1. An Invitation to Health Chapter 10 Drug Use, Misuse, and Abuse
Dr. Lana Zinger.
©2004 Wadsworth Publishing Co.

2. Drug Terminology
Drug: any substance that alters the user’s ability to function,
Including over-the-counter drugs, prescription medications,
and illegal substances.
Drug Misuse: the intentional or inappropriate use of over-the-counter or prescribed medications.
Drug Abuse: excessive drug use that’s inconsistent with accepted medical practice.
Toxicity: the dosage level at which a drug becomes poisonous to the body, causing either temporary or permanent damage.

3. Routes of Administration of Drugs
Figure 10.1

4. Drug-Drug Interactions
Additive
Synergistic
Potentiating
Antagonistic

5. Commonly Misused Over-The-Counter (OTC) Drugs
Aspirin
Nonsteroidal Anti-Inflammatory Drugs
Ibuprofen
Nasal Sprays
Laxatives
Eye Drops
Sleep Aids
Cough Syrup

6. Prescription Drugs Potential Complications
Nonadherence
Recurrent infections, serious medical complications, and emergency hospital treatment.
Physical Side Effects
Heart failure, heart attack, seizures, kidney and liver failure, severe blood disorders, birth defects, blindness, memory problems, and allergic reactions.
Psychological Side Effects
Depressive symptoms vs. agitation and anxiety.
Drug Interactions
OTC drugs, prescription drugs, alcohol, vitamins and minerals, and food components.

7. Drug Interactions
Figure 10.2

8. Substance Use Terminology
ADDICTION
The habitual use of substances, such as alcohol,
psychoactive drugs, and nicotine, and also to compulsive
behaviors, such as overeating.
DRUG
ABUSE
The use of chemical substances that results in physical,
mental, emotional, or social impairment.
DRUG
MISUSE
The occasionally inappropriate or unintentional use of
a medication.
PHYSICAL
DEPENDENCE
When a person develops tolerance to the effects of a
drug and needs larger and larger doses to achieve
intoxication or another desired effect.
PSYCHOLOGICAL
DEPENDENCE
A state in which individuals crave drugs to satisfy
some personality or emotional need.

9. Warning Signs Of A Substance Use Disorder
An Abrupt Change In Attitude
Mood Swings
A Decline In Performance
Increased Sensitivity
Secrecy
Physical Changes
Money Problems
Changes in Appearance
Defiance of Restrictions
Changes in Relationships

10. What Causes Drug Dependence and Abuse?
The Biology of Dependence
Dopamine, glutamine, GABA, and norepinephrine.
The Psychology of Vulnerability
Difficulty controlling impulses, a lack of values that may constrain drug use, low self-esteem, feelings of powerlessness, denial, and depression or anxiety.
Early Influences
Lower socioeconomic backgrounds, family instability, a lack of realistic, rewarding alternatives and role models, and increased hopelessness.
Teen Drug Use
Early use of tobacco and alcohol is linked with a greater likelihood of marijuana use, which in turn increases the likelihood of other illegal drug use.

11. Dopamine Levels For Cocaine
Figure 10.3

12. Factors Influencing Student Drug Use
Race/Ethnicity
Sexual Identity
Perception of Risk
Environment
Alcohol Use

13. Club Drugs/ Designer Drugs
Common Drugs Of Abuse
Cannabis
Club Drugs/ Designer Drugs
Stimulants
Depressants
Hallucinogens
Inhalants
Marijuana
MDMA, MDA, MDEA
Rohypnol
GHB
Amphetamines
Cocaine
Tobacco/ Nicotine
Alcohol
Barbituates
Tranquilizers
Narcotics/ Opioids
PCP
LSD
Mescaline
Solvents, Aerosols
Nitrates
Nitrous Oxide

14. Cannabis Marijuana and Hashish
The Facts
Marijuana is the most widely used illegal drug in the United States (~12 million Americans).
Marijuana is a drug derived from the cannabis plant that contains the active ingredient THC.
How Users Feel
A mild sense of euphoria, a sense of slowed time, a dreamy type of self-absorption, and some impairment in thinking and communicating.
The euphoria peaks within a half hour and usually lasts about three hours.
Potential for marijuana withdrawal syndrome.

15. Some Bodily Effects of Marijuana
Figure 10.4

16. Do Students Want Marijuana Legalized?
Student Snapshot

17. Club Drugs (Designer Drugs)
Alcohol
LSD
(acid)
MDMA
(ecstasy)
GHB
GBL
Ketamine
(Special K)
Fentanyl
Rohypnol
Amphetamines
Meth-
amphetamine

18. Club Drugs Ecstasy The Facts How Users Feel
Ecstasy is the common street name for methylenedioxymethamphetamine (MDMA).
MDMA belongs to a family of drugs called enactogens.
How Users Feel
MDMA is a mood elevator which produces a relaxed, euphoric state, but does not produce hallucinations.
The effects of MDMA begin in 45 minutes and last for 2 to 4 hours.

19. Club Drugs The Risks of Ecstasy
Psychological Difficulties
Confusion, depression (neurotoxicity), sleep problems, drug cravings, severe anxiety, and paranoia.
Physical Symptoms/Side Effects
Muscle tension, involuntary teeth clenching, nausea, blurred vision, rapid eye movement, faintness, chills, sweating, and increased heart rate and blood pressure.
Hyperthermia and hepatitis.
Psychological Dependence

20. Club Drugs GHB/GBL The Facts How Users Feel
GHB stimulates the release of human growth hormone, but has no known effects on muscle growth.
When GLB, an industrial solvent, is ingested it is converted to GHB.
How Users Feel
Smaller doses induce euphoria and enhance sex due to a rise in dopamine in the brain.
Larger doses can cause individuals to pass out and possibly fall into a coma.

21. Club Drugs The Risks of GHB/GBL
Side Effects
Nausea, amnesia, hallucinations, decreased heart rate, convulsions, and sometimes blackouts/coma.
Long Term Side Effects
Withdrawal reaction including rapid heartbeat, tremor, insomnia, anxiety, and occasionally hallucinations that last a few days to a week.
The danger is greatest when GHB is mixed with alcohol or opiates.

22. Club Drugs Ketamine (K)
The Facts
Ketamine is an anesthetic used by veterinarians.
K blocks chemical messengers in the brain that carry sensory input thereby leading to hallucinations.
Side Effects
At high doses, K can cause delirium, amnesia, impaired motor function, high blood pressure, depression, and potentially fatal respiratory problems.

23. Stimulants Amphetamines & Methamphetamine
The Facts
Amphetamines trigger the release of epinephrine (adrenaline) which stimulates the central nervous system.
Methamphetamine is a powerful addictive stimulant.
Meth remains in the central nervous system and the body, producing prolonged stimulant effects.
How Users Feel
Amphetamines produce a state of hyper-alertness and energy.
High doses make users feel wired: talkative, excited, restless, irritable, anxious, and moody.
Meth produces long-lasting toxic effects, including psychosis, violence, seizures, and cardiovascular abnormalities.

24. Stimulants Amphetamines & Methamphetamine
Side Effects
Bingeing and crashing.
Feelings of grandiosity, anxiety, tension, anger, agitation, paranoia, and impaired judgment.
Increased heart rate and blood pressure.
Long Term Side Effects
Malnutrition, skin disorders, ulcers, insomnia, depression, vitamin deficiencies, sexual dysfunction and impaired concentration or memory, and, in some cases, brain damage.

25. Cocaine
An estimated 5 million people in the United States use cocaine.
Cocaine is a white crystalline powder extracted from the leaves of the South American coca plant.
Routes of Administration:
Smoked (freebasing/crack)
Sniffed/Snorted
Injected (speedballing)
How Users Feel
Cocaine stimulates the central nervous system producing feelings of soaring well-being and boundless energy.
After a brief period of euphoria, users slump into depression.

26. Forms of Cocaine

27. Some Effects Of Cocaine On The Body
Figure 10.6

28. Depressants Benzodiazepines and Barbiturates
The Facts
Benzodiazepines are sedative-hypnotics.
Commonly prescribed for tension, muscular strain, sleep problems, anxiety, panic attacks, anesthesia, and in the treatment of alcohol withdrawal.
Rohypnol – date rape drug.
How Users Feel
Low doses reduce or relieve tension, but may cause rapid mood changes, impaired judgment, and impaired social and occupational functioning.
High doses produce slurred speech, drowsiness, and stupor.

29. Depressants Benzodiazepines and Barbiturates
Side Effects
Physical and psychological dependence within two to four weeks.
Cross-tolerance.
Mood and behavior changes, slurred speech, poor coordination, unsteady gait, involuntary eye movements, impaired attention or memory, and stupor and coma.
Synergistic effect when used in combination with alcohol.

30. Depressants Opioids and Nonopioid Synthetic Drugs
Opium
“Mother drug”; A base compound for all natural narcotics. Creates euphoria and escape from reality.
Morphine
Main alkaloid found in opium; used medically to kill pain and sedate. Ten times stronger than opium.
Heroin
Narcotic drug derived from morphine that is 35 times stronger than morphine. Skin-popping vs. mainlining.
Codeine
A natural derivative of opium used as a cough suppressant or mild painkiller.
Dilaudid
Semisynthetic derivative of morphine, legitimately used as a cough suppressant and an analgesic for treating severe pain.
Percodan
A semi-synthetic cough-suppressing and analgesic medication which is more potent than codeine.
Demerol
Short-acting synthetic narcotic used as an analgesic or a painkiller; usually injected.

31. Depressants Opioids and Nonopioid Synthetic Drugs
How Users Feel
All opioids relax the user, and impart feelings of euphoria and provide pain relief.
Side Effects
Addiction, lethargy, weight loss, loss of sex drive, anxiety, insomnia and restlessness.
Overdose causes shock, coma, and depressed respiration.
Long Term Injection of Opioids: infections of the heart lining and valves, skin absesses, and lung congestion.
Methadone Maintenance

32. Hallucinogens
Definition: a group of mind-altering drugs that affect the
brain and nervous system bringing about changes in thought,
self-awareness, emotion and sensation.
Natural Sources of Hallucinogens
Morning glories, jimsonweed, nutmeg, mace, peyote cactus, and psychodelic mushrooms
Synthesized Hallucinogens
LSD
PCP
LSD: lysergic acid diethylamide-24; a psychedelic drug that produces distorted reality.
PCP: an anesthetic that blocks nerve receptors from pain and temperature without producing numbness; angel dust.

33. Inhalants
Definition: drugs that produce vapors that cause psychoactive
Effects when inhaled or sniffed.
Examples
Model airplane glue, gasoline, paint thinner, transmission fluid, lighter fluid, liquid shoe polish, and fingernail polish remover.
Potential Side Effects
Gastroenteritis, depressed muscle tone, damage to the liver and kidneys, nervous system dysfunction, and bone marrow disorders.

34. Treating Drug Dependence and Abuse
Recognize the reality of the problem.
Consult a physician, counseling center, or local mental health clinic.
Intervention modalities:
Medical care
Medication
Detoxification
Individual psychotherapy
Marital and family therapy
Behavior modification
12-step programs