythms
Extreme depression
Often suicide ideation
Loss of menstruation
Takes 10-12 weeks for full nutritional recovery
Rate for full recovery is 40%
Prozac and other antidepressants help anorexics
improve eating behaviors
Bulimia Nervosa
• Characterized by eating large amounts of
food in one sitting, followed by
inappropriate methods of ridding self of
food
– Self-induced vomiting
– Use of diuretics, laxatives, fasting and
excessive exercise
– Often are ashamed of their behavior, doing it
in secret
– During binge episodes, there may be a feeling
of frenzy, not feeling in control and sense of
being disconnected from one’s surroundings
Bulimia Nervosa
• Causes include:
– Social pressure to look thin
– Socialization of girls to look thin
– Biochemical changes that reward bingeing and
purging
• Problems
– Dental complications and propensity towards alcohol
and drug abuse
– High rate of depression
– Greater risk of suicide
– Risk of stomach acid burns to esophagus and throat
resulting in chronic sore throat and risk of cancer
– Heart arrhythmias, electrolyte imbalances and
irregular or loss of menstruation
Binge Eating Disorder
• Marked by recurrent episodes of binge eating
without vomiting, laxatives or other
compensatory activities
• People eat in response to emotional states
rather than hunger
• Used to modify emotions, especially anxiety,
solitude, stress, and depression
• Generally overweight
• May suffer from high cholesterol, diabetes, high
blood pressure, gall bladder disease, heart
disease and high rates of depression
• Allows their self-esteem to suffer
Binge Eating Disorder
• Both physiological and psychological
causes underlie the disorder
• Treatment is addressed through
counseling, psychiatric treatment and
behavioral therapy and self-help groups
• Diet pills that contain amphetamines are
used for short-term periods
• Diet pills may work initially, but lose their
effectiveness
SEXUAL ADDICTION
• Sexual behavior which the addict has little
control over
• Practiced by males, females, gay, straight,
young and old
• Includes masturbation, pornography, serial
affairs, phone sex, visits to topless bars
and strip shows
• Practiced as a way to cope with anxiety,
solitude, low self-worth
• Can be the person’s all-consuming activity
INTERNET ADDICTION
• Survey of 18,000 people by ABC News
found that almost 6% of participants met
criteria for serious compulsive problem
• Symptoms include:
– Logging in on every chance there is
– Thinking about the internet constantly
– Needing progressively more time online to get
same satisfaction
– Losing track of time while online
– Neglecting responsibilities
– Checking email constantly
INTERNET ADDICTION
• Cybersexual addiction
– Over 10 million internet users log onto 10
popular sex sites in 1 month
• Computer Relationship Addiction
– Pursuit of online relationships to the neglect of
real-life relationships