Transcript Drugs of Addiction - City Vision University

Drugs of Addiction
Elizabeth McQueen, LMHC
Clinical Director
Stewart-Marchman Center
NET Training Institute
Freedom Series
Course Objectives
To define psycho active chemicals
 To examine the routes that drugs
take to the brain and the ways in
which they affect brain chemistry
 To present a system for classifying
these psychoactive substances.
 To detail the physiological effects of
uppers, downers and other
commonly abused drugs
 To outline the principles of effective
prevention and treatment

The Addictive Process:
Psychoactive drugs: Substances that
affect the central nervous system to
cause physical and mental changes to
take place
3 Factors that determine the
effects a chemical will have
The methods by which people put
psychoactive chemicals into their
bodies
2. The speed of transmission to the
brain
3. The attraction of the drug for
nerve cells, neurotransmitters and
other brain chemicals
1.
Routes of Administration
1. Inhaling
2. Injecting
3. Mucous Membrane
Absorption
4. Oral Ingestion
5. Contact Absorption
Inhaling
The vaporized drug enters the lungs and
is rapidly absorbed through tiny blood
vessels in the lungs called capillaries. It
travels back to the veins and then the
heart where it is pumped directly to the
brain and the rest of the body.
Time of transmission: 7-10 seconds for
change to begin
Inhaled drugs
 Marijuana
 Freebase
cocaine
 Glue
 Aerosols
 Cigarettes
Characteristics of Inhaled drugs
Effects felt quickly
 Easy to regulate the amount of the drug
used
 Only small amount absorbed with each
inhalation

Injecting
Intravenous injecting – “Slamming”
Injected directly into the blood stream by
way of a vein
 Intramuscular injecting – “muscling”
Injecting into a muscle mass
 Subcutaneous – “Skin popping”
Injecting just under the skin

Time of transmission:
15-30 seconds in the vein
Time of transmission for
injected drugs:
 15-30
seconds in the vein
 3-5 minutes in the muscle or
under the skin
Injected Drugs
Heroin
Cocaine
methamphetamines
Characteristics of
Injected Drugs
 Large
amount absorbed at once
 Instant “RUSH”
 Nothing of the drug is wasted
Snorting and Mucosal
absorption
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Insufflation – absorption into the muscosa
membranes in the nasal passages
Sublingual – absorption into the mucosa
under the tongue
Buccally – between the gums and the cheek
Rectally – absorption into the mucosa in the
rectum
Vaginally – absorption into the mucosa in the
vagina
Time of Transmission

From 3 to 15 minutes depending on the
place of administration
Drugs of Mucosal Absorption
Cocaine
 Herion
 nitroglycerin
 Chewing tobacco
 Morphione

Characteristics of Mucosal
Absorbed Drugs
Results more rapid
 High more intense
 Bypasses the digestive acids, enzymes
and liver

ORAL
Swallowed
 Passes through the esophagus into
stomach
 Absorbed in to the capillaries and enters
the vein and liver
 Pumped back to the heart and on to the
rest of the body

Time of transmission

20-30 minutes from administration
Drugs of Oral Admission
Oxycontin
 Xanax
 Valium
 Loratab
 Robotussin
 Alcohol

Characteristics of Oral Ingested
Drugs
Low Concentration at Absorption
 First Pass metabolism (first absorbed)
drugs are most potent

Transdermal Absorption

Absorbed through the skin
– Lotions
– Eye drops
– Patches
– Stamps
Time of Transmission
1-2 days for effects to be noticed
 Up to 7 days of absorption in the
average patch

Drugs of transdermal absorption
Nicotine
 Fentanyl
 Clonidine
 LSD
 Cocaine

Characteristics of Transdermal
Administration
Usually by prescription
 Measured amount of the drug
 Seldom used for illegal drugs

Drug Distribution: GETTING
TO THE BRAIN
Distribution depends on Blood volume
and characteristics of the drug
– Less blood volume, increased potency
 MOST PSYCHOACTIVE DRUGS ARE
FAT SOLUABLE
 THEY CAN CROSS THE BLOOD
BRAIN BARRIER

The Blood Brain Barrier
The Gateway to the central nervous
system
 The wall of the capillary in the brain
which is sealed to act as a barrier to the
brain.
 Only Fat soluble drugs can cross the
blood brain barrier

The Nervous System
The Central Nervous System – half of the
complete nervous system, includes the brain
and the spinal cord
 The Peripheral Nervous System – the
Other part of the nervous system which connects
the CNS with the internal and external systems
Includes the autonomic nervous system
and the somatic nervous system
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The Central Nervous System
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The Brain – Computer of the body, receiving,
analyzing and responding to messages from
the peripheral nervous system
Controls circulatory response
Respiration
Digestion
Excretory function
Endocrine function
Reproductive function
Enables us to reason and make judgments
Autonomic Nervous System

Controls involuntary functions such as
– Circulation
– Digestion
– Respiration
– Glandular outputs
– Genital reactions
– Sympathetic responses
Somatic Nervous System
Includes sensory neurons that reach the
skin, muscles and joints. Responsible
for relaying information about muscle
and limb position
 Transmits instructions back to skeletal
muscles
 Provides for voluntary response

Understanding how nervous
system processes messages

Neurons - nerve cells that act as the
building blocks of the nervous
system
Parts of a neuron:
(see handout)
Dendrites- finger like bodies that receive
signals from other cells and then relay
them to the cell body
 Soma – the cell body
 Axon – the finger like bodies that carry
the signals away from the cell
 Terminals – the pathway that carries the
signal from one cell to the dendrites of
the next cell.

Terminals of one cell do not touch
the dendrites of the next cell

Synaptic Gap – the microscopic space
between the terminals of one cell and
the dendrites of the next cell
A message jumps the synaptic gap in the
form of neurotransmitters.
– bits of
chemicals that are synthesized
electrical signals that jump the
synaptic gap
 Vesticles – tiny sacs that store
neurotransmitters
 Synapse – the transmission
process across the synaptic
gap
 Neurotransmitters
Sites – Protein
molecules that are activated by
neurotransmitters.
 When receptor sites are
activated, they open a
molecular gate that allow
electrical charges in or out
 Receptor
The process of message
transmission (see handout)
1.
2.
3.
4.
5.
6.
Incoming electrical signals force the
release of neurotransmitters
From the vesticles
And send them across the synaptic gap
On the other side the neurotranmitters
“fit themselves” into
receptor sites
The receptor sites open the ion
molecule gate
Allowing the electrical charges in or out
8. When enough electrical charge is achieved,
the next signal fires
9. Once the job is done, neurotranmitters
return to the synaptic gap and are
reabsorbed by reuptake ports
10. Auto receptors monitor the amount of
neurotransmitter needs for the transmission
7.
Psychoactive drugs disrupt the
process of message transmission
Drugs that enhance the activity of the
neurotransmitters and receptor sites are
called agonists
Drugs that block activity are called
antagonists
Specific Drug Examples:
AGONISTS:
Cocaine - forces the
release of extra
neurotranmitters
and blocks their
reabsorption
ANTAGONISTS:
Heroin – inhibits the
release of
neurotransmitters
and therefore blocks
a message of pain
from reaching the
brain
The body regards any drug as a toxin, but if
the use continues over a long time, it is
forced to adapt and and develop a tolerance
for the drug
Tolerance – the need to use increase
amounts to get the same effect!
Types of Tolerance
Dispositional Tolerance – the speeding up
of metabolism in order to eliminate the drug
 Pharmacodynamic Tolerance – nerve cells
become less sensitive to the drugs
 Reverse Tolerance – when the body
systems are no longer able to metabolize
drugs and the body can no longer tolerate the
drug (alcohol absorption after liver
destruction)

Acute tolerance – an automatic
acceptance of a drug by the body
Select Tolerance- When increased
quantities of a drug are taken to
overcome acute tolerance in order to
produce a high
Inverse Tolerance – When a person
becomes more sensitive to the effects
pf a drug as the brain’s chemistry
changes
Withdrawal – the bodies attempt
to rebalance itself
Nonpurposive Withdrawal – Physical
withdrawal -objective physical signs that
are directly observable when a drug is
stopped.
EXAMPLES:
 Seizures
Sweating
 Goosebumps
Vomiting
 Diarrhea
Tremors
Purposive Withdrawalpsychological withdrawal
Resulting behavior exhibited by an addict
when the drug stops
EXAMPLES:
 Manipulation
 Psychic Conversion (anticipated
nonexistent symptoms of withdrawal)
 Malingering
Protracted Withdrawal:
Environmental Influence

Withdrawal stimulated by environmental
triggers or cues
EXAMPLE:
Any white powder may trigger a cocaine
addict
Body Effect vs
Withdrawal
See hand out on opioids
- the body’s
mechanism for processing
foreign substances
 Metabolism
– the process of
eliminating foreign
substances
 Excretion
What effects Metabolism
Age – after 30 the body produces less
enzymes
 Race – different ethnic groups have
different levels of enzymes
 Sex – males and females metabolize at
different rates
 Health – certain conditions affect
metabolism

Emotional Health – Metabolism is affected
by preexisting chemical imbalance
Other Drugs – two or more drugs will
have the body fighting for metabolism
attention making the process slower
Desired Effects of Drug Use
Curiosity Satisfaction
 To “get high” and be in dreamlike state
 To self –medicate
 To have confidence
 To have energy
 Pain Relief
 Anxiety Control
 Peer influence
 Social Confidence
 Boredom Relief

Desired Effects of Drug Use:
To feel Normal
NORMAL________________________
Levels of Use
Abstinence
 Experimentation
 Social/Recreational
 Habituation
 Abuse
 Addiction

Theories of Origins of
Substance abuse
Moral Theory of Addiction
Intoxication
Originates
Addiction
Shift
is individual weakness
from Moral Decline
is shameful and sinful
away from this thinking in 1935
with the founding of AA
Genetic Theory
Nature
vs Nurture debate
Addiction
runs in families
Predisposition
to drug use
Research
indicates this is one degree
rather than full determinant
Lead
to development of the systems
theory of addictions
Disease Theory of Addiction
–A
physiological deficit in an individual making the
person unable to tolerate the effects of the
chemical therefore leading to addiction
–Does
not blame the addict for the disease
popularity in the mid 20th century and
elevated substance abuse from the realm of
morality to a treatable form
–Gained
Diagnosis
Chemical
Dependence – DSM IV (three or
more)
–1.
Tolerance
–2.
Withdrawal
–3.
Use more than intended
–4.
Efforts to quit or cut down
–5.
Large amount of time spent in use
–6.
Giving up or reducing importance activities
–7.
Continued use despite knowledge of physical and
psychological problems caused by chemical
Chemical Abuse: (One or more)
1.
Failure to fulfill major role obligations
2.
Chemical use in dangerous situations
3.
Substance related legal problems
4.
Continued use despite recurrent
interpersonal problems related to the
effects of substance use.
Compulsion Curve
Heredity
 Heredity + environment
 Heredity + environment + Drug Use
 Long/Term use
 Detoxification and Abstinence (no return
to starting place of curve)
 Relapse

SCHEDULE OF DRUGS
An organization effort by the Dept of
Criminal Justice to control substances
 Schedules are V-I beginning with those
of lease potential for abuse

Schedule of Drugs
Schedule I: Heroin, Marijuana, LSD
 Criteria

– High potential for abuse
– No currently acceptable medical use in US
– Lack of accepted safety for use under
medical supervision
Schedule 2: morphine, cocaine,
injectable methamphetamine
High potential for abuse
 Currently accepted medical use
 Abuse may lead to psychological or
physical dependence

Schedule 3: Amphetamines,
barbiturates, PCP
Potential for abuse less that I or 2
 Currently accepted medical use
 Abuse may lead to moderate physical
dependence or high psychological
dependence

Schedule 4: Barbital, Chloral
hydrate, paraldehyde
Low potential for abuse relative to 3
 Currently accepted for medical use
 Abuse may lead to limited physical or
psychological dependence relative to 3
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Schedule 5: Mixtures with
small amounts of codeine or
opium
Low potential for abuse relative to 4
 Currently accepted medical use
 Abuse may lead to limited physical or
psychological dependence relative to 4

UPPERS: Stimulants
Cocaine
 Amphetamines
 Diet Pills
 Caffeine
 Nicotine
 Ephedrine
 Herbal Ephedra

Cocaine:
Extract of the Coca plant

Origin: South America
 Common Names: Crack, Crank,
rock
 Ingestion: inhalation, injection,
smoking
Effects on the body:
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Directly effects the heart causing irregular
heat beat, vessel narrowing, restricted
oxygen, constricts blood flow
Heart attacks, Acute Hypertension and stroke
Forces release of neurotransmitters and
blocks reabsorption
Seizures/Psychosis
Diminished mental functioning
Crosses the Placenta and can cause
miscarriage, brain bleeds, SIDS and blood
vessel malformation
Tolerance and Dependence
Tolerance often after the first injection
 Physical dependence is possible
 Intense High which blocks dopamine
uptake is motivation

Withdrawal

Crash after binge
– Sleeping, total lack of energy
– Temporary return to normal (leave
treatment)
– Cravings start
– Emotional depression
– Relapse
Amphetamines:
Synthetic Ephedrine
–United States (Asthma
treatment)
 Common Names –speed, meth,
crystal
 Ingestion: orally ingested,
injected, snorted, smoked
 Origin
Effects on the body
Crosses the Blood Brain Barrier easily
 Acts on neurotransmitters and effect the
Sympathetic Nervous System by
blocking neurotransmitter reuptake
 Accelerates neural firing
 Rapid heart rate,
hypertension,headache,severe chest
pain
 Profuse sweating/heat elevation
 Delirium, psychosis, paranoia and
hallucinations

Tolerance and Dependence
Tolerance develops to specific actions
of the drug including euphoria,appetite
suppression,wakefulness, heart rate
increase, hyperactivity
 Physical and psychological dependence

Withdrawal: Due to reduction
of neurotransmitters
Depression
 Fatigue
 Increase appetite
 Prolonged sleep with REM
 Convulsions
 Circulatory collapse

Amphetamine Congeners
Stimulant drugs that produce same
effects as amphetamines
 Not as strong
 Examples

– Ritalin
– Stratera
– Diet Pills (obenex, Ephedra)
Caffeine: The most popular
stimulant in the world!
Origin: Primarily from South America
Common Names:
Coffee
Chocolate
Cocoa
Colas
Teas
Ingestion: Orally
Effects on the Body
Rapidly absorbed in the intestine
 Crosses the blood brain barrier
 Blocks the receptor sites for Adenosine
a natural sedative
 Dilatation of blood vessels
 Increases urine output
 Increase heart rate, Arrhythmias
 tachycardia

Tolerance and Dependence
Stimulation of the reward center of the
brain leads to increased tolerance
 Gradual exposure
 Potential for physical and psychological
dependence is small (yeah right!)

Withdrawal:
Cravings for Caffeine
 Headache
 Fatigue
 Nausea
 Marked anxiety
 Depression
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Nicotine
Origin: India
 Common Names:
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– Smokes
– Sticks
– Roll
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Ingestion: inhalation
Chimney
Chew
Snuff
Effects on Body:Stimulant and
Sedative
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Causes discharge of epinephrine
Absorbed in the body at every site of contact
(lips, teeth, lungs, hands)
Reaches every blood rich tissue of the body
Increased heart rate, blood pressure, cardiac
output,coronary blood flow
Earlier menopause
Profound contributor to mortality
Low birth weight in infants
Tolerance and Dependence
Tolerance occurs and nicotine remains
in the body
 Remains in the body 24 hours after use
 High potential for physical and
psychological dependence
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Withdrawal
Increased anger
 Hostility
 Aggression
 Loss of social cooperation
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Downers:
Downers depress the overall functioning
of the central nervous system to induce
sedation, muscle relaxation,
drowsiness, and even coma. They
cause disinhibition of impulses and
emotions.
Downers (depressants), which include
opiates/opioids, sedative-hypnotics, and
alcohol, depress the central nervous
system. Effects range from sedation, pain
relief, anxiety control, muscle relaxation,
suppression
of
inhibitions,
and
drowsiness up to unconsciousness, coma,
and death. They work by either inhibiting
pain,
stimulatory,
and
other
neurotransmitters or by mimicking the
body's natural sedating neurotransmitters.
Opiates/Opiods/.Alcohol
Major Depressants
Origin: Egypt, China
Common Names: heroin,morphine,
codeine, Darvon darvocet, loratab,
oxycontin,Dilauid,Vicodin,
Ingestion: oral, snorted,smoked,
Injected (most predominant)
Medical Use of opiods/opiates
Pain relief- mask pain signals
 Cough suppressant
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Effects on the Body
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Act at the neural synapse causing the release
of neurotransmitters
Decreased anxiety, sense of serenity
Deadening of emotions, inability to feel
Emptiness, depression,
Lowered blood pressure, pulse,respiration,
Eyelids droop,slurred speech,non reactive
pupils,
Trigger nausea center and suppress cough
center of the brain
Tolerance and Dependence
High risk of physical and psychological
dependence
 Learned association between the
effects of the drug and environmental
cues
 Rapid tolerance and dependence
 Produces “threshold effect”
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Withdrawal:
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Bone and joint pain
Muscle cramps
Nausea
Yawning
Sweating
Tearing
Runny nose
cravings
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Severe muscle pain
Flu like symptoms
Much anxiety
Chills
Goosebumps
High blood pressure
Insomnia
diarrhea
Heroin and Morphine
Origin: Asia, Mexico
 Common Names: “China White”
“Mexican Tar”
 Ingestion: injected, smoked, snorted

Effects on Body
Depressed heart rate
 Slow respiration
 Depressed muscular coordination
 Increased nausea
 Pinpoint pupils
 Itching
 Mental confusion

Tolerance and Dependence
Rapid tolerance
 Strong physical dependence
 Psychological dependence due to fear
of rebound pains

Withdrawal
Extremely painful muscle aches
 Strong cravings
 Sweating
 Runny nose
 Yawning
 Nausea
 Difficult, but no real risk of death

Methadone
Only one of two legally authorized
opiods used to treat heroin addiction
 Mehtadone is addictive and must be
monitored closely

Additional effects
Neonatal death
 Overdose
 Shared needles
 Hepatitis C
 HIV
 Adulteration

Sedative-Hypnotics
Origin: Ancient Greek Cultures
Common Names: Benzo, xany bars,
barbies,
Ingestion: Oral, snorted
Medical Use of
Benzodiazepines
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Manage anxiety disorders
Short term treatment for panic attacks
Control apprehensions of surgical patients
Treat sleep problems
Control muscle spasms
Elevate seizure threshold
Control acute alcohol withdrawal
Effects on the body
Anxiolytic,anticonvulsant, and sedative
effects
 Depressed breathing
 Slowed heart rate
 Coma in overdose

Tolerance and Dependence
Both physiological and psychological
dependence
 This is a metabolic dependence
 Short term use is safe
 Loge term use must be monitored
 A younger person can tolerate higher
dose

Withdrawal
Rebound symptoms
 Protracted withdrawal – long lasting
 Cravings-emotional,environmental

Barbiturates: Drug of the past
Origin: United States
 Common Names: Methaqualude
(ludes),Nembutal (yellow jacket),
Seconal (redbirds),Tuinal (rainbows)
 Ingestion: orally or injection

Effects on the body
Elevated mood
 Reduction of negative feelings
 Increased energy
 Unsteady gait
 Slurred speech
 Eye twitches
 Sedation
 Intoxication similar to alcohol

Tolerance and Dependence
Can create tolerance after single dose
 Psychological and physical dependence
 Tolerance develops as a result of
metabolic changes which destroy the
barbiturates faster.

Withdrawal
12-24 hours after last use
 Anxiety
 Tremors
 Nightmares
 Insomnia
 Anorexia
 Nausea
 Delirium
 Seizures
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Other Sedatives
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Club Drugs: Date drugs
– GHB: strong depressant
– Rohyypnol: “Ruffies”
Drug Interactions
Alcohol and sedatives-hypnotics used
together are especially dangerous
 Cross –tolerance and cross
dependence occur within the opiod
class of drugs of drugs

Alcohol
Origin – prehistoric use, fermented
grapes left in a basket
 Common Names – Beer, wine distilled
spirits
 Ingestion – Oral, rectal absorption

Effects of Body
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Body treats as poison and begins elimination as
soon as ingested
Metabolized in the liver
Immediate absorption
Cardiovascular system affected at low levels of
use: peripheral dilation, but depression of
cardiovascular function with severe intoxication
Gastritis, ulcers, pancreatic hemorrhage
Depressed respiration
Increased risk of cancer
Lower sexual function
Reproductive problems
Long terms effects of Alcohol
Addiction
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Liver damage
Digestive effects
Enlarged Heart
Loss of brain cells
Increased desire/decreased performance
Increased chance of breast cancer
Reduced fertility
Blood Alcohol Concentration:
BAC

1 ounce of alcohol is excreted each hour
 With this knowledge it is possible to
determine the amount of alcohol that is
circulating in the body
 It takes approximately 15-20 minutes for
alcohol to reach the brain and about 30-40
minutes for the alcohol to reach maximum
level of concentration. This is known as the
level of blood alcohol Concentration or BAC
Absorption: Rapid
Because alcohol is absorbed very quickly
after entering the body, it has a rapid
high.
 While absorption of most drugs begins in
the intestine, alcohol absorption begins in
the stomach and is metabolized and
excreted quickly
 10 – 20% of alcohol is excreted in the
urine or through the lungs without being
metabolized
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Factor effecting Absorption
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Body weight
Sex
Health
Drinking rate
High concentration
of alcohol in drinks
Using with
carbonated
beverages

Warming the alcohol
 Women absorb
faster
 Drinking on an
empty stomach
 Diluting alcohol with
ice, water or fruit
juices
Tolerance and Dependence
Liver function becomes more efficient
 Brain cells are less effected by the
alcohol
 Fewer symptoms of intoxication
 HOWEVER THE LEATHAL DOSE
DOES NOT CHANGE!
 Risk of dependence is moderate
 Younger the drinker the greater the risk
of dependence

Withdrawal
Symptoms appear in 12-72 hours of
cessation lasting 5-7 days
 Referred to as Delirium Tremens
 Sweating
 Shakes
 Anxiety
 Nausea
 Diarrhea
 Transitory hallucinations

Fetal Alcohol Syndrome

Specific toxic effects of alcohol on unborn
fetus is known as “Fetal Alcohol Syndrome”
– Retarded growth before and after birth
– CNS involvement including delayed intellectual
development
– Facial abnormalities
•
•
•
•
Heart shaped face
Shortened eye openings
Flattened mid-face
Thin upper lip
– Hearing loss
– Gait problems
Scope of the problem: 1999
stats

The majority of people in almost every
country, except for Islamic countries,
consume alcohol
 Last month about 113 million Americans had
at least a can of beer, a glass of wine, or
cocktail
 In 1998 over 2 million people died due to
alcohol
 10% of all diseases and accidents are alcohol
related
45% of homeless have serious
alcohol problems
 28% of high school students use
alcohol
 45% of all college students use
alcohol

Alcohol and Polydrug Abuse
Most drugs involve more than one
substance, especially alcohol
 When this happens the synergism effect
comes into play

ALL
AROUNDERS:Psychedelics
Origin: Psychedelics and hallucinogens
have been around since the origin of
man.Derived from plants including fungi.
 Common Names: marijuana, LSD,
PCP, peyote, psilcybin
(mushrooms),and MDMA
 Ingestion: oral, smoked, injected,
snorted

Effects on the Body
Major effect is overt stimulation
 Intensified sensations particularly
visuals ones
 Suppressed memory centers
 Impaired judgment

Lysergic Acid Diethylamide
(LSD)


LSD is 1,000 more powerful than natural
hallucinogens, but weaker than most
synthetic chemicals
Somatic effects are:
–
–
–
–
–
–

Dizziness
Weakness
Tremors
Altered vision
Intensified hearing
Dreamlike imagery
Tolerance and Dependence is not truly
known
Phencyclidine (PCP): Angel
Dust
PCP was developed as a general
anesthetic but was found unstable
 Major chemical is peperdine
 Purity can be anywhere from 5-100%
making use a tremendous risk
 Ingestion: smoke, oral, snorted
 No potential for physical tolerance, but
extreme psychological dependence

Effects on the Body
Amnesia
 Extremely high blood pressure
 Combativeness
 Tremors
 Seizures
 Catatonia
 Coma and kidney failure

Designer Drugs: synthetic
psychedelics
Ecstasy (MDMA): DATE DRUG
 Origin: Spread from the UA to
England in 1980s

Effects on the Body







Reduced depression
Heightened introspection and intimacy
Acts to deplete seritonin, a neurotransmitter
that leads to relaxation
Heart attacks, strokes
Liver disease, hyperthermia
Panic disorder, paranoid psychosis
depression
Marijuana:CANNABIS





Origin: Used for thousands of years,
cannabis’ place or origin appears to be the
Netherlands
Common Names: Weed, grass, pot, blunts,
joints,green
Ingestion: smoked, oral
Active ingredient: Tetrahydracannabinol- THC
Schedule 1 drug
Other information about
marijuana
Mostly widely used illicit psychoactive
drug
 Sinsemilla –a form of cannabis from an
unpollinated hemp plant- extra potent
 Standard cannabis has about 3% THC,
sinsemilla has about 15%, Hash oil has
about 60% THC

Effects on the Body

Irritation to lungs and respiratory system
– (5 times more tar than nicotine)







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Fluctuation in emotions
Impaired memory and concentration
More vivid senses, decreased tracking ability
Diminished hand-eye coordination
Sedation and dreamlike state
Dilated pupils, Bloodshot eyes
Inhibited sweating
A-motivational syndrome
Tolerance and Dependence
Conflicting research on physical
dependence but definite psychological
dependence
 Tolerance develops rapidly

Withdrawal

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Headaches
Anxiety
Depression
Irritability
Aggression
Restlessness
Tremors
Sleep distortions
Strong cravings
Other Drugs of Choice
Inhalants 
1.
2.
3.
Three types of inhalants:
Volatile and aerosols-paints, fuels,hair
sprays, cooking spray , air fresheners
Volatile nitrites – amyl nitrate “Poppers”
Anesthetics – nitrous oxide,ethylene
About 17% of all adolescents in the US
have used inhalants
 may be sniffed, snorted huffed, bagged,
or inhaled

Sports Drugs
Three main categories of sports drugs
1. Therapeutic drugs –analgesics,
muscle relaxants, asthma medications
2. Performance –enhancing drugs –
steroids, growth hormones,
amphetamines
3. Recreational/mood altering – cocaine,
marijuana, alcohol, tobacco
Other Addictions

Compulsive Behaviors – continuing a
behaviors despite adverse consequences
– Bad diets
– Exercise
– Fast food restaurants
– Credit cards
– shopping
Gambling

Includes:
– Cards, races, slots, stocks, day trading,

Characteristics include
–
–
–
–
–
Progressive betting
Attempts to recoup losses
Restlessness
Irritability
Jeopardizing of family, relationships, job
Eating Disorders

Three main disorders
1. Bulimia- look normal but bingeing and
throwing up
2. Anorexia-60% loss of body weight
3. Compulsive over eating –eating triggered
by emotional state
95% of anorexics and bulimics are female
Sexual Addiction

1.
2.
3.
4.
5.
6.
Compulsive Sexual Behaviors
Pornography
Masturbation
Phone sex
Voyeurism
Flashing
Repeated adultery
Sexual activity usually followed by guilt
remorse and fear.
The Treatment
Phase
Prevention
PREVENTION

Goal – prevent abuse before it happens
– Scare tactics
– Drug information
– Skill-building
– Environmental change programs
– Public health models – user testimonies
The Treatment Phase
Treatment
Components Of Substance
Abuse Treatment:

Medical and Biological Treatments:
–
–
–
–
–

Detoxification
Diet and Nutrition Concerns
Medication (Symptom Reduction)
Medication (Relapse Reduction)
Drug Screening
Psycho-Social Treatments:
–
–
–
Psychotherapy
Relapse Prevention
12 Step Programs
Stages of the Therapeutic
Process
• Intervention
• Assessment Phase
• Feedback phase: Diagnostic Phase
• Implementation phase or treatment phase
Resources
BOOKS:
Substance Abuse Counseling –
Patricia Stephens and Robert Smith
Treating Alcoholism, Robert Perkinson
Faithful and True – Mark Laaser