Transcript 2013 Uppers Downers Allarounders

West Virginia Department of Health and Human Resources
Bureau for Behavioral Health and Health Facilities
Behavioral Health is Essential to Health
Prevention Works
Treatment is Effective
People Recover
Improving the quality of life for West Virginians with behavioral health needs
Funded by:
This training is funded by a grant from the U.S. Department of Health
and Human Services, Substance Abuse and Mental Health Services
Administration, Center for Substance Abuse Prevention, and the
West Virginia Department of Health and Human Resources,
Bureau for Behavioral Health and Health Facilities.
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Recognize signs & symptoms of drug abuse
Look for ways to prevent drug abuse among
our youth
How to recognize drugs if you find them
Have your questions answered
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Alcohol and tobacco will remain principal
drug threats to WV because of existing high
levels of abuse, availability and accessibility
Pharmaceutical abuse (opiates) has
registered as a significant problem, reaching
into every county in WV
Marijuana will continue to be the most widely
available and commonly abused illicit drug in
WV.
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Methamphetamine production has increased
since 2006 and has spread throughout the
state.
The threat posed by Synthetic Drugs such as
Bath Salts and Synthetic Marijuana (K2) has
been on the radar since 2010 and has risen
significantly in 2011.
Cocaine has been found in WV but has not
shown a significant increase in use during the
recent past.
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Private and commercial vehicles.
 Most common way of transporting illegal drugs
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Passenger trains
 Daily service between Washington, D.C. and
Chicago with stops throughout West Virginia
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Commuter trains
 Monday – Friday service between Washington,
D.C. and Martinsburg
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Occasional transport via inland waterways
 420 miles of navigable waterways in WV
 The Ohio and Kanawha Rivers are often used
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Infrequent transport via couriers aboard
commercial and private aircraft
 40 small public airports and numerous private
airstrips
 New plan to build a regional airport in Lincoln
County. Concern exists about increased drug
trafficking after it is built
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Typically transported in from:
IL, KY, MD, MI, NY, NC, OH, PA, VA and D.C.
Drugs are transported in from Mexico, to a
lesser extent.
Using Interstates 64, 68, 70, 77, and 79
U.S. Highways 19, 33, 50, 340, and 460
State Routes 11, 22, 39, 41, and 55
Alcohol is alcohol is alcohol…
Source: National Institute for Alcohol Abuse and Alcoholism
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Alcohol affects your self-control
Alcohol depresses your central nervous
system, lowers your inhibitions, and impairs
your judgment
Drinking can lead to risky behaviors, such as
driving when you shouldn’t, having
unprotected sex, or missing work - calling in
sick - when you have a hangover
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Alcohol affects your brain and it can lead to a
loss of coordination, poor judgment, slowed
reflexes, distorted vision, memory lapses, and
even blackouts.
Alcohol affects your body. It can damage
every organ in your body. It is absorbed
directly into your bloodstream and can
increase your risk for a variety of lifethreatening diseases, including cancer.
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Drinking large amounts of alcohol at one time or
very rapidly can cause alcohol poisoning, which
can lead to coma or even death.
Alcohol can hurt you--even if you're not the one
drinking. If you're around people who are
drinking, you have an increased risk of being
seriously injured, involved in car crashes, or
affected by violence.
At the very least, you may have to deal with
people who are sick, out of control, or unable to
take care of themselves.
60
51.1
51.4
51.0
51.4
51.7
36.7
38.2
38.2
51.8
Percent Reporting Use
50
40
36.3
36.2
30
40.3
WV
US
20
10
0
04-05
Source: NSDUH
05-06
06-07
07-08
08-09
09-10
Source: YRBSS
18
16
15.4
15.8
Percent Reporting Use
15.8
15.1
15.6
14
12
15.8
11.2
9.8
10
9.2
9.0
WV
US
8
6
4
2
0
2006
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•
2007
2008
2009
2010
In 2011 WV reported the 2nd lowest prevalence nationwide for
binge drinking at 10.9%
WV had the 2nd highest in the nation for binge drinking
intensity with an average of 9 drinks per episode
Source: NSDUH
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Getting drunk on a regular basis
Lying about how much alcohol he or she is
using
Believing that alcohol is necessary to have
fun
Having frequent hangovers
Feeling run-down, depressed, or even suicidal
Having "blackouts"--forgetting what he or
she did while drinking
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Tobacco damages your health. Smoking is the most
common cause of lung cancer. Smoking is also a
leading cause of cancer of the mouth, throat,
bladder, pancreas, and kidney. Smokeless tobacco
can cause mouth cancer, tooth loss, and other
health problems.
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Tobacco affects your body's development. Smoking
is particularly harmful for teens because your body
is still growing and changing. The 200 known
poisons in cigarette smoke affect your normal
development and can cause life-threatening
diseases, such as chronic bronchitis, heart disease,
and stroke.
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Tobacco is addictive. Cigarettes contain
nicotine-a powerfully addictive substance.
Three-quarters of young people who use
tobacco daily continue to do so because they
find it hard to quit.
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Tobacco can kill you. Smoking is the leading
preventable cause of death in this country. More
than 440,000 Americans die from tobaccorelated causes each year, and most of them
began using tobacco before the age of 18.
60
56.0
52.6
52.0
53.4
54.2
51.7
Percent Reporting Use
50
41.0
41.3
40
38.0
36.5
16.4
16.7
38.4
40.9
30
20
19.5
18.3
16.9
17.4
WV 1217
10
0
04-05
Source:
05-06
06-07
07-08
08-09
09-10
Source:
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Cannabis and Hashish: Weed, Pot, 420, Grass,
Hash, Joints, Mary Jane, Chronic, Herb, Dope
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It increases heart rate
It causes anxiety, paranoia, panic attacks
It causes impaired memory and learning
Contributes to accidents to self and others
 Automobile
 Household
 Occupational
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High doses of marijuana may result in image
distortion, loss of personal identity and
hallucinations
Repeated use can cause:
 Low motivation (A-motivational Syndrome)
 Breathing problems (same as tobacco smokers)
 cough, chronic bronchitis and frequent chest colds
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Marijuana contains toxins and carcinogens
 increased risk for cancer (head, neck, lungs)
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Poor concentration
Increased appetite
Diminished inhibitions
 increased risk for AIDS and other STDs
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New medical marijuana laws
 Marinol (medical marijuana) is FDA approved
and has been on the market for years
 the active ingredient is THC (delta-9tetrahydrocannabinol)
The average potency of marijuana has
more than doubled since 1998
There are also synthetic forms of marijuana
which are chemically based and more potent
Source: National Center for National Products Research
Mehmedic, Z. et al. (2010) Potency trends of THC and other cannabinoids in confiscated
cannabis preparations from 1993 to 2008. Journal of Forensic Sciences, 55(5), 1209-1217.
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Specific odor
Rolling papers, baggies, empty canisters
Pipes, bongs, other smoking devices
Abundance of incense
Source: Google Images
Source:
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Indications of possible use/misuse:
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Animated behavior, loud talking, followed by sleepiness
Dilated pupils, bloodshot eyes
Distortions in perception; hallucinations
Distortions in depth and time perception; loss of
coordination
Withdrawal syndromes – insomnia, hyperactivity,
sometimes decreased appetite
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Drugs used medicinally to relieve pain
Have a high potential for abuse and dependence
 tolerance builds quickly; user needs more and more to
get same effect
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Cause relaxation with an immediate “rush”
Initial unpleasant effects – restlessness, nausea
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Names:
 Heroin (Smack, Horse, Junk)
 Morphine (M, Miss Emma)
 Prescription drugs (Vicodin, Percodan, Demerol,
Oxycontin, Methadone, Codeine)
 Opium
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Usually smoked, injected, sniffed, or oral
Use causes confusion, itching, constipation,
blocks pain messages to brain
Increases risk of Hepatitis and HIV
*Illicit Drug Use is defined as any drug other than Marijuana or any abusable product that can be
obtained legally.
Source:
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Oxycodone (OxyContin, Percodan, Percocet)
Propoxyphene (Darvon)
Hydrocodone (Vicodin, Lortab, Lorcet)
Hydrmorphone (Dilaudid)
Meperidine (Demerol)
Diphenoxylate (Lomotil)
Morphine (Kadian, Avinza, MS Contin)
Codeine
Fentanyl (Duragesic)
Methadone
Drug Name
Oxycodone
Brand Names
Drug Class
Oxycontin, Tylox, Percodan,
Opioid
Percocet, Combunox
Hydrocodone Loret, Lortab, Norco,
Opioid
Vicoprofen, Vicodin
Alprazolam
Xanax
Benzodiazepine
Morphine
MS Contin, Oramorph, MS-IR,
Opioid
Kadian, Aviniza, Roxanol,
Duramorph
Hydromorphone Dilaudid
Opioid
*Percentage of the total drugs abused in 2010
Source: WV Prescription Drug Abuse Quitline
Percentage*
39%
28%
10%
4%
2%
WV
40
36.5
Percent Reporting Use
35
30.7
30
26.6
25
26.6
24.8
21.5
18.3
20
15
10
26.7
12.0
13.8
9.2
5
0
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Source: WV Health Statistics Center
25
20
15
18.8
14.9
12.0
10
19.3
18.5
12.0
12.1
9.5
5
0
2008
2009
Source: Kaiser State Health Facts
2010
2011
WV
US
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Possible effects: “euphoria,” drowsiness,
respiratory depression, constricted (pinpoint) pupils
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Withdrawal
 Watery eyes, runny nose, yawning, cramps
 Loss of appetite, irritability, nausea
 Tremors, panic, chills, sweating
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Indications of possible misuse:
 Scars (tracks) caused by injections
 Constricted (pin-point) pupils
 Loss of appetite
 Sniffles, watery eyes, cough, nausea
 Lethargy, drowsiness, nodding
 Syringes, bent spoons, needles, etc.
Source: WV Poison Center
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Heroin abuse is associated with serious
health conditions, including fatal overdose,
spontaneous abortion, collapsed veins, and,
particularly in users who inject the drug,
infectious diseases, including HIV/AIDS and
hepatitis
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Usually smoked, injected, sniffed, or taken orally
Use causes confusion, itching, constipation,
blocks pain messages to brain
Increases risk of Hepatitis and HIV if injected
Source:
Minimum $1 per milligram
on the street, but this is on
the rise due to tightening of
prescription drug laws.
Street Value:
Approximately
$10 per pill
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Cocaine, Amphetamines, Methamphetamines
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High potential for abuse/dependence
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Taken for the following affects:
 relieve fatigue and increase alertness
 feel stronger and more decisive
 to counteract tranquilizers and alcohol
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Indications of possible misuse:
 Excessive activity, talkativeness, irritability,
argumentativeness or nervousness
 Increased blood pressure or pulse rate, dilated
pupils
 Long periods without sleeping or eating
 Euphoria
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Symptoms of Overdose:
 agitation
 increase in body temperature
 hallucinations, convulsions, possible death
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Withdrawal Syndrome:
 apathy, depression, disorientation
 long periods of sleep
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Dextroamphetamine (Dexedrine and
Adderall)
Methylphenidate (Ritalin and Concerta)
Source: www.justice.gov/dea
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Street Names: Coke, Dust, Snow, Blow,
Powder, Lines, Rock (Crack Cocaine)
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Warning signs of use:
 red, bloodshot eyes
 runny nose or frequently sniffing
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Addictive
 cocaine stimulates pleasure centers of the brain
 tolerance increases
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Use can kill
 causes heart attacks, seizures, strokes and
respiratory failure
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It is illegal – in any form
Even first-time users can have seizures or fatal
heart attacks
It is expensive – regular users can spend
hundreds or thousands of dollars on cocaine
each week
Cocaine impairs judgment and increases risk for:
 poor decision-making (financial, breaking the law)
 HIV/AIDS and Hepatitis
 being the victim of rape and/or unplanned
pregnancy
Source:
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“Meth” is an extremely powerful and addictive
stimulant that affects the nervous system
Street Names: Speed, Meth, Crank, Chalk, Ice,
Glass
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increased alertness
extreme nervousness
anxiety, irritability
hyperactivity
rapid, constant talking
jaw clenching
bad breath
teeth grinding
rotten teeth, loss of
teeth (meth-mouth)
 strong body odor (due
to sweating drug out)
 hair loss (due to drug
oils and poisons, lack of
care, or pulling it out)
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Source:
300
271
250
200
171
140
150
109
100
As of April 16, 2013, there
have been 124 reported
labs for 2013.
50
0
2009
2010
2011
2012
Source: WV Bureau for Public Health, Office of Environmental Health Services
Source: WV Bureau for Public
Health, Office of Environmental
Health Services
01
HANCOCK
2012
Methamphetamine Lab
Notifications
BROOKE
OHIO
WETZEL
MONONGALIA
MARION
MARION
TYLER
02
02
RITCHIE
09
BARBOUR
BARBOUR
03
WIRT
01
22
01
ROANE
07
05
GRANT
05
05
HARDY
03
RANDOLPH
09
PENDLETON
01
08
WEBSTER
07
KANAWHA
85
POCAHONTAS
NICHOLAS
20
LINCOLN
03
02
TUCKER
TUCKER
01
BRAXTON
15
20
WAYNE
07
CLAY
PUTNAM
CABELL
09
HAMPSHIRE
02
LEWIS
JACKSON
04
MINERAL
04
WOOD
MASON
PRESTON
TAYLOR
BOONE
FAYETTE
Total Lab Notifications:
2012: 271
GREENBRIER
02
01
LOGAN
RALEIGH
05
MONROE
WYOMING
MCDOWELL
MERCER
2011: 171
2010: 140
2009: 109
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Gammahydroxybutyrate (GHB), Ecstasy,
Ketamine, Rohypnol, Lysergic Acid
Diethylamide (LSD), and
Methylenedioxymethamphetamine (MDMA)
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These produce behavioral changes that are
often multiple and dramatic
Source:
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Known as: Grievous Bodily Harm, G, Liquid
Ecstasy, Georgia Home Boy
Physical Effects: CNS depressant that can
relax or sedate the body, and slow breathing
and heart rate to dangerous levels at higher
doses
Often used in combination with alcohol and
used as a “date rape” drug
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Psychological Effects: has intoxicant,
sedative, and euphoric effects that begin
within 10 to 20 minutes of the drug being
taken
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Overdose Effects: drowsiness, nausea,
vomiting, headache, loss of consciousness,
loss of reflexes, impaired breathing, and
death
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Known as: K, Special K, Vitamin K, Cat Valium
Liquid or white powder that is snorted or
smoked with marijuana or tobacco; injection
into muscles also reported
Physical Effects: impaired motor function, high
blood pressure, and respiratory problems
Psychological Effects: dream-like states,
hallucinations, and depression
Overdose Effects: delirium, amnesia, and death
from respiratory depression
Ever notice a sign that says: “drugs not kept on
premise” at your Vet’s office?
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Known as:
 Roofies, Rophies, Roche,
Forget-Me Pill
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Form:
 white tablet that dissolves
easily in carbonated drinks
 can be ground up to snort
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Physical Effects:
 sedation and intoxication
 decreased blood pressure
 visual disturbances,
dizziness, confusion
 gastrointestinal
disturbances and urinary
retention
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Psychological Effects: can cause inability to
remember events that happened while under
the influence of it – this contributes to its
popularity as a “date rape” drug
Overdose Effects: CNS depression that
manifests in drowsiness, mental confusion
and lethargy, coma and possibly death (more
likely when used in combination with alcohol)
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Known as: Ecstasy, XTC, X, Adam, Clarity,
Lover’s Speed, Mollies
Chemical action – similar to the stimulant
amphetamine and the hallucinogen mescaline
Form: tablet or capsule taken orally
Physical Effects: stimulation that allows users to
dance for extended periods, dehydration,
hypertension, and heart or kidney failure
Psychological Effects: confusion, depression,
anxiety, and paranoia
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Overdose Effects:
 increased body temperature leads to muscle
breakdown and cardiovascular system failure
 death from heart attack or stroke is possible
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When using:
 people often drink large amounts of water to cool
themselves down -- this can leading to “water
logging” and death
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Under influence:
 eyes are dilated
 users put on “light shows” for one another
 people with pacifiers (to keep teeth from clenching
while under influence)
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Known as: Acid, Boomer, Yellow Sunshines
Form: tablet, capsule or liquid, or on small
pieces of blotter paper to take orally
Physical Effects: dilated pupils, increased
body temperature, increased blood pressure
and heart rate, sweating, loss of appetite, dry
mouth, sleeplessness, tremors, numbness,
weakness, and nausea
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Psychological Effects: abnormalities in
sensory perceptions (effects vary according
to the amount taken, the user’s surroundings,
and his/her personality, mood, and
expectations)
Effects of long-term use: persistent
psychosis and flashbacks
Overdose Effects: Longer and more intense
trip, psychosis, and possible death
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Inhalant abuse refers to the intentional
breathing of gas or vapors with the purpose
of reaching a high.
Inhalants are legal, everyday products which
have a useful purpose, but can be misused.
More than 1,000 products that are very
dangerous when inhaled -- things like
typewriter correction fluid, air-conditioning
refrigerant, felt tip markers, spray paint, air
freshener, butane and even cooking spray.
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Adhesives: model airplane glue, rubber cement, other glue
Aerosols: spray paint, hairspray, air freshener, deodorant,
fabric protector
Solvents and gases: nail polish remover, paint thinner,
typewriter correction fluid, paint thinner, toxic markers,
pure toluene, cigar lighter fluid, gasoline, carburetor cleaner,
octane booster
Cleaning agents: dry cleaning fluid, spot remover, degreaser
Food products: vegetable cooking spray, dessert topping
spray (whipped cream), whippets
Gases: nitrous oxide, butane, propane, helium
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Anesthetics
 Chloroform, ether, nitrous oxide
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Nitrites (nitrite room odorizes)
 Amyl: poppers, snappers
 Butyl: rush, locker room, bolt, climax, also
marketed in head shops as video head cleaner
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Potential Sudden Sniffing Death (SSD) during
any use even the first time
Short term memory loss
Hearing loss
Limb spasms
Permanent brain damage
Bone marrow damage
Liver and kidney damage
Possible fetal effects similar to fetal alcohol
syndrome
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Sitting with a pen/marker near nose
Constantly smelling clothing sleeves
Showing paint or stain marks on fingers, face
or clothing
Hiding rags, clothes, or empty containers of
potentially abused products in closets or
other places
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Emotional instability
Short term memory loss
Cognitive impairment /thought process
Slurred and "scanning" speech
Wide-based ataxic gait
Staggering or stumbling
Ocular flutter / vision problems
Hearing loss
Tremor
Loss of sense of smell
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Abnormal or absent brainstem auditory-evoked
response
Diffuse cerebral, cerebella, and brainstem atrophy
Enlarged ventricles and widening of cortical sulci,
especially in the frontal or temporal cortex
spots or sores around the mouth
red or runny eyes or nose
chemical odor on breath
drunk, dazed or dizzy actions
nausea, loss of appetite
anxiety, excitability, irritability
Source: Gordon T. Pryor, Ph.D.
Source: Youth Risk Behavior Surveillance Survey
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Known as: Roids, stacking, gym candy
Symptoms of use: aggression, acne, rashes,
bone pain, muscle cramps
Highly addictive, organ damage, emotional
disturbances
Males more feminine, females more
masculine
Causes testicular shrinkage
Source: Youth Risk Behavior Surveillance Survey
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On-going drug education
Realize that this is a community problem that
affects all of us
Report suspicious activities to law
enforcement officials
Continued legislative support
What are some examples of legislation?
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Alcoholics Anonymous
1-800-333-5051
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Narcotics Anonymous
1-800-766-4442
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Suicide Prevention Lifeline
1-800-273-8255
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WV Prescription Drug Abuse Quit-line
1-866-987-8488
Center for Substance Abuse Prevention (CSAP),
www.samhsa.gov
 National Drug Intelligence Center,
www.usdoj.gov/ndic/index.htm
 Street Drugs, www.streetdrugs.org
 www.TheAntiDrug.com
 www.freevibe.com
 www.putingkidsfirst.org
 www.lifematters.com
 Erowid.org
 Dea.gov
 www.wvrxabuse.org
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Cathy Coontz, MA, MS, PSII, NPN
Prevention Lead for WV and
National Prevention Network for WV
Division on Alcoholism and Drug Abuse
Bureau for Behavioral Health and Health Facilities
350 Capitol Street, Room 350
Charleston, WV 25301
[email protected]