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“The Faces of Substance Abuse in America” It’s Ugly and Getting Uglier

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1 “The Faces of Substance Abuse in America” It’s Ugly and Getting Uglier
by Paul L. Doering, M.S. Distinguished Service Professor, Emeritus College of Pharmacy University of Florida

2 The Two Faces of Drug Abuse
Faces of those who use and abuse. Faces of the drugs being used. News Flash: Quaalude is “out” Breaking News: “Bath Salts” are “in” out

3 HEALTH PROFESSIONALS KNOW A LOT ABOUT DRUGS, BUT………...
Many curricula do not contain coursework in substance abuse Thus, they are not schooled in this “other” use of pharmaceutical products Most have limited personal experience with recreational drugs (thankfully) But, these persons are often sought out by parents, family members, etc. for help

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5 The Faces of Three Drug Experts From the 1960s
James Marshall Hendrix Born- 11/27/42 Died- 9/18/70 Paul Louis Doering Born- 2/25/49 Not Dead Yet Janis Lyn Joplin Born- 1/19/43 Died- 10/4/70

6 Makin’ the “Big Time”

7 Florida IS the Face of Drug Abuse in Our Country

8 And It’s a Local Problem too….

9 But it is a knotty problem…..

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12 Marijuana: The flowering top of the pistillate plant (or female) of the genus and species, Cannabis Sativa, Family Moraceae. Lecture by Prof. Carl Johnson in Weeds and Seeds course, circa 1969

13 “Square Grouper” that used to fall into Biscayne Bay in Miami

14 Lot’s of Pot!

15 The New Face of Marijuana (aka Spice or K2)

16 “Synthetic Marijuana”
Cannabicyclohexanol JWH-018 Tetrahydrocannabinol HU-210 JWH-073

17 For More Information: http://info. publicintelligence. net/spicealert

18 DEA Re-Scheduling On November 24, 2010, the DEA notified the public through the Federal Register of their intent to temporarily control five synthetic cannabinoid chemicals found in so-called “fake pot” products such as K2 and Spice.

19 The Face of Real Bath Salts
magnesium sulfate (Epsom salts) sodium chloride (table salt) sodium bicarbonate (baking soda) sodium hexametaphosphate (Calgon, amorphous/glassy sodium metaphosphate) sodium sesquicarbonate borax

20 The Face of “Not Real” Bath Salts
Methylenedioxypyrovalerone (MDPV) Some Brand Names: Cloud 9, Ivory Wave, Ocean, Charge Plus, White Lightning, Scarface, Hurricane Charlie, Red Dove and White Dove.

21 Emergency Re-Scheduling in Florida

22 Digital Drugs

23 Digital Drugs

24 Example of a Digital Drug

25 In Your Face: Nitrous Oxide
Synonyms: nitrous, laughing gas, whippets, “Blue Nun” Mental effects: giddiness, silly laughter, buzzing or ringing in ears Duration of effect is only 2-3 minutes Danger: hypoxia, possible nerve damage with prolonged use

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27 Whip-Its

28 Individual Cylinders of N20

29 Whipped Cream Dispenser
                                                                                             

30 The Many Recognizable Faces of Ecstasy

31 The Fashionable Face of Ecstasy

32 The Kinda Weird Faces of People Rolling

33 The Three Faces of Coke

34 An Impromptu Drug Delivery Device
This is called a “stem” on the street

35 From The Face of a Meth User

36 Meth Bugs

37 The Face of a Burn Victim from Meth lab- 19 yo

38 Oxycontin Express

39 Pharmaceutical Drugs are “In”
Obtained from legal prescriptions Given or sold among friends Stolen from medicine cabinets Stolen from pharmacies

40 The Ugly Face of Prescription Drug Abuse In America

41 The Figures Fit the Face
>27,000 deaths from Rx drug Ods in 2007 five-fold increase since 1990 declining mortality rates for all other conditions including heart disease and cancer OD deaths from Rx opioids are exceeding deaths from heroin and cocaine overdoses combined.

42 The Figures Fit the Face (cont’d)
Drug-induced deaths (which includes all drugs) is approaching the number of deaths from motor vehicle crashes. Drug abuse deaths have also surpassed deaths from suicide, homicide, and fire arms.

43 Pharmaceutical vs Street Drugs
Safer identity purity less HIV / hepatitis risk Safer because "it's just a prescription drug" Low or no acquisition cost Medicaid, Workers’ Comp, private insurance, VA, Indian Health Service There is an illusion that pharmaceutical drugs are safer than street drugs because the drug is easily identified (determined by the indicia on the pill), it is pure, and there is less risk of contracting HIV or hepatitis if not injecting and sharing needles. However, risk of sexually-transmitted disease may remain unchanged if a drug abuser with impaired judgment has sex with other abusers who are sharing needles. Another illusion, particularly among the young, is that a prescription drug is safer because “it’s just a prescription drug”: “If my 80-year-old grandmother takes them, how bad can they be?” They don’t realize that the grandmother, who has pain, has built up tolerance to the respiratory depressant effects of the medication over time. A healthy 18-year-old who abuses his grandmother’s pain medication is taking a big risk—he does not have the same pain condition and his body is not adapted to the presence of that drug. There is also the issue of low or no acquisition cost for prescription drugs. For example, Workers’ Compensation, the VA Health System, and Indian Health Services usually have zero acquisition costs; Medicaid has a small co-pay; and private insurance companies may have a small or no co-pay. This may motivate some individuals to profitably sell all or part of their medication.

44 The Different Faces of “Ritalin”
Concerta ER 18 mg Concerta ER 36 mg Concerta ER 54 mg Ritalin 10 mg Ritalin 5 mg Ritalin SR 20 mg Ritalin LA 20 mg Ritalin LA 30 mg Ritalin LA 40 mg

45 Stimulant Identification

46 OxyContin (oxycodone HCl)

47 The Face of Grandaddy Morphine

48 The Face of Codeine (aka methoxymorphine

49 The Face of Hydrocodone

50 The All-Too Familiar Face of Oxycodone

51 The Face of Methadone

52 The Face of Meperidine

53 Comparing the Faces Codeine Morphine Hydrocodone Meperidine Methadone
Oxycodone

54 Rohypnol is now wearing a mask to hide his sneaky face

55 Xanax- A Household Word

56 Depressants: Benzodiazepines and non-benzodiazepines
Valium 2 mg Valium 5 mg Valium 10 mg Xanax 0.5 mg Xanax 1 mg Xanax 2 mg

57 Depressants Identification

58 Depressants Identification
Restoril 30 mg

59 Just Your Typical FDA Certified Manufacturing Laboratory

60                        Turning this……………….into this.

61

62 Chlorpheniramine Maleate
'Skittling' New Drug Of Choice For Some Teens: Product Sold On Store Shelves October 22, 2003 Ingredients: Dextromethorphan Chlorpheniramine Maleate

63 Other Products Containing Dextromethorphan
                                          

64 Buying Dextromethorphan in Bulk


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