DRUG ABUSE
History
• Drugs have been used in religious and healing
ceremonies in ancient cultures
• Cocaine was in Coca Cola until 1927
• Coca leaves were chewed by the guides over
the Andes in Peru
• Most everyone has taken drugs, aspirin,
antibiotics, tylenol
• 18 million people have used marijuana
• 32 million have tried cocaine
– 4-5 million use it regularly
Drugs
• Drugs that work on the central nervous
system to alter moods or perceptions are
called psychoactive drugs
• For this lecture, drugs refer to a non food
substance that is deliberately taken to
produce some physiological or
psychological effect
Process of Addiction
• Exposure
– Introduction to the drug
• Compulsion
– More energy, money, time spent getting the drug
– Normal life disintegrates
– Always searching for the high feeling
• Loss of control
– Want the drug to avoid withdrawal
Terms
• Tolerance
– Body become accustomed to the drug
– Need larger doses to get the same effect
• Cross tolerance
– Become tolerant to other drugs
• Alcoholics need higher doses of anesthetic drugs
• Dependence
– Become so accustomed to the drug you can’t live
without it
– May be psychological or physical dependence
Terms
• Psychological dependence
– Do not become physically ill during withdrawal
– You need the drug for your sense of well being
• Physical dependency
– Go through withdrawal syndrome (nausea,
vomiting even seizures)
– Body cells have become reliant on the drug and
continued use of the drug is necessary
• Addiction
– Indicates either a psychological or physical
dependence
– Unable to control craving for the drug
Terms
• Withdrawal syndrome
– Reflects the body’s attempt to regain normality
without the drug
– Ranges from irritability, depression to seizures
and death
Why Take Drugs?
• Individual factors
– Genetic predisposition
• Alcohol dependence
– Personality traits, attitudes and beliefs
• Kids easily bored
• Rebellious
• Resist authority
– Low interpersonal skills and self esteem
Why Take Drugs
• Environmental factors
– Home and family
• Parents model behavior that kids follow
• Antisocial behavior at home
– School
• Kids have hard time fitting in at school
• Poor grades
– Peers
• If you have friends who use drugs increases the chance
that you will too
Narcotics
• Used for pain relief
• Morphine, opium, heroin, demerol, codeine,
methadone
• Resembles endorphins body produces
• Reduce pain
• Mood changes
• Euphoria
• Unable to think clearly
Heroin
Narcotics
• High potential for dependency and addiction
• Easily develop tolerance
• Psychological and physical dependence
• Withdrawal symptoms last 48-72 hours
– Flu symptoms
– Runny nose
– Sweats
– Nausea, vomiting
– Muscle and bone pain
Narcotics
• By the 7-10 day withdrawal complete
• Must treat the psychological addiction
• May use methadone to ease withdrawal
symptoms
Depressants
• Central nervous system depressants
• Decrease overall activity of nerves, muscles
and heart
• Common depressants
– Alcohol
– Quaaludes
– Barbiturates
– Valium
– Rophynol – date rape drug
• 10 times stronger then valium
• Can last up to 8 hours
Depressants
• Valium is the most prescribed tranquilizer, 45 million
prescriptions/yr
• Depressants
– Decrease anxiety
– Mood changes
– Drowsiness
• Many depressants are initially medically prescribed
and addiction follows
• May quickly develop an addiction and a tolerance
– May tolerate up to 15 times the normal dose
• Both psychological and physical addiction
Depressants
• Withdrawal must be done under MDs care
– Nervousness
– Trembling
– Weakness
– Seizures
– Hallucinations
• Barbiturate overdose combined with alcohol
is a common way to commit suicide
Stimulants
• Caffeine
– Coffee
– Tea
– Cocoa
– Cola
– No doz
– Chocolate
– Anacin
Stimulants
• Caffeine
– Increased alertness
– Stimulates heart rate and respiratory rate
– High doses cause nervousness, irritability
• Ephedra
– OTC herbal stimulant
– Weight loss pills
– Many have died taking ephedra overdose
Stimulants
• Amphetamines
– Pep pills, uppers
– Quickly develop a tolerance
– Found in diet pills
– Students, truck drivers use them to stay awake
– When the drug wears off you suddenly fall asleep
– Avoid the experimental stage and use it for a
specific reason which increases the chance for
addiction
– Depression occurs during withdrawal
– Must deal with psychological addiction
Stimulants
• Methamphetamines
– Ice, crystal meth
– Produced in illegal labs, kitchens
• Can be made with OTC cold medications, fertilizers,
battery acid, and hydrogen peroxide
– Effects felt in first 7 seconds after smoked,
injected, pills or snorted
– Effects last several hours
– Chronic use
• Wt loss
• Infections
– Psychological addiction
– Withdrawal see fatigue, depression
Stimulants
• Cocaine
– Originally from Andes to relieve fatigue
– In the US by 1880s
– Very addictive
• Can be
– Snorted
– Injected
– Free based
• Effects do not last long
– Repeat dose in 5-30 min especially for heavy
users
Stimulants
• Cocaine physical effects
– Destroys users nose
– Euphoria, impaired judgment
– Seizures
– Aneurysm due to high blood pressure
Cocaine
• Feels like bugs under your skin
• Severe lung damage with heavy use
• Heart attacks
• Strokes
• Life threatening arrhythmias
• Decreased appetite, malnutrition
• Acute paranoia
Stimulants
• Crack cocaine
– Very addictive
• Only 50% able to kick the habit
– Cheap
– Combines cocaine with baking soda and heated in
a pipe and vapors inhaled into the lungs
– May be combined with heroin or
methamphetamine and given IV a speedball
– Feel effects in 10 seconds and gone in 6 min
Stimulants
• Cocaine
– Pregnancy
• Devastating effects on fetus
• Low IQ scores
• Deficit in language skills
• Withdrawal symptoms include depression
and lethargy, beware of suicide
• Psychological dependence
Hallucinogens
• Psychedelic drugs
• Very popular in the 1960s
• Generally do not cause physical dependence
but may cause psychological dependence
Hallucinogens
• LSD
– Made in home labs
– May be placed on blotter paper and then put into
the mouth
– Physical symptoms include
• Dizziness
• Weakness
• Visual disorders
Hallucinogens
• LSD
– Psychological symptoms
• Mood changes
• Depersonalization
• Alteration in the relationship between self and
external reality, known as an altered state of
consciousness
– symptoms start within minutes of ingestion and
last 6-9 hours
Hallucinogens
• LSD
– “bad trips” caused by impurities in the
drug
– Flashbacks may occur five years after the
initial bad trip
LSD
Hallucinogens
• PCP
– Angel dust
– Used as a large animal anesthetic
– Lasts 4-6 hours
– Low dose
• Euphoria
• Numbness
• Slurred speech
• Hostile behavior
Hallucinogens
• PCP
– Large dose
• Psychotic behavior
• Violence
• Seizures
• Coma
• Paranoia
• Aggressive behavior
• Unable to feel pain
• Cardiovascular collapse
• Damage to respiratory centers
Hallucinogens
• Designer Drugs
– Made in illegal labs, uncontrolled,
dangerous
– Produces a peaceful feeling
– MDMA (ecstasy)
• Illegal since 1985
• Part of the club scene
• About 8.1 million Americans have tried it
• Affects serotonin and dopamine a neural
transmitters
Hallucinogens
• Designer Drugs
– Ecstasy
• Leads to Parkinsonian symptoms, trembling,
shaking with movement
• High body temperatures up to 110 degrees
resulting in death
• May lead to chronic depression
• Strong psychological addiction occurs
Ecstasy
Marijuana
• 5000 year old history
• Used as a pain reliever before aspirin
• Euphoria, heightened sensory experience
• THC active ingredient, fat soluble and may
stay in body tissue for a month
• High probability of psychological
dependence, low probability of physical
dependence
• Used for glaucoma, chemotherapy and AIDS
patients
Marijuana
• Long term effects
– Chronic abuse leads to amotivational syndrome
– Chronic bronchitis and damage to lungs
– Lung cancer
• 400 chemicals in marijuana linked to lung
cancer
– Lower testosterone levels and abnormalities in
sperm count
– Alters menstrual cycle, low birth weight infants
– Damages the immune system
Inhalants
• Huffing, sniffing, wanging
• Found in about 1000 products
– Correction fluid
– Air fresheners
– Sprays used to clean electronic keyboards
• Cheap, easy to obtain
• Produces euphoria,
• Depresses the central nervous system
• Slows the heart rate and can kill you
Inhalants
• Signs to look for in abuse
– Paint stains on clothing
– Sores around the mouth
– Chemical odor on the breath
– Drunk, dazed appearance
– Anxiety, excitability, irritability
– Highest use in 7th and 8th grade
Prevention of Drug Use
• Education at the grade school level
• Eliminate the demand for the drug
• Early detection
• Chronic users are very difficult to treat
Drug Testing
• Approx 70% of companies use drug testing
• Tests 90% accurate
• Drugs commonly tested
– Amphetamines
– Barbiturates
– Valium
– Marijuana
– Opiates
– PCP
Drug Treatment
• Relapse rate very high
• Multiple dependencies
– Addicted to multiple drugs and alcohol
• Counseling options
– Most common is individual therapy
– Group therapy
– Family therapy
– Crisis intervention
– Detoxification
– Chemotherapy (antibuse, methadone)
