Final Essay Questions, 5 problems total, each answer should be at least 100 words. Due 4/29 by midnight. PLEASE read those PowerPoints first, and make sure CITE all sources in MLA/APA format.
Please cite all work, APA or MLA.
1. Describe in detail the elements for effective alcohol/drug treatment.
2. What are the greatest risk factors for using stimulants, including Rx, cocaine, crack and meth. How are they similar or different?
3. Explain how are hallucinogenic drugs both dangerous and being used for medical research?
4. What are the risk factors for common caffeine use and how can users reduce their risk for these factors?
5. Moving from an Rx opioid epidemic to heroin/fentanyl laced drugs how can communities in our country reduce the use/death rate of these drugs?
4 Stages of Alcohol Use
*Information taken from the Prevention Research Institute
Prime for Life Risk-Reduction Program
Stage One Low Risk
0-2 Drinks Daily 0-3 in not Daily
No more than one drink per hour
No risk for impairment problems/long term health problems due to use.
Stage Two High Risk Infrequent
4 or more drinks in a sitting for a woman
5 or more drinks in a sitting for a man
Move into Stage Two because of:
Celebration, Holiday, Special Occasion
Warning Signs:
2 or more blackouts in a month, short term memory loss, increased tolerance
Making High Risk Choices on a Regular Basis
People who start to make high risk drinking choices on a regular basis will eventually move into Stage 3.
Remember Stage 2 in Infrequent behavior or unplanned or unexpected behavior.
If you are making high risk drinking choices on more than two occasions in a month that is a sign of moving into Stage3.
Stage Three Dependence
The individual is dependent on the Drinking Ritual, they are not yet an alcoholic.
Many in Stage 3 will have enablers who support their high risk drinking choices.
All of their friends drink to the same level, have had judicial, legal, social, academic and financial problems.
Other drug use may become more regular.
This is where the gateway effect may come into play.
NO ONE CAN STAY IN STAGE 3 FOREVER
Stage Three Dependence
50% of the people in Stage 3 will move back to low risk choices due to a life changing event.
Of the 50% who remain in Stage 3 some will Die.
Those who do not die or move back to low-risk will eventually move to Stage 4.
Moving into Stage 4 is considered crossing the “Trigger Level” or the point at which a diagnosis could be made.
Stage Four Alcoholism
The individual has crossed the “Trigger Level” into addiction.
What are the Choices?
Detox, treatment, rehab and aftercare.
Continue behavior and die of what didn’t kill you before.
Develop and eventually die of an alcohol related illness.
Alcoholism
Alcohol addiction is a complex disease that results from a variety of genetic, social, and environmental influences. Alcoholism affected approximately 32 million or 30% producing severe economic, social, and medical ramifications. NIAAA, 2015
Three medications have been FDA–approved for treating alcohol dependence: naltrexone, Campral, and disulfiram.
https://www.youtube.com/watch?v=4hKmYthx718
Family History
Parent or Grandparent with alcoholism or alcohol related problems
Unusual early response to alcohol
Extended family members, brothers, sisters, aunts and uncles with alcoholism or alcohol related problems
Low-Risk Guidelines
No to all 3: 0-2 daily 0-3 if not daily
no more that 1 per hour
Yes to 1: 2 not daily, no more
than one per hour
Yes to 1
& 2 or 3 0
Individual Differences
Individual differences change how your body reacts to alcohol and increase impairment.
Small body size/muscle mass
Gender
Age
Altitude
Other Drugs
Individual Differences
Illness or Tiredness
Empty Stomach
Mental Health Status
What’s High Risk About being Impaired?
What’s Harmful About High Risk Drinking If People Don’t Become Impaired?
What Is A Drink?
12oz. of Beer is equal to….
4-5 oz. of Wine is equal to …
Liquor
80 Proof (40% Alcohol)…………………………………… 1-1/2 ounce shot
100 Proof (50% Alcohol)………………. 1 ounce shot
Carbonated mixers cause more impairment that food based mixers
This is approximately one-half once of pure alcohol
What Is A Drink?
Beer/Malt Liquor (8% alcohol)……………… 6 Ounces
***40oz bottle = 6.4 drinks***
Wine
Bottle (25.6 ounces at 10% alcohol)….. 5 standard drinks
Magnum (64 ounces at 10% alcohol)..….12.8 standard drinks
Box Wine is equal to 4-5 standard bottles
Wine Coolers*(5-7% alcohol)………………. . .8-10 ounces
**Includes Bacardi Breezers, sky, ciders, etc.) **Three 12ounce bottles at 7% alcohol = 4.5 drinks**
Number of Standard Drinks per Keg
Keg (31 gallons, 12 ounce cups) ………330 standard drinks
Caffeine and Alcohol
Mixing caffeine and alcohol can increase the risk of alcohol poisoning. Since caffeine makes people feel “less drunk” than they really are, they tend to drink more than they should.
Mixing alcohol and caffeine can make your heart rate and blood pressure rise.
Caffeine and alcohol are both diuretics, leading to dehydration (and really bad hangovers).
Caffeine and Alcohol
Caffeine can make you feel energetic even if you’re drunk. Why is this dangerous? Because people can be “tricked” into thinking they are alert enough to do things like drive a car, when they really aren’t.
Adding caffeine to alcohol can make drinking alcohol all the more addictive.
Before you drink read the label.
Drunkorexia
so named because it straddles the line between an alcohol disorder and an eating disorder
The practice involves skipping meals, exercising heavily before drinking alcohol, taking laxatives or diuretics, or vomiting after imbibing
Alcohol & Sexual Assault
Over 80% of sexual assaults on college campuses involve alcohol.
Alcohol is the number 1 Acquaintance/Date rape drug.
Contributing factors……………
Alcohol & Sexual Assault
Ohio Revised Code:
Occur on a continuum of intrusion and violation
ANY unwanted sexual behavior
If permission has NOT been given
or
the s/he does not want to engage in the activity
or
is mentally impaired, intoxicated, tricked, coerced,
or
pressured into the behavior,
then it is sexual assault.
https://www.google.com/maps/d/edit?mid=1LM_EVliSnNiJgb_MQKGvcZ-SHMiO6oni&ll=39.327605665152525%2C-82.09775885560833&z=15
Alcohol & Sexual Assault
If YOU are charged judicially with…
A sexual violation Expect a minimum of
1 semester suspension
If there was physical Expect a minimum of
contact 1 year suspension
If there was penetration Expect expulsion
Caring for a Drunk Person
Cut them off!
Provide high-protein foods & bottled water.
Keep your distance. Before approaching or touching, explain your intent and concern.
Try to get as much info as you can about how much they have consumed and what other drugs they are using.
Stay with someone who is vomiting. When laying down make sure to put him/her on their side.
Monitor the persons breathing.
If you are unsure you can handle the situation call 911.
If the person is in a life threatening health crisis call 911.
Alcohol Overdose
Warning Signs:
Difficulty Breathing- Slow, less than 8 breaths per minute or irregular with 10 or more seconds between each breath.
Passed out or Stuporous- Semiconscious or unconscious and can not be awakened.
Dehydrated- Bluish tint of the lips and fingernails.
Cold and clammy skin.
Vomiting while sleeping or passed out.
For more info www.ohio.edu/alcohol
Medical Emergency Assistance
What does MEA provide?
A Medical Emergency Assistance Program would allow a student experiencing an alcohol or other drug overdose to receive medical attention without judicial charge. It would also remove judicial charges for those who assisted the student in need if they had been in violation of an alcohol or drug policy.
How will MEA support current environmental strategies to reduce high-risk drinking?
According to a recent survey, 94% of students surveyed said that they would not call for help in a medical emergency involving alcohol or other drugs. The students experiencing these emergencies did not receive any type of interventions. MEA will provide appropriate interventions to students experiencing medical emergencies, caringly confronting their high-risk behaviors.
MEA
Why Is High-Risk Use A Problem?
Ohio University Students reported the following experiences from their own drinking:
18% missed class at least once
16% had unprotected sexual activity
26% did something they regretted
Ohio University Students reported the following experiences from other students’ drinking:
45% had studying or sleep interrupted
51% had to care for a drunk person
3% were taken advantage of sexually
Taken from the Healthy Campus Survey (Spring 19)
Alcohol Edu Data Fall 2019
survey 1 survey 3
Summer Fall
Moderate Drinkers 23% 23%
1-5 drinks on one occasion least one occasion in the past two weeks
High Risk Drinkers 17% 22%
5-9 drinks on at least one occasion in the past two weeks
Problematic Drinkers 6% 9%
10+ drinks on at least one occasion in the past two weeks
Abstainers 25% 24%
0 drinks in the last year
Nondrinker 26% 19%
0 drinks in the last two weeks
The College Effect
The Healthy Campus Majority
82% Of Ohio University students are in the Healthy Drinking Majority
13% Abstainer
21% Nondrinker
48% Moderate Drinker
Source, Health Campus Survey Spring 2019
The Minimum Legal Drinking Age (MLDA)
The minimum legal drinking age (MLDA), also referred to as the Age 21 laws, refers to the Uniform Drinking Age Act of 1984.
In 2013, 10,076 people died in drunk driving crashes. One every 52 minutes. 290,000 were injured in drunk driving crashes.
The Minimum Legal Drinking Age (MLDA)
Citizen advocacy groups responded to this evidence by pressuring legislators to raise the MLDA back to 21, prompting passage of the Uniform Drinking Age Act of 1984.
All states had restored an age-21 MLDA by 1988, once again providing researchers with many natural experiments to assess effects of these policy changes on alcohol consumption and related problems among.
There seems to be support for lowering the legal drinking age – is this true?
According to an ABC News/Washington Post poll conducted in 2005, the majority (78 percent) of Americans, youth and adults, support the age 21 drinking law.4 In fact, 73 percent of young adults under the age of 34 oppose allowing 18- to 20-year-olds to drink.4
A 2001 Associated Press poll found that fully three-quarters of adults and teens alike thought the drinking age should be enforced more vigorously.3
“The current age restriction was signed into law by President Reagan on July 17, 1984. Its support today is nearly identical to its level then — 79 percent in a Gallup poll in June ’84.”4
Alcohol Consumption Patterns of Women
Women 21 to 34 years of age were least likely to report alcohol-related problems if they had stable marriages and were working full time.
Women tend to marry men whose drinking habits match their own.
Between 35 to 49 years of age, the heaviest drinkers were divorced or separated women without children.
Between 50 to 64 years of age, the heaviest drinkers were women whose husbands/partners drank heavily.
Women 65 and older comprised less than 10% of drinkers with drinking problems.
Women who have one drink per day have an increased risk of breast cancer compared to those who do not drink.
FASD Fetal alcohol spectrum disorder
Fetal alcohol syndrome FAS
Fetal alcohol effect FAE, not a diagnosis
Alcohol is the second leading cause of premature death in America.
The CDC reports – about 3.3 million US women, 15-44 years, are at risk of exposing their developing baby to alcohol.
https://www.youtube.com/watch?v=m7zfJCW9Yco&t=5s
FASD Fetal alcohol spectrum disorder
Approximately $176 billion is spent annually dealing with social and health problems related to alcohol use.
More recent reports from specific U.S. sites found the prevalence of FAS to be 2 to 7 cases per 1,000 CDC estimates 1,000 to 6,000 births each year,24 and the prevalence of Fetal Alcohol Spectrum Disorders (FASD) to be as high as 20 to 50 cases per 1,000.25
The Circle of Hope: A Mentoring Network for Birth Mothers
A strong international network that will work to mentor women who are struggling with addiction or have used alcohol or other drugs while pregnant. Most members have a child or children with Fetal Alcohol Spectrum Disorders (FASD).
Goals:
1.To improve and strengthen the lives of birth families
2. To provide peer support for birth families
3. To decrease the stigma, blame and shame that birth families may experience
Stimulants
Why do we need them?
How are they socially acceptable?
Reasons Why People Use
Experimentation/study aid (students)
Appetite suppressant/weight control
4% of OU students have used cocaine at least once in the last 30 days 0.42 Crack
63% had used Ritalin type medications for non-medical reasons 18% to increase academic performance
2019 Healthy Campus Survey
Stimulants
Major and Minor Stimulants
All major stimulants cause increased alertness, excitation, and euphoria; thus these drugs are referred to as “uppers.”
Amphetamines
Cause dependence due to their euphoric properties and ability to eliminate fatigue.
Can be legally prescribed by physicians.
Abuse occurs in people who acquire their drugs by both legitimate and illicit ways.
Approved Uses of Amphetamines
Narcolepsy
Attention Deficit Hyperactivity Disorder (ADHD) Tell your doctor if…….
you or your child have any heart problems, heart defects, high blood pressure, or a family history of these problems.
you or your child have, or about a family history of suicide, bipolar illness, or depression
Side Effects
Abuse
Cardiovascular toxicities
Increased heart rate
Elevated blood pressure
Damage to blood vessels
Minor Stimulants
Caffeine is the most frequently consumed stimulant in the world.
It is classified as a
methylxanthine
It is found in a number
of beverages
Also found in some OTC
medicines and chocolate
Americans consume 400 million cups of coffee per day. 75% of caffeine consumed is coffee.
Caffeine Content of Beverages
and Chocolate
Beverage Caffeine Content (mg)/cup Amount
Brewed coffee 90–125 5 oz.
Instant coffee 35–164 5 oz.
Decaffeinated coffee 1–6 5 oz.
Tea 25–125 5 oz.
Cocoa 5–25 5 oz.
Coca-Cola 45 12 oz.
Pepsi-Cola 38 12 oz.
Mountain Dew 54 12 oz.
Chocolate bar 1–35 1 oz.
Physiological Effects of Stimulants
CNS effects
Enhances alertness, causes arousal, diminishes fatigue
Adverse CNS effects
Insomnia, increase in tension, anxiety, and initiation of muscle twitches
Over 500 milligrams—panic sensations, chills, nausea, clumsiness
Extremely high doses (5 to 10 grams)— seizures, respiratory failure, and death
Physical Effects of Stimulants
Caffeine intoxication
Restlessness, nervousness,
excitement, insomnia,
flushed face, dizzy,
muscle twitching, rambling thoughts and speech, stomach complaints
Caffeine dependence
OTC Drugs Containing Caffeine or Caffeine-like Stimulants
Analgesics (OTC pain meds)
Stay-awake products
Decongestants
Herbal stimulants
Major Stimulants
Meth
Ecstasy
Rx medications
Cocaine
Methamphetamine
Meth, Speed, Ice, Crystal, Crank, Glass
Comes in 2 forms
Powered and Crystallized
Can take orally, intranasally, intravenously
ohttps://www.youtube.com/watch?v=AkiqQaw87AAr smoked
Meth
Immediately after smoking or injection a meth user experiences an intense sensation called a “Rush”
Users become addicted quickly and with frequent use increase doses
Meth releases high levels of dopamine
1% of OU students have used meth in the last 30 days Healthy Campus Survey 2019
Meth Short Term Effects
Increased alertness Increase heart rate
Sense of well-being Paranoia
Intense high “Rush” Violent behavior
Hallucinations Insomnia
Intense sexual pleasure No appetite
Aggressive behavior Numbness
Meth Long-Term Effects
Fatal kidney/lung disorders Decreased social life
Depression Loss of coping skills
Psychological problems Liver damage
Weight loss Stroke
Insomnia Death
Paranoid schizophrenia
Malnutrition
Violent/aggressive behavior
Meth Addiction/Tolerance
Addiction
Occurs when the user seeks out and takes the drug compulsively
Tolerance
The user needs larger
doses of the drug to
get the same desired results
Meth
4 step process of clandestine production
Extraction Phase: extracting ephedrine/pseudoephedrine
Reaction Phase: combining pre-cursors and add heat match books, RedP, ephedrine, anhydrous, ammonia, peroxide, lithium, metal mason jars, hot plates, milk jugs and vinyl tubing
Meth
Separation/Oil Phase: adding solvent to form oil to separate from water lighter fluid, gasoline, kerosene or coleman fuel
Crystallization Phase: use of acid gas generator precipitates Methamphetamine add hydrogen chloride, salt or drano
Highly Volatile Production Process
Shake and Bake
Rx Medications
Methylphenidate
Classified as a Schedule II drug
Common use to treat ADD
Non-ADD user could be charged with possession of a controlled substance.
63% of OU students have used for non-medical use.
Rx Medications
More potent that caffeine and less potent than amphetamines
In large doses can cause seizures, psychosis or stroke, psychotic episodes
Dexedrine, Concerta,Vyvanse, Adderall
Short-Term Effects
Appetite Suppression
Wakefulness/Increased heart rate & BP
Increased focus/attentiveness
Euphoria
Insomnia
Weight loss
Long-Term Effects
Potential for dependence and addiction
Anxiety, restlessness, paranoia, delusions
Formication, skin rash & itching
Tremors and muscle twitching
Nausea/vomiting/headaches/dizziness
Severe depression upon withdrawal
Ecstasy is a synthetic (man-made) drug.
The Facts – Ecstasy
Stimulant and Hallucinogen
Acts as a Psychoactive Drug
The chemical is MDMA, Molly
Street Names: Ecstasy, X, Beans, XTC, Stacy, Adam, Love Drug
Became a Schedule I drug in 1985
Most people using Molly in Athens are really using Meth
The Wanted Effects
“Mood elevator” that produces a relaxed, euphoric state
Heightened feelings of empathy, emotional warmth, and self-acceptance
Sensations of understanding and accepting others
Enhances physical senses such as touch, taste, and smell
Enhanced sexual experience, loss of gag reflex
3.1% of OU students had used in the last 30 days
The Unwanted Effects
Short-term Effects
Muscle tension
Nausea
Blurred vision
Rapid eye-movement
Faintness, chills, and sweating
Death from overheating
The Unwanted Effects
Long-term Effects
Psychological difficulties:
Confusion
Sleep problems
Depression (Serotonin depletion)
Drug craving
Severe Anxiety
Paranoia
Addiction
The Unwanted Effects
Long-term Effects
Physical symptoms:
Increase in heart rate and blood pressure
Develop a rash that looks like severe acne because of liver damage
Development of panic disorders
Jaw clenching that leads to the grinding away of tooth enamel
Ecstasy and illegal use
Many pills sold on the illicit market as “Ecstasy” usually contain substances far more dangerous than MDMA.
PMA – a powerful stimulant used in place of MDMA
Cheaper
Easier to manufacture
Cough Syrup
DXM – a legal cough suppressant, that in high does can prevent sweating
Deaths can occur
Various Over-the-Counter medications
Bath Salts
The synthetic powder is sold legally online and in drug paraphernalia stores under a variety of names, such as “Ivory Wave,” “Purple Wave,“ “Cloud Nine,“ “Vanilla Sky,” “White Lightning,” “Scarface,” and “Hurricane Charlie.“
Knowledge about their precise chemical composition and short- and long-term effects is limited.
http://www.youtube.com/watch?v=bKbTbRqXVFg
Bath Salts
These products often contain various amphetamine-like chemicals, such as (MPDV), mephedrone and pyrovalerone.
Produce Meth like effects with high rate of overdose.
NIDA reports that death rates of 23,000 peaked in 2012.
Krokodil-Desomorphine
Derivative of codeine may contain unknown ingredients. Can be cooked at home like Meth.
Those who inject causes extreme skin ulcerations, infections and gangrene.
Zombie like psychotic behavior
Cocaine is a naturally occurring psychostimulant
found in the leaves of a South American shrub.
The Facts – Cocaine
History
1814 – researchers encouraged people to use cocaine as a food supplement
Coca-Cola was introduced in 1886 as a “valuable brain tonic and cure for all nervous afflictions.”
In 1906 there was undetectable amounts of cocaine in Coca-Cola.
It was illegalized in 1914.
By 1982, 20 million Americans tried cocaine compared to only 4 million in 1974.
The Facts – Cocaine
Powerful central nervous system stimulant
Interferes with the re-absorption process of dopamine, serotonin
Major route of administration – sniffing, snorting, smoking, injecting
Street Names:
China White, Blow, Snow, Candy,
Coke, Happy dust, Line, Rock
Free-basing is a method of reducing impurities in cocaine.
It is also the most powerful form of cocaine.
This is also known as crack or rock.
The removal of hydrochloride for a lower melting point to smoke.
Cocaine Administration
Orally-chewing the coca leaf
Inhaled into the nasal passages-snorting
Injecting intravenously
Smoked
14,566 overdose, 2017 NIH
The Wanted Effects
Intense sense of pleasure and being alive
Intense feeling of supremacy
Having more energy and being more alert
Elevates mood
Clearer thinking
Enhanced concentration and performance.
The Unwanted Effects
Insomnia/Restlessness
Increased temperature
Dilated pupils
Constricted vessels
Increased blood pressure
Decreased appetite
Increased heart rate
Convulsions
Nausea
Blurred vision
Chest pain
Muscle spasms
Coma
Short-term Effects
The Unwanted Effects
Long-term Effects
Paranoia/anxiety disorders
Irritability
Restlessness
Auditory Hallucinations
Formication/sensory hallucinations
Depression
Heart attacks, strokes and seizures
Open sores from continuous injections
Coca ethylene
A drug that is formed in your body when cocaine and alcohol are mixed
Enhances cocaine’s euphoric effects
Increases cardiovascular risks
Leads to more impulsive decision-making
Increases the risk of sudden death
Source: National Institute on Drug Abuse
3 Stages of Cocaine Withdrawal
The Crash, initial abstinence phase consisting of depression, agitation, suicidal thoughts, and fatigue
Withdrawal, including mood swings, craving and drug seeking
Extinction, when normal pleasure returns, which cues trigger cravings and mood swings
Treatment of Cocaine Dependence
Is highly individualistic and has variable success
Principal strategies include inpatient and outpatient programs
Drug therapy often is used to relieve short-term cocaine craving and to alleviate mood problems and long-term craving
Counseling and support therapy are essential
Cocaine Trends
Cocaine abuse continues to be one of the greatest drug concerns in the U. S.
From 1978 to 1987, the U.S. experienced the largest cocaine epidemic in history
Decline of abuse began in the later 1980’s
Substance-induced psychotic disorder
Prominent psychotic symptoms (i.e., hallucinations and/or delusions ) determined to be caused by the effects of a psychoactive substance is the primary feature of a substance-induced psychotic disorder.
A substance may induce psychotic symptoms during intoxication (while the individual is under the influence of the drug) or during withdrawal (after an individual stops using the drug).
*
DEA Schedule
Schedule I and II drugs have a high potential for abuse.
Schedule I – available for research only and have not medical use
Schedule II – available only by prescription (not refillable) and require a form for ordering
Schedule III & IV – available by prescription, may have five refills in 6 months, and may be ordered through the mail
Schedule V – available over the counter
Terry Koons
Hallucinogens
, Depressants
and Opiates
Hallucinogens
LSD
PCP
Ketamine
Mushrooms
Hallucinogens
Drugs that cause changes in a persons perceptions: see images, hear sounds, feel sensations, all seem real, but don’t exist.
History of Hallucinogens
The Native American church
-The American Indian Religious Freedom Act of 1978
Timothy Leary and the League of Spiritual Discovery
– The Psychedelic Experience
Traditional Hallucinogens: LSD Types of Agents
LSD (lysergic acid diethylamide), mescaline, psilocybin, dimethyltryptamine (DMT), and myristicin
These drugs cause predominantly psychedelic effects
2013 229,000 age 12 and older had used in the last month
SAMHSA
2019 HCS Survey 5% of OU students had used LSD at least once in the last 30 days
LSD
Usually felt within 30-90 minutes after ingestion and lasting 6-12 hours
Traditional Hallucinogens: LSD Type of Agents
About half of the substance is cleared from the body within 3 hours, and more than 90% is excreted within 24 hours
Effects of this hallucinogen can last 2-12 hours
Tolerance to the effects of LSD develops very quickly
LSD: Emotional and Sensory Effects
Rapidly shifting emotions from fear to euphoria
Hear or feel colors and see sounds
LSD can trigger underlying mental problems and produce delusions, paranoia and schizophrenia-like syndrome
Distortion or transformation of shape and time.
Bad trips
Terrifying thoughts and nightmarish feelings of anxiety and despair, fears of insanity, death or losing control.
LSD: Physical Effects
Increase in blood pressure
Increase in heart rate
Dizziness
Loss of appetite
Dry mouth
Sweating
Nausea
Numbness
Tremors
LSD: Long Term Effects
Persistent Psychosis
-Distortion or disorganization of a person’s capacity to recognize reality, think rationally or communicate with others.
Hallucinogen Persisting Perception Disorder (Flashback)
-Spontaneous, repeated, sometimes continuous recurrences of some of the sensory distortions originally produced by LSD.
LSD: Addiction and Tolerance
Addiction
No evidence
Tolerance
Quickly developed
Cross tolerance to other
Hallucinogens
LSD: What to do for a bad trip
Stay calm. If you are scared, the tripper will know it—and feel even more panicky
Be supportive. Define reality. Remind the person that they’re experiencing drug effects that will go away.
Use distractions. LSD users are distractible, so help focus their attention on something more pleasant.
Change the setting. Sometimes, simple changes in setting–dimming lights or turning down music, for instance–is all it takes to calm an anxious, prospective acid casualty.
Other LSD Types of Agents
Mescaline (Peyote)
-Mescaline is the most active drug in peyote; it induces intensified perception of colors and euphoria
-Effects include dilation of pupils, increase in body temperature, anxiety, visual hallucinations, and alteration of body image, vomiting, muscular relaxation; very high doses may cause death
-Street samples are rarely authentic
Mushrooms
A mushroom “trip” tends to last for about four to five hours.
Effects similar to those of LSD.
Used by many indigenous Cultures to induce altered states of consciousness during religious rituals.
2019 HCS survey 5% of OU students had used shrooms at least once in the last 30 days.
Mushrooms
Low doses
Feelings of relaxation, not dissimilar to those of cannabis
Laughing a lot and finding things funnier than they would normally
High doses
The experience is closer to that of LSD, intensified colors and producing visual hallucinations and feeling of euphoria
Mushrooms: Adverse Effects
Misidentification. Some mushrooms are poisonous and cause stomach pains, vomiting, diarrhea and even death.
Some users report getting sick even after ingesting real psilocybin varieties.
Impair judgment.
Can trigger underlying mental disorders and cause schizophrenic-type symptoms.
“Bad trips,” which can include confusion, anxiety and panic. In rare instances, users can experience recurring episodes of anxiety and panic (flashbacks) days, weeks, or even months after a bad trip.
Mushrooms
Addiction
No evidence
Occurs when the user seeks out and takes the drug compulsively
Tolerance
The user needs larger doses of the drug to get the same desired results
PCP Phencyclidine
PCP
Developed as a surgical anesthetic with sedative and anesthetic effects that produce trance-like, out of body, detached from their environment, unpredictable effects.
Phencyclidine, illegal in 1978/Schedule II drug
Usually felt minutes after ingestion and last several hours
Street Names: Angel Dust, Hog, Dippers, Ozone & Rocket Fuel
2013 6 million age 12 and older had used in the their lifetime
SAMHSA
https://www.youtube.com/watch?v=QjJSjU9EDUI
PCP: Low Dose Effects
Shallow, rapid breathing
Increased blood pressure and heart rate
Elevated temperature
Distortion of space, time and body image
Exaggerated strength
Hallucinations
Panic
Fear
Invulnerability
Severely disoriented
Violent
Suicidal
PCP: Higher Dose Effects
Changes in blood pressure, heart rate and respiration
Nausea
Blurred vision
Dizziness
Decreased awareness of pain
Muscle contractions
PCP: Very High Doses
Convulsions
Coma
Hyperthermia
Death
PCP: Addiction and Tolerance
Addiction
Memory loss and depression may continue for up to a year after stopping
Tolerance
The user needs larger doses of the drug to get the same desired results
Ketamine
Human and animal anesthetic
White powder that can be smoked, snorted or injected
Street Names:
Special K, K, Cat and Vitamin K
Effects:
Out of body experience, loss of muscle coordination
Depression, amnesia and breathing problems
Depressants
GHB
Benzodiazepine
GHB
Human growth stimulants for body building
Usually a clear, odorless liquid
Popular recreation use due to what has been described as a pleasant alcohol-like high without the hangover.
Can be transported in water bottles or eye droppers and slipped into drinks or taken by the capful.
GHB
It is classified as a sedative-hypnotic, and originally developed as a sleep-aid.
Lower doses- euphoric effects similar to alcohol, relaxed, happy and sociable.
Higher doses- dizzy and sleepy, and can sometimes cause vomiting, muscle spasms, and loss of consciousness.
Overdose- loss of consciousness(temporary coma), and slows down breathing.
Sometimes, and particularly if mixed with alcohol, GHB can slow breathing down to a dangerously low rate, which had caused a number of deaths.
GHB: Effects
Usually felt within 15 minutes and last anywhere from 1-2 ½ hours with after effects lasting 2-4 hours.
Water soluble and is metabolized and out of the body within 4-6 hours
GHB: Effects
Intoxication (similar to 4-6 drinks)
Increased energy
Happiness
Talkative
Difficulty concentrating
Possible nausea
Feeling of affection or playfulness
Mild disinhibition
Sensuality
Enhanced Sexual experience
Loss of gag reflex
GHB: Large Doses
Disinhibition
Sedation
Desire to sleep
Rambling incoherent speech
Giddiness
Silliness
Difficulty thinking
Slurred speech
Passing out( if lose consciousness, always seek medical attention)
Death
GHB: Adverse Doses
Nausea
Headaches
Drowsiness
Dizziness
Amnesia (lead to SA)
Vomiting
Loss of muscle control
Respiratory problems
Loss of consciousness
Being conscious but unable to move especially when combined with other drugs.
GHB: Addiction and Tolerance
Addiction
Similar to alcohol and withdrawal
Can be life threatening
Tolerance
The user needs larger doses of the drug to get the same desired results
GHB: Legislation
October 1996: “Drug-Induced Rape Prevention and Punishment Act” was passed. Increased federal penalties for use of any controlled substance to aid in sexual assault.
February 18, 2000: Hillory J. Farias and Samantha Reid Date-Rape prohibition Act was signed by President Clinton. Made GHB a Schedule I drug, MDMA is Schedule I, Rohypnol is Schedule IV, and Ketamine is Schedule III.
Rohypnol/Valium/Xanax
Brand name benzodiazepine about ten times stronger then valium.
Usually felt within 20-30 minutes after ingestion, peaking at 2 hours, lasting up to 8 hours of more and remaining in the system for up to 20 hours.
Dropped into the drink and dissolves. ROCHE laboratories has made adjustments so that light drinks will turn blue and dark drinks will turn murky.
2019 10% of OU students had used a Benzo in the last 30 days
Benzo: Effects
Drowsiness
Confusion
Impaired motor skills
Dizziness
Disorientation
Memory impairment
Drowsiness
Impaired judgment
Reduced levels of consciousness
Slurred speech
Difficulty walking
Rendered unconscious
Headaches
Benzo: Overdose
Following overdose with oral benzodiazepines
vomiting should be induced (within one hour) if the patient is conscious
Gastric lavage undertaken with the airway protected if the patient is unconscious
Beyond one hour
Activated charcoal should be given to reduce absorption
Respiratory and cardiovascular function should be monitored as they may evidence depression
Central nervous system depression may manifest in degrees ranging from drowsiness, mental confusion, lethargy, to coma and death. Flunitrazepam overdose alone is unlikely to be lethal, but in combination with alcohol, death is considerably more likely.
Benzo: Addiction and Tolerance
•Ohio Deaths involving benzodiazepines were 10.4% or 506 in 2017
Addiction
Occurs when the user seeks out and takes the drug compulsively.
Tolerance
The user needs larger doses of the drug to get the same desired results.
What are Narcotics?
The term narcotic currently refers to naturally occurring substances derived from the opium poppy and their synthetic substitutes.
These drugs referred to as the opioid (or opiate) narcotics because of their association with opium.
What are Narcotics? (cont.)
The opioid narcotics possess abuse potential, but they also have important clinical value (analgesic, antitussive).
The term narcotic has been used to label many substances, from opium to marijuana to cocaine.
https://www.youtube.com/watch?v=kKDoJpWzwjQ
Pharmacological Effects
The most common clinical use of the opioid narcotics is an analgesics to relieve pain.
The opioid narcotics relieve pain by activating the same group of receptors that are controlled by the endogenous substances called endorphins.
Activation of opioid receptors block the transmission of pain through the spinal cord or brain stem.
Pharmacological Effects (cont.)
Morphine is particularly potent pain reliever and often is used as the analgesic standard by which other narcotics are compared.
With continued use. Tolerance develops to the analgesic effects of morphine and other narcotics.
Physicians frequently under prescribe narcotics, for fear of causing narcotic addiction.
Pharmacological Effects (cont.)
The principal side effects of the opioid narcotics, besides their abuse potential, include:
Drowsiness, mental clouding
Respiratory depression
Nausea, vomiting and constipation
Inability to urinate
Drop in blood pressure
Ohio
Rx Opiate Painkillers
Morphine Methadone
Fentanyl Oxycodone
OxyContin Hydromorphone
Codeine Hydrocodone
2019 AOD survey 13% of OU students had used (opiate painkillers) not prescribed to them.
8% reported taking while drinking alcohol
Narcotic-Related Drugs
Dextromethorphan (OTC antitussive)
Clonidine (relieves some of the opioid withdrawal sympotms)
Naloxone/Naltrexone (narcotic antagonist; used for narcotic overdoses)
National Rx Abuse
Drug treatment admissions for prescription painkillers increased more than 300 percent from 1995 to 2005
Every day, 2500 kids age 12 to 17 try a painkiller for the first time
Opioid analgesic ER visits increased 117% over the last decade, and the death rate surpassed that of heroin and cocaine
There are as many new abusers age 12 to 17 of prescription drugs as there are of marijuana
1 in 5 teens say they have taken a prescription drug without having a prescription for it themselves
Rx Abuse
What are the possible legal consequences of obtaining or providing prescription drugs to others?
Ohio Revised Code-Chapter 2925.11- Possession of Controlled Substances (w/o a legal prescription):
FELONY OF THE FIFTH DEGREE
A violation including a schedule I or II class drug such as Adderall or Ritalin is a prison term of up to 12 months and a fine of up to $2,500
A violation including a schedule III, IV, V class drug such as Vicodin (III), Xanax, Valium, or OxyContin (II) will result in a misdemeanor of the 1st degree, prison term of up to 180 days and a fine up to $1,000
Heroin Abuse
Heroin is classified as a Schedule I drug.
Heroin is the most widely abused illegal drug in European and Far Easter countries.
Greater purity leads users to administer heroin in less efficient ways
Many youths believe that heroin can be used safely if it is not injected
The volume of heroin imported into the U.S has doubled since the 1980’s
Patterns of Heroin Abuse
Emergency room visits due to narcotic overdoses have increased significantly since 2000.
2019 AOD survey 0.21% of OU students had used at least once in the last 30 days.
In Ohio 86% of overdose deaths are related to opioids.
Deaths related to opioids in Ohio, 2017-
Fentanyl 70.7% 3,432
Heroin 20.3% 987
Rx opioids 10.8% 523
Ohio Dept. of Health
Methods of Administration
Sniffing the powder
Injecting it into a muscle (intramuscular)
Smoking
Mainlining (intravenous injection)
Heroin: Short Term Effects
-“Rush,” warm flushing of skin, dry mouth and heavy feeling in extremities.
-Nausea
-Vomiting
-Severe itching
-Clouded mental functioning
-Cardiac function slow
-Breathing slows sometimes to point of death
Heroin: Long Term Effects
Addiction
HIV, Hepatitis B and/or C
Collapsed veins
Bacterial infections
Abscesses (boils)
Infection of heart lining and valves
Arthritis and other rheumatoid problems
Heroin: Addiction and Tolerance
Addiction
High
Occurs when the user seeks out and takes the drug compulsively.
Tolerance
The user needs larger doses of the drug to get the same desired results.
Stages of Dependence
Initially, the effects of heroin are often unpleasant.
Euphoria gradually overcomes the aversive effects.
The positive feelings increase with narcotic use, leading to psychological dependence.
Stages of Dependence (cont.)
After psychological dependence, physical dependence occurs with daily use over a 2-week period.
If the user stops taking the drug after physical dependence has developed, severe withdraw symptoms result.
Withdrawal Symptoms
After the effects of heroin wear off, the addict has only a few hours in which to find the next dose before sever withdrawal symptoms begin.
A single “shot” of heroin lasts 4-6 hours
Withdrawal symptoms –runny nose, tears, minor stomach cramps, loss of appetite, vomiting, diarrhea, abdominal cramps, chills, fever, aching bones, muscle spasms
Heroin Dependence Drugs “Antagonist”
Buperenorphin (subutex)
Methadone
Suboxone
Vivitrol, once a month
Naloxone-for overdose
Narcan
Heroin Addicts and AIDS
Over 50% of IV heroin users have been exposed to the AIDS virus
Fear of contracting HIV from IV heroin use has contributed to the increase in smoking or snorting heroin
Many who start by smoking or snorting progress to IV administration due to its more intense effects
Risk Reduction
Needle exchange
Athens County-City Health Dept.
Safe injection sites
STI-HIV Testing
Hepatitis A and B testing
Prep
Latex use
Treatment/Recovery
Heroin and Crime
Factors related to crime
Pharmacological effects encourage antisocial behavior that is crime-related
Heroin diminishes inhibition
Addicts are self-centered, impulsive and governed by need
Cost addiction
Similar personality of criminal and addict
Substance Use Disorder Treatment
Drug addiction is a complex illness characterized by intense and, at times, uncontrollable drug craving, along with compulsive drug seeking and use that persist even in the face of devastating consequences.
Too often, addiction goes untreated:
In 2017, an estimated 20.7 million people age 12 and older needed treatment for a substance use disorder. Only 4 million people received treatment, or about 19% of those who needed it.
In 2017, of the more than 18 million people who needed but did not receive treatment for substance use, only 1 million, or 5.7%, of those people felt they needed treatment.
Alcoholics Anonymous (AA) has more than 120,000 groups in more than 175 countries around the world, with more than 2 million members.
There are over 14,500 specialized substance abuse treatment facilities in the United States providing a variety of care options, including counseling, behavioral therapy, medication, case management, and other forms of care.
Principles of Effective Treatment
Scientific research since the mid–1970s show key principles that should form the basis of any effective treatment programs:
No single treatment is appropriate for everyone.
Treatment needs to be readily available.
Effective treatment attends to multiple needs of the individual, not just his or her drug abuse.
Remaining in treatment for an adequate period of time is critical.
Marijuana
Marijuana
Thoughts………..
Marijuana
Today, marijuana is 20 times more potent than the marijuana on the street in the 1960’s and 1970’s.
1 in 13 or 8 percent of people aged 12 or older report using marijuana in the past month.
Marijuana use has resulted in approximately 4.2 million people meeting the diagnostic criteria for abuse or dependence on marijuana
(SAMHSA, 2016)
Marijuana Users
It is the most highly abused type of illicit drug.
Marijuana is the most commonly used illicit drug (20 million past-month users) according to the 2014 National Survey on Drug Use and Health (NSDUH). That year, marijuana was used by 77 percent of current illicit drug users.
The average age of first use was 17 years.
81% of OU students reported using at least once in the last 30 days (2019) Healthy Campus Survey)
92% use for recreational purposes
8% use for medical reasons 1.29% report having a medical card from the State of Ohio.
Marijuana Users
In Recovery No use Low Mod High
OU 3.7% 41.5% 18% 19.1% 17.6%
National 3.7 65.5% 11% 11.1% 8.6%
ScreenU Marijuana Data
Marijuana
Marijuana consists of the dried and crushed leaves, flowers, stems and seeds of the Cannabis Sativa plant
THC (delta-9-tetrahydrocannabinal) is the primary mind-altering ingredient in marijuana
Derivatives of the Cannabis Plant
Hashish
Average concentration of THC is 15% to 20%
Ganja
Consists of the dried tops of female plants
9% to 23%
Sinsemilla
Average concentration of THC is 14%
Bhang
Average concentration of THC is 7% to 8%
Street Names
General Street Names
Pot, weed, reefer, ganja, maryjane, ceeba, doobage. cannabis, bud, herb, green, buddga, shivah
Street Names for Higher TCH
Chronic, dank, nuggets, kind bud, superskunk, funk
Street Names for Mid-to-Lower THC
Swag (pronounced shwag), commercial (merch), dirt weed, middies, headies, tendies, brown frown, brick weed, mex/mexi
Behavioral Effects
Low to moderate doses produce euphoria and a pleasant state of relaxation
Common effects: dry mouth, elevated heartbeat, some loss of coordination and balance, slower reaction times, reddening of the eyes, elevated blood pressure, impaired memory
A typical “High” lasts from 2-3 hours and a users experiences altered perception of space and time
Behavioral Effects
An acute dose of cannabis can produce adverse reactions: mild anxiety to panic and paranoia
A few rare cases exhibit psychoses, delusional and bizarre behavior, and hallucinations. These reactions occur most frequently in individuals who are under stress, anxious, depressed or borderline schizophrenic
Short Term Effects
Increased heart rate and blood pressure by 20-100%
Reddening of the eyes
Dry mouth
Laryngitis/Bronchitis
Asthma-like conditions
Problems with memory and learning
Distorted perceptions
Cough/dry throat/hoarseness
Trouble with critical thinking and problem solving
Loss of coordination
Long Term Effects
Dependence
Damage to immune system
from smoking
Dependence
Physical – exhibit withdrawal symptoms
Psychological – attachment to euphoric effects
Tolerance – increasingly higher doses of marijuana must be given to obtain the same intensity of initial effects
Withdrawal – irritability, restlessness, decreased appetite, weight loss
Amotivational syndrome
This characterizes regular users of marijuana who experience a lack of motivation and reduced productivity
Specifically, users show apathy, poor short-term memory, difficulty in concentration and a lingering disinterest in pursuing goals
Critical Thinking Skills
Marijuana Has been found to have a negative impact on critical thinking skills
Impairment can affect: attention, memory, learning
The unresolved question is whether these impairments are short or long term
Sexual Functioning
Women
Reduces level of hormone necessary for fertilized egg to implant into uterus
Low birth weight babies
Reduces mother’s milk
Men
Reduces levels of testosterone and sperm count
Marijuana as Medicine
28 states have laws allowing use
92% are using for chronic pain
Who is using:
18-24 18%
25-34 27%
35-44 21%
45-54 20%
55 + 12%
Data from the state of CA
Medicinal Marijuana
Marinol- indicated for treatment of nausea and vomiting in cancer patients
AIDS patients with wasting syndrome
Anorexia Muscle relaxation Analgesic
The Ohio law prohibits smoking or growing marijuana at home but allows cannabis oils, tinctures, patches, edibles and plant material to be used and sold in state-licensed dispensaries.
medicalmarijuana.ohio.gov
Ohio Medicinal Marijuana
People with the following medical conditions will be able to use medical marijuana under the law: HIV/AIDS, amyotrophic lateral sclerosis (ALS), Alzheimer’s disease, cancer, chronic traumatic encephalopathy (CTE), Crohn’s disease, epilepsy or another seizure disorder, fibromyalgia, glaucoma, hepatitis C, inflammatory bowel disease, multiple sclerosis, pain that is either chronic and severe or intractable, Parkinson’s disease, post-traumatic stress disorder, sickle cell anemia, spinal cord disease or injury, Tourette’s syndrome, traumatic brain injury and ulcerative colitis.
Marijuana Legalization
Nov. 5, 1996 – California Becomes First State to Legalize Medical Marijuana
Medical marijuana activist Chris Conrad and his wife Mikki Norris advocated for the passage of Prop. 215
“Voters in California pass a state medical marijuana initiative in 1996. Known as Proposition 215 , it permits patients and their primary caregivers, with a physician’ s recommendation, to possess and cultivate marijuana for the treatment of AIDS, cancer, muscular spasticity, migraines, and several other disorders; it protects physicians from recommending.
Medical Marijuana
CBD is one of at least 85 active cannabinoids. CBD is considered to have a wider scope of medical applications than THC.
Marijuana and Treatment
According to the CDCP nearly 100,000 people per year seek treatment for marijuana dependence.
The Ohio Department of Transportation reported last year there were 4,165 crashes on Ohio highways caused by drugged drivers. That was a 21 percent increase since 2013.
One third of the drugged drivers arrested last year were for driving high on marijuana, and the numbers of all drugged drivers continue to climb.
The Law in Ohio…….
Up to 100 grams (or up to five grams hashish). Ohio has decriminalized possession of small amounts of marijuana. Violations are considered minor misdemeanors, which incur a $150 fine but no jail time, and do not become part of the defendant’s criminal record.
Between 100 and 200 grams (or five and ten grams hashish). Penalties include a fine of up to $250, up to 30 days in jail, or both. License suspended 6 months to 5 years.
Between 200 and 1,000 grams (or ten and 50 grams hashish). Penalties include a fine of up to $2,500, up to one year in jail, or both.
Between 1,000 and 20,000 grams (or 50 and 1,000 grams hashish). Penalties include a fine of between $5,000 and $10,000, between one and five years in prison, or both.
Between 20,000 and 40,000 grams (or 1,000 and 2,000 grams hashish). Penalties include a fine of between $7,500 and $15,000, between five and eight years in prison, or both.
40,000 grams or more (or 2,000 grams hashish). Penalties include a fine of between $10,000 and $20,000, at least eight years in prison, or both.
Athens TACO
The Athens Cannabis Ordinance
TACO is not legalization or even decriminalization: marijuana remains illegal. A better term is de-penalization, or removing penalties. It changes fines to $0 for misdemeanors. … The stated purpose of TACO is not to reduce fines but rather to redirect law-enforcement resources toward more serious and violent crimes.
OU Judicial Policy
Manufacture, Distribution, Sale, Offer for Sale, Possession or Misuse of Drugs or Narcotics – Conduct covered by this offense includes but is not limited to:
a. manufacture, distribution, sale, offer for sale, possession, or use of any illegal drug or narcotic, including but not limited to barbiturates, hallucinogens, amphetamines, cocaine, opium, heroin or marijuana except as defined by offense
b. misuse or abuse of legal drugs or narcotics;
c. possession of a device (drug paraphernalia) that has been used to ingest an illegal drug or narcotic, other than marijuana as defined in offense= $200.00 fine.
*
How do you know if you have a problem?
Has pot smoking stopped being fun?
Do you ever get high alone?
Is it hard for you to imagine your life without marijuana?
Do you find that your friends are determined by your marijuana use?
Do you smoke marijuana to avoid dealing with your problems?
Do you smoke pot to cope with your emotions?
Does your marijuana use let you live in a privately defined world?
Have you ever failed to keep promises you made about cutting down or controlling your use?
Has your use of marijuana caused problems with memory, concentration or motivation?
When your stash is nearly empty, do you feel anxious or worried about getting more?
Do you plan your life around marijuana use?
Have your friends or relatives ever complained about your smoking and how it affects your relationships with them?
Health Assessment
No to all questions
Yes to three of the questions
Yes to six or more of the questions
Please cite all work, APA or MLA.
1. Describe in detail the elements for effective alcohol/drug treatment.
2. What are the greatest risk factors for using stimulants, including Rx, cocaine, crack and meth. How are they similar or different?
3. Explain how are hallucinogenic drugs both dangerous and being used for medical research?
4. What are the risk factors for common caffeine use and how can users reduce their risk for these factors?
5. Moving from an Rx opioid epidemic to heroin/fentanyl laced drugs how can communities in our country reduce the use/death rate of these drugs?
4 Stages of Alcohol Use
*Information taken from the Prevention Research Institute
Prime for Life Risk-Reduction Program
Stage One Low Risk
0-2 Drinks Daily 0-3 in not Daily
No more than one drink per hour
No risk for impairment problems/long term health problems due to use.
Stage Two High Risk Infrequent
4 or more drinks in a sitting for a woman
5 or more drinks in a sitting for a man
Move into Stage Two because of:
Celebration, Holiday, Special Occasion
Warning Signs:
2 or more blackouts in a month, short term memory loss, increased tolerance
Making High Risk Choices on a Regular Basis
People who start to make high risk drinking choices on a regular basis will eventually move into Stage 3.
Remember Stage 2 in Infrequent behavior or unplanned or unexpected behavior.
If you are making high risk drinking choices on more than two occasions in a month that is a sign of moving into Stage3.
Stage Three Dependence
The individual is dependent on the Drinking Ritual, they are not yet an alcoholic.
Many in Stage 3 will have enablers who support their high risk drinking choices.
All of their friends drink to the same level, have had judicial, legal, social, academic and financial problems.
Other drug use may become more regular.
This is where the gateway effect may come into play.
NO ONE CAN STAY IN STAGE 3 FOREVER
Stage Three Dependence
50% of the people in Stage 3 will move back to low risk choices due to a life changing event.
Of the 50% who remain in Stage 3 some will Die.
Those who do not die or move back to low-risk will eventually move to Stage 4.
Moving into Stage 4 is considered crossing the “Trigger Level” or the point at which a diagnosis could be made.
Stage Four Alcoholism
The individual has crossed the “Trigger Level” into addiction.
What are the Choices?
Detox, treatment, rehab and aftercare.
Continue behavior and die of what didn’t kill you before.
Develop and eventually die of an alcohol related illness.
Alcoholism
Alcohol addiction is a complex disease that results from a variety of genetic, social, and environmental influences. Alcoholism affected approximately 32 million or 30% producing severe economic, social, and medical ramifications. NIAAA, 2015
Three medications have been FDA–approved for treating alcohol dependence: naltrexone, Campral, and disulfiram.
https://www.youtube.com/watch?v=4hKmYthx718
Family History
Parent or Grandparent with alcoholism or alcohol related problems
Unusual early response to alcohol
Extended family members, brothers, sisters, aunts and uncles with alcoholism or alcohol related problems
Low-Risk Guidelines
No to all 3: 0-2 daily 0-3 if not daily
no more that 1 per hour
Yes to 1: 2 not daily, no more
than one per hour
Yes to 1
& 2 or 3 0
Individual Differences
Individual differences change how your body reacts to alcohol and increase impairment.
Small body size/muscle mass
Gender
Age
Altitude
Other Drugs
Individual Differences
Illness or Tiredness
Empty Stomach
Mental Health Status
What’s High Risk About being Impaired?
What’s Harmful About High Risk Drinking If People Don’t Become Impaired?
What Is A Drink?
12oz. of Beer is equal to….
4-5 oz. of Wine is equal to …
Liquor
80 Proof (40% Alcohol)…………………………………… 1-1/2 ounce shot
100 Proof (50% Alcohol)………………. 1 ounce shot
Carbonated mixers cause more impairment that food based mixers
This is approximately one-half once of pure alcohol
What Is A Drink?
Beer/Malt Liquor (8% alcohol)……………… 6 Ounces
***40oz bottle = 6.4 drinks***
Wine
Bottle (25.6 ounces at 10% alcohol)….. 5 standard drinks
Magnum (64 ounces at 10% alcohol)..….12.8 standard drinks
Box Wine is equal to 4-5 standard bottles
Wine Coolers*(5-7% alcohol)………………. . .8-10 ounces
**Includes Bacardi Breezers, sky, ciders, etc.) **Three 12ounce bottles at 7% alcohol = 4.5 drinks**
Number of Standard Drinks per Keg
Keg (31 gallons, 12 ounce cups) ………330 standard drinks
Caffeine and Alcohol
Mixing caffeine and alcohol can increase the risk of alcohol poisoning. Since caffeine makes people feel “less drunk” than they really are, they tend to drink more than they should.
Mixing alcohol and caffeine can make your heart rate and blood pressure rise.
Caffeine and alcohol are both diuretics, leading to dehydration (and really bad hangovers).
Caffeine and Alcohol
Caffeine can make you feel energetic even if you’re drunk. Why is this dangerous? Because people can be “tricked” into thinking they are alert enough to do things like drive a car, when they really aren’t.
Adding caffeine to alcohol can make drinking alcohol all the more addictive.
Before you drink read the label.
Drunkorexia
so named because it straddles the line between an alcohol disorder and an eating disorder
The practice involves skipping meals, exercising heavily before drinking alcohol, taking laxatives or diuretics, or vomiting after imbibing
Alcohol & Sexual Assault
Over 80% of sexual assaults on college campuses involve alcohol.
Alcohol is the number 1 Acquaintance/Date rape drug.
Contributing factors……………
Alcohol & Sexual Assault
Ohio Revised Code:
Occur on a continuum of intrusion and violation
ANY unwanted sexual behavior
If permission has NOT been given
or
the s/he does not want to engage in the activity
or
is mentally impaired, intoxicated, tricked, coerced,
or
pressured into the behavior,
then it is sexual assault.
https://www.google.com/maps/d/edit?mid=1LM_EVliSnNiJgb_MQKGvcZ-SHMiO6oni&ll=39.327605665152525%2C-82.09775885560833&z=15
Alcohol & Sexual Assault
If YOU are charged judicially with…
A sexual violation Expect a minimum of
1 semester suspension
If there was physical Expect a minimum of
contact 1 year suspension
If there was penetration Expect expulsion
Caring for a Drunk Person
Cut them off!
Provide high-protein foods & bottled water.
Keep your distance. Before approaching or touching, explain your intent and concern.
Try to get as much info as you can about how much they have consumed and what other drugs they are using.
Stay with someone who is vomiting. When laying down make sure to put him/her on their side.
Monitor the persons breathing.
If you are unsure you can handle the situation call 911.
If the person is in a life threatening health crisis call 911.
Alcohol Overdose
Warning Signs:
Difficulty Breathing- Slow, less than 8 breaths per minute or irregular with 10 or more seconds between each breath.
Passed out or Stuporous- Semiconscious or unconscious and can not be awakened.
Dehydrated- Bluish tint of the lips and fingernails.
Cold and clammy skin.
Vomiting while sleeping or passed out.
For more info www.ohio.edu/alcohol
Medical Emergency Assistance
What does MEA provide?
A Medical Emergency Assistance Program would allow a student experiencing an alcohol or other drug overdose to receive medical attention without judicial charge. It would also remove judicial charges for those who assisted the student in need if they had been in violation of an alcohol or drug policy.
How will MEA support current environmental strategies to reduce high-risk drinking?
According to a recent survey, 94% of students surveyed said that they would not call for help in a medical emergency involving alcohol or other drugs. The students experiencing these emergencies did not receive any type of interventions. MEA will provide appropriate interventions to students experiencing medical emergencies, caringly confronting their high-risk behaviors.
MEA
Why Is High-Risk Use A Problem?
Ohio University Students reported the following experiences from their own drinking:
18% missed class at least once
16% had unprotected sexual activity
26% did something they regretted
Ohio University Students reported the following experiences from other students’ drinking:
45% had studying or sleep interrupted
51% had to care for a drunk person
3% were taken advantage of sexually
Taken from the Healthy Campus Survey (Spring 19)
Alcohol Edu Data Fall 2019
survey 1 survey 3
Summer Fall
Moderate Drinkers 23% 23%
1-5 drinks on one occasion least one occasion in the past two weeks
High Risk Drinkers 17% 22%
5-9 drinks on at least one occasion in the past two weeks
Problematic Drinkers 6% 9%
10+ drinks on at least one occasion in the past two weeks
Abstainers 25% 24%
0 drinks in the last year
Nondrinker 26% 19%
0 drinks in the last two weeks
The College Effect
The Healthy Campus Majority
82% Of Ohio University students are in the Healthy Drinking Majority
13% Abstainer
21% Nondrinker
48% Moderate Drinker
Source, Health Campus Survey Spring 2019
The Minimum Legal Drinking Age (MLDA)
The minimum legal drinking age (MLDA), also referred to as the Age 21 laws, refers to the Uniform Drinking Age Act of 1984.
In 2013, 10,076 people died in drunk driving crashes. One every 52 minutes. 290,000 were injured in drunk driving crashes.
The Minimum Legal Drinking Age (MLDA)
Citizen advocacy groups responded to this evidence by pressuring legislators to raise the MLDA back to 21, prompting passage of the Uniform Drinking Age Act of 1984.
All states had restored an age-21 MLDA by 1988, once again providing researchers with many natural experiments to assess effects of these policy changes on alcohol consumption and related problems among.
There seems to be support for lowering the legal drinking age – is this true?
According to an ABC News/Washington Post poll conducted in 2005, the majority (78 percent) of Americans, youth and adults, support the age 21 drinking law.4 In fact, 73 percent of young adults under the age of 34 oppose allowing 18- to 20-year-olds to drink.4
A 2001 Associated Press poll found that fully three-quarters of adults and teens alike thought the drinking age should be enforced more vigorously.3
“The current age restriction was signed into law by President Reagan on July 17, 1984. Its support today is nearly identical to its level then — 79 percent in a Gallup poll in June ’84.”4
Alcohol Consumption Patterns of Women
Women 21 to 34 years of age were least likely to report alcohol-related problems if they had stable marriages and were working full time.
Women tend to marry men whose drinking habits match their own.
Between 35 to 49 years of age, the heaviest drinkers were divorced or separated women without children.
Between 50 to 64 years of age, the heaviest drinkers were women whose husbands/partners drank heavily.
Women 65 and older comprised less than 10% of drinkers with drinking problems.
Women who have one drink per day have an increased risk of breast cancer compared to those who do not drink.
FASD Fetal alcohol spectrum disorder
Fetal alcohol syndrome FAS
Fetal alcohol effect FAE, not a diagnosis
Alcohol is the second leading cause of premature death in America.
The CDC reports – about 3.3 million US women, 15-44 years, are at risk of exposing their developing baby to alcohol.
https://www.youtube.com/watch?v=m7zfJCW9Yco&t=5s
FASD Fetal alcohol spectrum disorder
Approximately $176 billion is spent annually dealing with social and health problems related to alcohol use.
More recent reports from specific U.S. sites found the prevalence of FAS to be 2 to 7 cases per 1,000 CDC estimates 1,000 to 6,000 births each year,24 and the prevalence of Fetal Alcohol Spectrum Disorders (FASD) to be as high as 20 to 50 cases per 1,000.25
The Circle of Hope: A Mentoring Network for Birth Mothers
A strong international network that will work to mentor women who are struggling with addiction or have used alcohol or other drugs while pregnant. Most members have a child or children with Fetal Alcohol Spectrum Disorders (FASD).
Goals:
1.To improve and strengthen the lives of birth families
2. To provide peer support for birth families
3. To decrease the stigma, blame and shame that birth families may experience
Stimulants
Why do we need them?
How are they socially acceptable?
Reasons Why People Use
Experimentation/study aid (students)
Appetite suppressant/weight control
4% of OU students have used cocaine at least once in the last 30 days 0.42 Crack
63% had used Ritalin type medications for non-medical reasons 18% to increase academic performance
2019 Healthy Campus Survey
Stimulants
Major and Minor Stimulants
All major stimulants cause increased alertness, excitation, and euphoria; thus these drugs are referred to as “uppers.”
Amphetamines
Cause dependence due to their euphoric properties and ability to eliminate fatigue.
Can be legally prescribed by physicians.
Abuse occurs in people who acquire their drugs by both legitimate and illicit ways.
Approved Uses of Amphetamines
Narcolepsy
Attention Deficit Hyperactivity Disorder (ADHD) Tell your doctor if…….
you or your child have any heart problems, heart defects, high blood pressure, or a family history of these problems.
you or your child have, or about a family history of suicide, bipolar illness, or depression
Side Effects
Abuse
Cardiovascular toxicities
Increased heart rate
Elevated blood pressure
Damage to blood vessels
Minor Stimulants
Caffeine is the most frequently consumed stimulant in the world.
It is classified as a
methylxanthine
It is found in a number
of beverages
Also found in some OTC
medicines and chocolate
Americans consume 400 million cups of coffee per day. 75% of caffeine consumed is coffee.
Caffeine Content of Beverages
and Chocolate
Beverage Caffeine Content (mg)/cup Amount
Brewed coffee 90–125 5 oz.
Instant coffee 35–164 5 oz.
Decaffeinated coffee 1–6 5 oz.
Tea 25–125 5 oz.
Cocoa 5–25 5 oz.
Coca-Cola 45 12 oz.
Pepsi-Cola 38 12 oz.
Mountain Dew 54 12 oz.
Chocolate bar 1–35 1 oz.
Physiological Effects of Stimulants
CNS effects
Enhances alertness, causes arousal, diminishes fatigue
Adverse CNS effects
Insomnia, increase in tension, anxiety, and initiation of muscle twitches
Over 500 milligrams—panic sensations, chills, nausea, clumsiness
Extremely high doses (5 to 10 grams)— seizures, respiratory failure, and death
Physical Effects of Stimulants
Caffeine intoxication
Restlessness, nervousness,
excitement, insomnia,
flushed face, dizzy,
muscle twitching, rambling thoughts and speech, stomach complaints
Caffeine dependence
OTC Drugs Containing Caffeine or Caffeine-like Stimulants
Analgesics (OTC pain meds)
Stay-awake products
Decongestants
Herbal stimulants
Major Stimulants
Meth
Ecstasy
Rx medications
Cocaine
Methamphetamine
Meth, Speed, Ice, Crystal, Crank, Glass
Comes in 2 forms
Powered and Crystallized
Can take orally, intranasally, intravenously
ohttps://www.youtube.com/watch?v=AkiqQaw87AAr smoked
Meth
Immediately after smoking or injection a meth user experiences an intense sensation called a “Rush”
Users become addicted quickly and with frequent use increase doses
Meth releases high levels of dopamine
1% of OU students have used meth in the last 30 days Healthy Campus Survey 2019
Meth Short Term Effects
Increased alertness Increase heart rate
Sense of well-being Paranoia
Intense high “Rush” Violent behavior
Hallucinations Insomnia
Intense sexual pleasure No appetite
Aggressive behavior Numbness
Meth Long-Term Effects
Fatal kidney/lung disorders Decreased social life
Depression Loss of coping skills
Psychological problems Liver damage
Weight loss Stroke
Insomnia Death
Paranoid schizophrenia
Malnutrition
Violent/aggressive behavior
Meth Addiction/Tolerance
Addiction
Occurs when the user seeks out and takes the drug compulsively
Tolerance
The user needs larger
doses of the drug to
get the same desired results
Meth
4 step process of clandestine production
Extraction Phase: extracting ephedrine/pseudoephedrine
Reaction Phase: combining pre-cursors and add heat match books, RedP, ephedrine, anhydrous, ammonia, peroxide, lithium, metal mason jars, hot plates, milk jugs and vinyl tubing
Meth
Separation/Oil Phase: adding solvent to form oil to separate from water lighter fluid, gasoline, kerosene or coleman fuel
Crystallization Phase: use of acid gas generator precipitates Methamphetamine add hydrogen chloride, salt or drano
Highly Volatile Production Process
Shake and Bake
Rx Medications
Methylphenidate
Classified as a Schedule II drug
Common use to treat ADD
Non-ADD user could be charged with possession of a controlled substance.
63% of OU students have used for non-medical use.
Rx Medications
More potent that caffeine and less potent than amphetamines
In large doses can cause seizures, psychosis or stroke, psychotic episodes
Dexedrine, Concerta,Vyvanse, Adderall
Short-Term Effects
Appetite Suppression
Wakefulness/Increased heart rate & BP
Increased focus/attentiveness
Euphoria
Insomnia
Weight loss
Long-Term Effects
Potential for dependence and addiction
Anxiety, restlessness, paranoia, delusions
Formication, skin rash & itching
Tremors and muscle twitching
Nausea/vomiting/headaches/dizziness
Severe depression upon withdrawal
Ecstasy is a synthetic (man-made) drug.
The Facts – Ecstasy
Stimulant and Hallucinogen
Acts as a Psychoactive Drug
The chemical is MDMA, Molly
Street Names: Ecstasy, X, Beans, XTC, Stacy, Adam, Love Drug
Became a Schedule I drug in 1985
Most people using Molly in Athens are really using Meth
The Wanted Effects
“Mood elevator” that produces a relaxed, euphoric state
Heightened feelings of empathy, emotional warmth, and self-acceptance
Sensations of understanding and accepting others
Enhances physical senses such as touch, taste, and smell
Enhanced sexual experience, loss of gag reflex
3.1% of OU students had used in the last 30 days
The Unwanted Effects
Short-term Effects
Muscle tension
Nausea
Blurred vision
Rapid eye-movement
Faintness, chills, and sweating
Death from overheating
The Unwanted Effects
Long-term Effects
Psychological difficulties:
Confusion
Sleep problems
Depression (Serotonin depletion)
Drug craving
Severe Anxiety
Paranoia
Addiction
The Unwanted Effects
Long-term Effects
Physical symptoms:
Increase in heart rate and blood pressure
Develop a rash that looks like severe acne because of liver damage
Development of panic disorders
Jaw clenching that leads to the grinding away of tooth enamel
Ecstasy and illegal use
Many pills sold on the illicit market as “Ecstasy” usually contain substances far more dangerous than MDMA.
PMA – a powerful stimulant used in place of MDMA
Cheaper
Easier to manufacture
Cough Syrup
DXM – a legal cough suppressant, that in high does can prevent sweating
Deaths can occur
Various Over-the-Counter medications
Bath Salts
The synthetic powder is sold legally online and in drug paraphernalia stores under a variety of names, such as “Ivory Wave,” “Purple Wave,“ “Cloud Nine,“ “Vanilla Sky,” “White Lightning,” “Scarface,” and “Hurricane Charlie.“
Knowledge about their precise chemical composition and short- and long-term effects is limited.
http://www.youtube.com/watch?v=bKbTbRqXVFg
Bath Salts
These products often contain various amphetamine-like chemicals, such as (MPDV), mephedrone and pyrovalerone.
Produce Meth like effects with high rate of overdose.
NIDA reports that death rates of 23,000 peaked in 2012.
Krokodil-Desomorphine
Derivative of codeine may contain unknown ingredients. Can be cooked at home like Meth.
Those who inject causes extreme skin ulcerations, infections and gangrene.
Zombie like psychotic behavior
Cocaine is a naturally occurring psychostimulant
found in the leaves of a South American shrub.
The Facts – Cocaine
History
1814 – researchers encouraged people to use cocaine as a food supplement
Coca-Cola was introduced in 1886 as a “valuable brain tonic and cure for all nervous afflictions.”
In 1906 there was undetectable amounts of cocaine in Coca-Cola.
It was illegalized in 1914.
By 1982, 20 million Americans tried cocaine compared to only 4 million in 1974.
The Facts – Cocaine
Powerful central nervous system stimulant
Interferes with the re-absorption process of dopamine, serotonin
Major route of administration – sniffing, snorting, smoking, injecting
Street Names:
China White, Blow, Snow, Candy,
Coke, Happy dust, Line, Rock
Free-basing is a method of reducing impurities in cocaine.
It is also the most powerful form of cocaine.
This is also known as crack or rock.
The removal of hydrochloride for a lower melting point to smoke.
Cocaine Administration
Orally-chewing the coca leaf
Inhaled into the nasal passages-snorting
Injecting intravenously
Smoked
14,566 overdose, 2017 NIH
The Wanted Effects
Intense sense of pleasure and being alive
Intense feeling of supremacy
Having more energy and being more alert
Elevates mood
Clearer thinking
Enhanced concentration and performance.
The Unwanted Effects
Insomnia/Restlessness
Increased temperature
Dilated pupils
Constricted vessels
Increased blood pressure
Decreased appetite
Increased heart rate
Convulsions
Nausea
Blurred vision
Chest pain
Muscle spasms
Coma
Short-term Effects
The Unwanted Effects
Long-term Effects
Paranoia/anxiety disorders
Irritability
Restlessness
Auditory Hallucinations
Formication/sensory hallucinations
Depression
Heart attacks, strokes and seizures
Open sores from continuous injections
Coca ethylene
A drug that is formed in your body when cocaine and alcohol are mixed
Enhances cocaine’s euphoric effects
Increases cardiovascular risks
Leads to more impulsive decision-making
Increases the risk of sudden death
Source: National Institute on Drug Abuse
3 Stages of Cocaine Withdrawal
The Crash, initial abstinence phase consisting of depression, agitation, suicidal thoughts, and fatigue
Withdrawal, including mood swings, craving and drug seeking
Extinction, when normal pleasure returns, which cues trigger cravings and mood swings
Treatment of Cocaine Dependence
Is highly individualistic and has variable success
Principal strategies include inpatient and outpatient programs
Drug therapy often is used to relieve short-term cocaine craving and to alleviate mood problems and long-term craving
Counseling and support therapy are essential
Cocaine Trends
Cocaine abuse continues to be one of the greatest drug concerns in the U. S.
From 1978 to 1987, the U.S. experienced the largest cocaine epidemic in history
Decline of abuse began in the later 1980’s
Substance-induced psychotic disorder
Prominent psychotic symptoms (i.e., hallucinations and/or delusions ) determined to be caused by the effects of a psychoactive substance is the primary feature of a substance-induced psychotic disorder.
A substance may induce psychotic symptoms during intoxication (while the individual is under the influence of the drug) or during withdrawal (after an individual stops using the drug).
*
DEA Schedule
Schedule I and II drugs have a high potential for abuse.
Schedule I – available for research only and have not medical use
Schedule II – available only by prescription (not refillable) and require a form for ordering
Schedule III & IV – available by prescription, may have five refills in 6 months, and may be ordered through the mail
Schedule V – available over the counter
Terry Koons
Hallucinogens
, Depressants
and Opiates
Hallucinogens
LSD
PCP
Ketamine
Mushrooms
Hallucinogens
Drugs that cause changes in a persons perceptions: see images, hear sounds, feel sensations, all seem real, but don’t exist.
History of Hallucinogens
The Native American church
-The American Indian Religious Freedom Act of 1978
Timothy Leary and the League of Spiritual Discovery
– The Psychedelic Experience
Traditional Hallucinogens: LSD Types of Agents
LSD (lysergic acid diethylamide), mescaline, psilocybin, dimethyltryptamine (DMT), and myristicin
These drugs cause predominantly psychedelic effects
2013 229,000 age 12 and older had used in the last month
SAMHSA
2019 HCS Survey 5% of OU students had used LSD at least once in the last 30 days
LSD
Usually felt within 30-90 minutes after ingestion and lasting 6-12 hours
Traditional Hallucinogens: LSD Type of Agents
About half of the substance is cleared from the body within 3 hours, and more than 90% is excreted within 24 hours
Effects of this hallucinogen can last 2-12 hours
Tolerance to the effects of LSD develops very quickly
LSD: Emotional and Sensory Effects
Rapidly shifting emotions from fear to euphoria
Hear or feel colors and see sounds
LSD can trigger underlying mental problems and produce delusions, paranoia and schizophrenia-like syndrome
Distortion or transformation of shape and time.
Bad trips
Terrifying thoughts and nightmarish feelings of anxiety and despair, fears of insanity, death or losing control.
LSD: Physical Effects
Increase in blood pressure
Increase in heart rate
Dizziness
Loss of appetite
Dry mouth
Sweating
Nausea
Numbness
Tremors
LSD: Long Term Effects
Persistent Psychosis
-Distortion or disorganization of a person’s capacity to recognize reality, think rationally or communicate with others.
Hallucinogen Persisting Perception Disorder (Flashback)
-Spontaneous, repeated, sometimes continuous recurrences of some of the sensory distortions originally produced by LSD.
LSD: Addiction and Tolerance
Addiction
No evidence
Tolerance
Quickly developed
Cross tolerance to other
Hallucinogens
LSD: What to do for a bad trip
Stay calm. If you are scared, the tripper will know it—and feel even more panicky
Be supportive. Define reality. Remind the person that they’re experiencing drug effects that will go away.
Use distractions. LSD users are distractible, so help focus their attention on something more pleasant.
Change the setting. Sometimes, simple changes in setting–dimming lights or turning down music, for instance–is all it takes to calm an anxious, prospective acid casualty.
Other LSD Types of Agents
Mescaline (Peyote)
-Mescaline is the most active drug in peyote; it induces intensified perception of colors and euphoria
-Effects include dilation of pupils, increase in body temperature, anxiety, visual hallucinations, and alteration of body image, vomiting, muscular relaxation; very high doses may cause death
-Street samples are rarely authentic
Mushrooms
A mushroom “trip” tends to last for about four to five hours.
Effects similar to those of LSD.
Used by many indigenous Cultures to induce altered states of consciousness during religious rituals.
2019 HCS survey 5% of OU students had used shrooms at least once in the last 30 days.
Mushrooms
Low doses
Feelings of relaxation, not dissimilar to those of cannabis
Laughing a lot and finding things funnier than they would normally
High doses
The experience is closer to that of LSD, intensified colors and producing visual hallucinations and feeling of euphoria
Mushrooms: Adverse Effects
Misidentification. Some mushrooms are poisonous and cause stomach pains, vomiting, diarrhea and even death.
Some users report getting sick even after ingesting real psilocybin varieties.
Impair judgment.
Can trigger underlying mental disorders and cause schizophrenic-type symptoms.
“Bad trips,” which can include confusion, anxiety and panic. In rare instances, users can experience recurring episodes of anxiety and panic (flashbacks) days, weeks, or even months after a bad trip.
Mushrooms
Addiction
No evidence
Occurs when the user seeks out and takes the drug compulsively
Tolerance
The user needs larger doses of the drug to get the same desired results
PCP Phencyclidine
PCP
Developed as a surgical anesthetic with sedative and anesthetic effects that produce trance-like, out of body, detached from their environment, unpredictable effects.
Phencyclidine, illegal in 1978/Schedule II drug
Usually felt minutes after ingestion and last several hours
Street Names: Angel Dust, Hog, Dippers, Ozone & Rocket Fuel
2013 6 million age 12 and older had used in the their lifetime
SAMHSA
https://www.youtube.com/watch?v=QjJSjU9EDUI
PCP: Low Dose Effects
Shallow, rapid breathing
Increased blood pressure and heart rate
Elevated temperature
Distortion of space, time and body image
Exaggerated strength
Hallucinations
Panic
Fear
Invulnerability
Severely disoriented
Violent
Suicidal
PCP: Higher Dose Effects
Changes in blood pressure, heart rate and respiration
Nausea
Blurred vision
Dizziness
Decreased awareness of pain
Muscle contractions
PCP: Very High Doses
Convulsions
Coma
Hyperthermia
Death
PCP: Addiction and Tolerance
Addiction
Memory loss and depression may continue for up to a year after stopping
Tolerance
The user needs larger doses of the drug to get the same desired results
Ketamine
Human and animal anesthetic
White powder that can be smoked, snorted or injected
Street Names:
Special K, K, Cat and Vitamin K
Effects:
Out of body experience, loss of muscle coordination
Depression, amnesia and breathing problems
Depressants
GHB
Benzodiazepine
GHB
Human growth stimulants for body building
Usually a clear, odorless liquid
Popular recreation use due to what has been described as a pleasant alcohol-like high without the hangover.
Can be transported in water bottles or eye droppers and slipped into drinks or taken by the capful.
GHB
It is classified as a sedative-hypnotic, and originally developed as a sleep-aid.
Lower doses- euphoric effects similar to alcohol, relaxed, happy and sociable.
Higher doses- dizzy and sleepy, and can sometimes cause vomiting, muscle spasms, and loss of consciousness.
Overdose- loss of consciousness(temporary coma), and slows down breathing.
Sometimes, and particularly if mixed with alcohol, GHB can slow breathing down to a dangerously low rate, which had caused a number of deaths.
GHB: Effects
Usually felt within 15 minutes and last anywhere from 1-2 ½ hours with after effects lasting 2-4 hours.
Water soluble and is metabolized and out of the body within 4-6 hours
GHB: Effects
Intoxication (similar to 4-6 drinks)
Increased energy
Happiness
Talkative
Difficulty concentrating
Possible nausea
Feeling of affection or playfulness
Mild disinhibition
Sensuality
Enhanced Sexual experience
Loss of gag reflex
GHB: Large Doses
Disinhibition
Sedation
Desire to sleep
Rambling incoherent speech
Giddiness
Silliness
Difficulty thinking
Slurred speech
Passing out( if lose consciousness, always seek medical attention)
Death
GHB: Adverse Doses
Nausea
Headaches
Drowsiness
Dizziness
Amnesia (lead to SA)
Vomiting
Loss of muscle control
Respiratory problems
Loss of consciousness
Being conscious but unable to move especially when combined with other drugs.
GHB: Addiction and Tolerance
Addiction
Similar to alcohol and withdrawal
Can be life threatening
Tolerance
The user needs larger doses of the drug to get the same desired results
GHB: Legislation
October 1996: “Drug-Induced Rape Prevention and Punishment Act” was passed. Increased federal penalties for use of any controlled substance to aid in sexual assault.
February 18, 2000: Hillory J. Farias and Samantha Reid Date-Rape prohibition Act was signed by President Clinton. Made GHB a Schedule I drug, MDMA is Schedule I, Rohypnol is Schedule IV, and Ketamine is Schedule III.
Rohypnol/Valium/Xanax
Brand name benzodiazepine about ten times stronger then valium.
Usually felt within 20-30 minutes after ingestion, peaking at 2 hours, lasting up to 8 hours of more and remaining in the system for up to 20 hours.
Dropped into the drink and dissolves. ROCHE laboratories has made adjustments so that light drinks will turn blue and dark drinks will turn murky.
2019 10% of OU students had used a Benzo in the last 30 days
Benzo: Effects
Drowsiness
Confusion
Impaired motor skills
Dizziness
Disorientation
Memory impairment
Drowsiness
Impaired judgment
Reduced levels of consciousness
Slurred speech
Difficulty walking
Rendered unconscious
Headaches
Benzo: Overdose
Following overdose with oral benzodiazepines
vomiting should be induced (within one hour) if the patient is conscious
Gastric lavage undertaken with the airway protected if the patient is unconscious
Beyond one hour
Activated charcoal should be given to reduce absorption
Respiratory and cardiovascular function should be monitored as they may evidence depression
Central nervous system depression may manifest in degrees ranging from drowsiness, mental confusion, lethargy, to coma and death. Flunitrazepam overdose alone is unlikely to be lethal, but in combination with alcohol, death is considerably more likely.
Benzo: Addiction and Tolerance
•Ohio Deaths involving benzodiazepines were 10.4% or 506 in 2017
Addiction
Occurs when the user seeks out and takes the drug compulsively.
Tolerance
The user needs larger doses of the drug to get the same desired results.
What are Narcotics?
The term narcotic currently refers to naturally occurring substances derived from the opium poppy and their synthetic substitutes.
These drugs referred to as the opioid (or opiate) narcotics because of their association with opium.
What are Narcotics? (cont.)
The opioid narcotics possess abuse potential, but they also have important clinical value (analgesic, antitussive).
The term narcotic has been used to label many substances, from opium to marijuana to cocaine.
https://www.youtube.com/watch?v=kKDoJpWzwjQ
Pharmacological Effects
The most common clinical use of the opioid narcotics is an analgesics to relieve pain.
The opioid narcotics relieve pain by activating the same group of receptors that are controlled by the endogenous substances called endorphins.
Activation of opioid receptors block the transmission of pain through the spinal cord or brain stem.
Pharmacological Effects (cont.)
Morphine is particularly potent pain reliever and often is used as the analgesic standard by which other narcotics are compared.
With continued use. Tolerance develops to the analgesic effects of morphine and other narcotics.
Physicians frequently under prescribe narcotics, for fear of causing narcotic addiction.
Pharmacological Effects (cont.)
The principal side effects of the opioid narcotics, besides their abuse potential, include:
Drowsiness, mental clouding
Respiratory depression
Nausea, vomiting and constipation
Inability to urinate
Drop in blood pressure
Ohio
Rx Opiate Painkillers
Morphine Methadone
Fentanyl Oxycodone
OxyContin Hydromorphone
Codeine Hydrocodone
2019 AOD survey 13% of OU students had used (opiate painkillers) not prescribed to them.
8% reported taking while drinking alcohol
Narcotic-Related Drugs
Dextromethorphan (OTC antitussive)
Clonidine (relieves some of the opioid withdrawal sympotms)
Naloxone/Naltrexone (narcotic antagonist; used for narcotic overdoses)
National Rx Abuse
Drug treatment admissions for prescription painkillers increased more than 300 percent from 1995 to 2005
Every day, 2500 kids age 12 to 17 try a painkiller for the first time
Opioid analgesic ER visits increased 117% over the last decade, and the death rate surpassed that of heroin and cocaine
There are as many new abusers age 12 to 17 of prescription drugs as there are of marijuana
1 in 5 teens say they have taken a prescription drug without having a prescription for it themselves
Rx Abuse
What are the possible legal consequences of obtaining or providing prescription drugs to others?
Ohio Revised Code-Chapter 2925.11- Possession of Controlled Substances (w/o a legal prescription):
FELONY OF THE FIFTH DEGREE
A violation including a schedule I or II class drug such as Adderall or Ritalin is a prison term of up to 12 months and a fine of up to $2,500
A violation including a schedule III, IV, V class drug such as Vicodin (III), Xanax, Valium, or OxyContin (II) will result in a misdemeanor of the 1st degree, prison term of up to 180 days and a fine up to $1,000
Heroin Abuse
Heroin is classified as a Schedule I drug.
Heroin is the most widely abused illegal drug in European and Far Easter countries.
Greater purity leads users to administer heroin in less efficient ways
Many youths believe that heroin can be used safely if it is not injected
The volume of heroin imported into the U.S has doubled since the 1980’s
Patterns of Heroin Abuse
Emergency room visits due to narcotic overdoses have increased significantly since 2000.
2019 AOD survey 0.21% of OU students had used at least once in the last 30 days.
In Ohio 86% of overdose deaths are related to opioids.
Deaths related to opioids in Ohio, 2017-
Fentanyl 70.7% 3,432
Heroin 20.3% 987
Rx opioids 10.8% 523
Ohio Dept. of Health
Methods of Administration
Sniffing the powder
Injecting it into a muscle (intramuscular)
Smoking
Mainlining (intravenous injection)
Heroin: Short Term Effects
-“Rush,” warm flushing of skin, dry mouth and heavy feeling in extremities.
-Nausea
-Vomiting
-Severe itching
-Clouded mental functioning
-Cardiac function slow
-Breathing slows sometimes to point of death
Heroin: Long Term Effects
Addiction
HIV, Hepatitis B and/or C
Collapsed veins
Bacterial infections
Abscesses (boils)
Infection of heart lining and valves
Arthritis and other rheumatoid problems
Heroin: Addiction and Tolerance
Addiction
High
Occurs when the user seeks out and takes the drug compulsively.
Tolerance
The user needs larger doses of the drug to get the same desired results.
Stages of Dependence
Initially, the effects of heroin are often unpleasant.
Euphoria gradually overcomes the aversive effects.
The positive feelings increase with narcotic use, leading to psychological dependence.
Stages of Dependence (cont.)
After psychological dependence, physical dependence occurs with daily use over a 2-week period.
If the user stops taking the drug after physical dependence has developed, severe withdraw symptoms result.
Withdrawal Symptoms
After the effects of heroin wear off, the addict has only a few hours in which to find the next dose before sever withdrawal symptoms begin.
A single “shot” of heroin lasts 4-6 hours
Withdrawal symptoms –runny nose, tears, minor stomach cramps, loss of appetite, vomiting, diarrhea, abdominal cramps, chills, fever, aching bones, muscle spasms
Heroin Dependence Drugs “Antagonist”
Buperenorphin (subutex)
Methadone
Suboxone
Vivitrol, once a month
Naloxone-for overdose
Narcan
Heroin Addicts and AIDS
Over 50% of IV heroin users have been exposed to the AIDS virus
Fear of contracting HIV from IV heroin use has contributed to the increase in smoking or snorting heroin
Many who start by smoking or snorting progress to IV administration due to its more intense effects
Risk Reduction
Needle exchange
Athens County-City Health Dept.
Safe injection sites
STI-HIV Testing
Hepatitis A and B testing
Prep
Latex use
Treatment/Recovery
Heroin and Crime
Factors related to crime
Pharmacological effects encourage antisocial behavior that is crime-related
Heroin diminishes inhibition
Addicts are self-centered, impulsive and governed by need
Cost addiction
Similar personality of criminal and addict
Substance Use Disorder Treatment
Drug addiction is a complex illness characterized by intense and, at times, uncontrollable drug craving, along with compulsive drug seeking and use that persist even in the face of devastating consequences.
Too often, addiction goes untreated:
In 2017, an estimated 20.7 million people age 12 and older needed treatment for a substance use disorder. Only 4 million people received treatment, or about 19% of those who needed it.
In 2017, of the more than 18 million people who needed but did not receive treatment for substance use, only 1 million, or 5.7%, of those people felt they needed treatment.
Alcoholics Anonymous (AA) has more than 120,000 groups in more than 175 countries around the world, with more than 2 million members.
There are over 14,500 specialized substance abuse treatment facilities in the United States providing a variety of care options, including counseling, behavioral therapy, medication, case management, and other forms of care.
Principles of Effective Treatment
Scientific research since the mid–1970s show key principles that should form the basis of any effective treatment programs:
No single treatment is appropriate for everyone.
Treatment needs to be readily available.
Effective treatment attends to multiple needs of the individual, not just his or her drug abuse.
Remaining in treatment for an adequate period of time is critical.
Marijuana
Marijuana
Thoughts………..
Marijuana
Today, marijuana is 20 times more potent than the marijuana on the street in the 1960’s and 1970’s.
1 in 13 or 8 percent of people aged 12 or older report using marijuana in the past month.
Marijuana use has resulted in approximately 4.2 million people meeting the diagnostic criteria for abuse or dependence on marijuana
(SAMHSA, 2016)
Marijuana Users
It is the most highly abused type of illicit drug.
Marijuana is the most commonly used illicit drug (20 million past-month users) according to the 2014 National Survey on Drug Use and Health (NSDUH). That year, marijuana was used by 77 percent of current illicit drug users.
The average age of first use was 17 years.
81% of OU students reported using at least once in the last 30 days (2019) Healthy Campus Survey)
92% use for recreational purposes
8% use for medical reasons 1.29% report having a medical card from the State of Ohio.
Marijuana Users
In Recovery No use Low Mod High
OU 3.7% 41.5% 18% 19.1% 17.6%
National 3.7 65.5% 11% 11.1% 8.6%
ScreenU Marijuana Data
Marijuana
Marijuana consists of the dried and crushed leaves, flowers, stems and seeds of the Cannabis Sativa plant
THC (delta-9-tetrahydrocannabinal) is the primary mind-altering ingredient in marijuana
Derivatives of the Cannabis Plant
Hashish
Average concentration of THC is 15% to 20%
Ganja
Consists of the dried tops of female plants
9% to 23%
Sinsemilla
Average concentration of THC is 14%
Bhang
Average concentration of THC is 7% to 8%
Street Names
General Street Names
Pot, weed, reefer, ganja, maryjane, ceeba, doobage. cannabis, bud, herb, green, buddga, shivah
Street Names for Higher TCH
Chronic, dank, nuggets, kind bud, superskunk, funk
Street Names for Mid-to-Lower THC
Swag (pronounced shwag), commercial (merch), dirt weed, middies, headies, tendies, brown frown, brick weed, mex/mexi
Behavioral Effects
Low to moderate doses produce euphoria and a pleasant state of relaxation
Common effects: dry mouth, elevated heartbeat, some loss of coordination and balance, slower reaction times, reddening of the eyes, elevated blood pressure, impaired memory
A typical “High” lasts from 2-3 hours and a users experiences altered perception of space and time
Behavioral Effects
An acute dose of cannabis can produce adverse reactions: mild anxiety to panic and paranoia
A few rare cases exhibit psychoses, delusional and bizarre behavior, and hallucinations. These reactions occur most frequently in individuals who are under stress, anxious, depressed or borderline schizophrenic
Short Term Effects
Increased heart rate and blood pressure by 20-100%
Reddening of the eyes
Dry mouth
Laryngitis/Bronchitis
Asthma-like conditions
Problems with memory and learning
Distorted perceptions
Cough/dry throat/hoarseness
Trouble with critical thinking and problem solving
Loss of coordination
Long Term Effects
Dependence
Damage to immune system
from smoking
Dependence
Physical – exhibit withdrawal symptoms
Psychological – attachment to euphoric effects
Tolerance – increasingly higher doses of marijuana must be given to obtain the same intensity of initial effects
Withdrawal – irritability, restlessness, decreased appetite, weight loss
Amotivational syndrome
This characterizes regular users of marijuana who experience a lack of motivation and reduced productivity
Specifically, users show apathy, poor short-term memory, difficulty in concentration and a lingering disinterest in pursuing goals
Critical Thinking Skills
Marijuana Has been found to have a negative impact on critical thinking skills
Impairment can affect: attention, memory, learning
The unresolved question is whether these impairments are short or long term
Sexual Functioning
Women
Reduces level of hormone necessary for fertilized egg to implant into uterus
Low birth weight babies
Reduces mother’s milk
Men
Reduces levels of testosterone and sperm count
Marijuana as Medicine
28 states have laws allowing use
92% are using for chronic pain
Who is using:
18-24 18%
25-34 27%
35-44 21%
45-54 20%
55 + 12%
Data from the state of CA
Medicinal Marijuana
Marinol- indicated for treatment of nausea and vomiting in cancer patients
AIDS patients with wasting syndrome
Anorexia Muscle relaxation Analgesic
The Ohio law prohibits smoking or growing marijuana at home but allows cannabis oils, tinctures, patches, edibles and plant material to be used and sold in state-licensed dispensaries.
medicalmarijuana.ohio.gov
Ohio Medicinal Marijuana
People with the following medical conditions will be able to use medical marijuana under the law: HIV/AIDS, amyotrophic lateral sclerosis (ALS), Alzheimer’s disease, cancer, chronic traumatic encephalopathy (CTE), Crohn’s disease, epilepsy or another seizure disorder, fibromyalgia, glaucoma, hepatitis C, inflammatory bowel disease, multiple sclerosis, pain that is either chronic and severe or intractable, Parkinson’s disease, post-traumatic stress disorder, sickle cell anemia, spinal cord disease or injury, Tourette’s syndrome, traumatic brain injury and ulcerative colitis.
Marijuana Legalization
Nov. 5, 1996 – California Becomes First State to Legalize Medical Marijuana
Medical marijuana activist Chris Conrad and his wife Mikki Norris advocated for the passage of Prop. 215
“Voters in California pass a state medical marijuana initiative in 1996. Known as Proposition 215 , it permits patients and their primary caregivers, with a physician’ s recommendation, to possess and cultivate marijuana for the treatment of AIDS, cancer, muscular spasticity, migraines, and several other disorders; it protects physicians from recommending.
Medical Marijuana
CBD is one of at least 85 active cannabinoids. CBD is considered to have a wider scope of medical applications than THC.
Marijuana and Treatment
According to the CDCP nearly 100,000 people per year seek treatment for marijuana dependence.
The Ohio Department of Transportation reported last year there were 4,165 crashes on Ohio highways caused by drugged drivers. That was a 21 percent increase since 2013.
One third of the drugged drivers arrested last year were for driving high on marijuana, and the numbers of all drugged drivers continue to climb.
The Law in Ohio…….
Up to 100 grams (or up to five grams hashish). Ohio has decriminalized possession of small amounts of marijuana. Violations are considered minor misdemeanors, which incur a $150 fine but no jail time, and do not become part of the defendant’s criminal record.
Between 100 and 200 grams (or five and ten grams hashish). Penalties include a fine of up to $250, up to 30 days in jail, or both. License suspended 6 months to 5 years.
Between 200 and 1,000 grams (or ten and 50 grams hashish). Penalties include a fine of up to $2,500, up to one year in jail, or both.
Between 1,000 and 20,000 grams (or 50 and 1,000 grams hashish). Penalties include a fine of between $5,000 and $10,000, between one and five years in prison, or both.
Between 20,000 and 40,000 grams (or 1,000 and 2,000 grams hashish). Penalties include a fine of between $7,500 and $15,000, between five and eight years in prison, or both.
40,000 grams or more (or 2,000 grams hashish). Penalties include a fine of between $10,000 and $20,000, at least eight years in prison, or both.
Athens TACO
The Athens Cannabis Ordinance
TACO is not legalization or even decriminalization: marijuana remains illegal. A better term is de-penalization, or removing penalties. It changes fines to $0 for misdemeanors. … The stated purpose of TACO is not to reduce fines but rather to redirect law-enforcement resources toward more serious and violent crimes.
OU Judicial Policy
Manufacture, Distribution, Sale, Offer for Sale, Possession or Misuse of Drugs or Narcotics – Conduct covered by this offense includes but is not limited to:
a. manufacture, distribution, sale, offer for sale, possession, or use of any illegal drug or narcotic, including but not limited to barbiturates, hallucinogens, amphetamines, cocaine, opium, heroin or marijuana except as defined by offense
b. misuse or abuse of legal drugs or narcotics;
c. possession of a device (drug paraphernalia) that has been used to ingest an illegal drug or narcotic, other than marijuana as defined in offense= $200.00 fine.
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How do you know if you have a problem?
Has pot smoking stopped being fun?
Do you ever get high alone?
Is it hard for you to imagine your life without marijuana?
Do you find that your friends are determined by your marijuana use?
Do you smoke marijuana to avoid dealing with your problems?
Do you smoke pot to cope with your emotions?
Does your marijuana use let you live in a privately defined world?
Have you ever failed to keep promises you made about cutting down or controlling your use?
Has your use of marijuana caused problems with memory, concentration or motivation?
When your stash is nearly empty, do you feel anxious or worried about getting more?
Do you plan your life around marijuana use?
Have your friends or relatives ever complained about your smoking and how it affects your relationships with them?
Health Assessment
No to all questions
Yes to three of the questions
Yes to six or more of the questions