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HBCU Student Leadership Certification Academy. Participants will:  Understand the concepts of tolerance and withdrawal.  Be introduced to the various.

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Presentation on theme: "HBCU Student Leadership Certification Academy. Participants will:  Understand the concepts of tolerance and withdrawal.  Be introduced to the various."— Presentation transcript:

1 HBCU Student Leadership Certification Academy

2 Participants will:  Understand the concepts of tolerance and withdrawal.  Be introduced to the various classes of drugs of abuse.  Become familiar with the criteria by which addiction is defined as a chronic disease.

3   

4 As human beings we do whatever we do for a reason. We do nothing “just because.” We do whatever we do for one of two reasons and two reasons only:  Increase pleasure  Decrease pain

5  Drugs enter the blood stream  The “Blood Brain Barrier”  Drugs act on certain parts of the brain  Memory

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8  Use – Ingestion of alcohol or other drugs without the experience of any negative consequences.  Misuse – When a person experiences negative consequences from the use of alcohol or other drugs i.e. drinks too much and gets sick.  Abuse – Continued use of alcohol or other drugs in spite of negative consequences.  Dependence / Addiction – “Compulsive” use of alcohol or other drugs regardless of the consequences.

9  Changes to brain chemistry  Genetic Predisposition  Environmental factors

10  Alcohol  Drugs  Alcohol and Other Drugs  Alcoholism  Drug Addiction  Chemical Dependency  Substance Use Disorders

11  Addiction may occur with or without the presence of physical dependence.  Physical dependence results from the body’s adaptation to a drug or medication and is defined by the presence of – Tolerance and/or – Withdrawal

12  Tolerance: the loss of or reduction in the normal response to a drug or other agent, following use or exposure over a prolonged period a higher dose is required to achieve the same effect.

13 Dependence:  A state in which an organism functions normally in the presence of a drug. It is manifested as a disturbance when the drug is removed (withdrawal).  Can be physiological, psychological or both

14 Withdrawal:  a period during which somebody addicted to a drug or other addictive substance stops taking it, causing the person to experience painful or uncomfortable symptoms OR  a person takes a similar substance in order to avoid experiencing the effects described above.

15 Psychoactive chemicals that are found to have abuse liability are placed under restricted use by the Drug Enforcement Administration (DEA) and are called “Controlled Substances”. Those drugs with the highest abuse potential are the ones that produce euphoria and have a rapid onset. Since the DEA focuses on reduction of availability of drugs, those drugs with the highest abuse liability are policed the most aggressively.

16 ScheduleDescriptionAbuse Liability Medical UsesExamples I May lead to severe psychological or physical dependence High potential for abuse No medical use; can’t be dispensed by an MD. PCP, GHB, Ecstasy, Marijuana, Peyote II May lead to severe psychological or physical dependence High potential for abuse Some medical uses with severe restrictions; can be dispensed by Rx from an MD. Dilaudid, Oxycontin, Seconol, Methadone III May lead to high psychological or moderate to low physical dependence Moderate potential for abuse Accepted medical uses; can be dispensed by Rx from an MD. Anabolic Steroids, Ketamine, Buprenorphine IV May lead to limited psychological and/or physical dependence Low potential for abuse Accepted medical uses; can be dispensed by Rx from an MD. Xanax, Klonopin, Ambien, V May lead to limited psychological and or physical dependence Very low potential for abuse Accepted medical uses; can be dispensed by Rx from an MD. Robitussin A-C, Lomotil

17  Oral – drink or swallow  Smoking  Nasal – snorting, inhaling  Topical – Rub on skin  Injection – Intramuscularly (IM), Intravenously (IV), Subcutaneous (SC)

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20 DRUGSBRAND OR COMMON NAMESLANG TERMS OpiumLaudanum, ParegoricOpium MorphineMorphine, Roxanol“M”, Miss Emma, Monkey CodeineCodeine, Tylenol with Codeine, Robitussin A-C School Boy HeroinDiacetylmorphineHorse, Smack, Junk MeperidineDilaudidLittle D, Lords HydromorphoneDemerolDolantol MethadoneDolophine, Methadone, Methadose Meth, Dolly Other NarcoticsPercodan, Fentanyl, Hydrocodone, Loritab, Darvon

21  Analgesic, pain relief  Antitussive  Antidiarrheal  Methadone and Buprenorphine can be used for drug addiction treatment

22  Methods of Use Oral, smoked, nasal, injected  Effects Euphoria, Drowsiness, respiratory suppression, constricted pupils, nausea, itching skin, constipation

23  3-6 hours for Opium, Heroin, Morphine, Codeine, Meperidine and Hydromorphone hours for Methadone and Buprenorphine Variable for the rest  Watery eyes, runny nose, loss of appetite, yawning, irritability, tremors, panic, chills and sweating, cramps, nausea, diarrhea

24  Require Medically Monitored Detoxification  Death by overdose is common  Significant synergistic effect  Medication Assisted Treatment is the most effective.

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28 DRUGSBRAND OR COMMON NAMESLANG TERM GHBLiquid Ecstasy, GHBX, Georgia Home Boy, Grievous Bodily Harm BarbituratesPhenobarbitol, Seconal, Amytal, Tuinal Barbs, Yellows, Reds, Tooies, Phennies BenzodiazepinesXanax, Valium, Klonopine, Ativan, Halcion,Rohypnol Downers, Benzos, Sleeping Pills, Nerve pills, Roofies MethaqualoneQuaalude, MecquinLudes, Mandrex Other DepressantsMilltown, PlacydilMuscle

29 And then there is Ethyl Alcohol: Commonly know as Beer, Wine, Ale, Liquor, Distilled Spirits Or Booze / Brew

30  GHB - none  Benzodiazepenes –Anti-anxiety, sedative, anticonvulsant, muscle relaxant  Barbiturates – Originally anti-anxiety, anticonvulsant  Ethyl Alcohol – Mild Sedative, mild sleep inducement, solvent for other drugs

31 Methods of Use Mainly Oral though some can be injected Effects Slurred speech, disorientation, “drunken behavior” without odor of alcohol, diminished coordination, increased reflex time

32 Duration of effect Can vary from 1 to 16 hours depending on the drug and amount used. Withdrawal Symptoms Anxiety, insomnia, tremors, delirium, convulsions

33  Medically monitored detoxification required  Major synergistic effect with opiates/opioids  Benzodiazepines are seriously overprescribed  Fetal Alcohol Syndrome Disorders

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37 DRUGBRAND OR COMMON NAMESLANG TERM MarijuanaSinsemilla,Pot, Grass, Weed, Smoke, Dope, Blunt, Reefer TetrahydrocannabinolTHC, Marinol Hashish or Hashish OilHash or Hash Oil K2 Spice

38  Appetite Stimulant, relieves ocular pressure associated with glaucoma

39  Methods of Use Smoke, Oral  Effects Euphoria, relaxed inhibitions, increased appetite

40  Duration of Effect 2-4 Hours  Withdrawal symptoms Irritability, insomnia, loss of appetite

41  K2 Spice It is a synthetic cannabinoid, it provides the same euphoric effect as marijuana. Is marketed as “incense” on the internet and in locations where it is not illegal. Is not detectable on urine drug screens.

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45 DRUGSBRAND OR COMMON NAMESLANG TERMS CocaineCoke, CrackSnow, Blow, Crack Amphetamines / Methamphetamine Adderall, Crystal Meth, Dexadrine Crank, Speed, Ice MethylphenidateRitalin, Concerta CaffeineCoffee, tea, chocolate, No- doz, Vivarin Java, Joe NicotineCigarettes, Smokeless tobacco Chew, dip, cigs

46  Cocaine and it’s cousins can be a topical anesthetic  Amphetamines can be used for weight loss, narcolepsy, ADHD  Caffeine is a mild stimulant and can be used to treat headaches  Nicotine has no medical use but is a good insect repellant

47  Methods of Use Oral, smoked, nasal, injected  Effects Increased alertness, excitation, euphoria, insomnia, loss of appetite, increased pulse and blood pressure

48  Duration of effect Can vary from a few minutes to 4-6 hours  Withdrawal Symptoms Apathy, long period of sleep, depression, irritability, disorientation

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54 DRUGSBRAND OR COMMON NAMESLANG TERMS MDMA and AnalogsMDMA, MDA, MDEA, MBDAMDMA- Ecstasy; MDA – Love Drug; MDEA – Eve; LSDLysergic Acid DiethylamideAcid, Blotter, Microdot Phencyclidine and AnalogsKetamine, PCP,Angel Dust, Special K Mescaline and PeyoteMescalCactus, Button, Mesc Other HallucinagensDextromethorphan (DXM), Psilocybe mushrooms Shrooms,

55  With the exception of Ketamine which is an anesthetic, none.

56 Methods of Use Oral, smoked, snorted, PCP and Ketamine can be injected Effects Illusions, hallucinations, poor perception of time and distance, sensory crossover, impaired hand eye coordination.

57  Duration of Effect Depending on the substance anywhere from one to twelve hours.  Withdrawal Symptoms Muscle Aches, drowsiness. No “withdrawal symptoms” in classic sense.

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60 DRUGSBRAND OR COMMON NAMESLANG TERMS Volatile SolventsGasoline, Airplane glue, Vegetable Spray, Hairspray, Deodorant, Spray Paint, Paint Thinner, Transmission Fluid, Air Freshener Sniffing, Huffing NitritesButyl Nitrite, Amyl NitriteRush, Locker Room, Poppers Nitrous OxideLaughing Gas, Whippets

61  Amyl Nitrite can be used to treat Angina. Nitrous Oxide is an anesthetic.

62  Methods of use Sniffing and inhaling  Effects Slurred speech, euphoria, rapid heart beat, stupor, headache

63  Duration of Effect Fifteen minutes to two hours  Withdrawal Symptoms Insomnia, Irritability, Cramps, Nausea, Tremors, Depression, Headache, Confusion, Convulsions

64  Inhalants cause severe damage to the lungs, liver, kidneys, bone marrow and the brain.  Additionally they can cause suffocation, stroke, loss of consciousness and possible death

65 Is Addiction a

66 A. When any cell tissue or any organ is affected in such a way that the tissue or organ cannot function as it is intended. B. It is a primary condition. C. It has a predictable and progressive course. D. There is an established etiological agent or cause. E. The disorder has a recognizable, measurable set of signs and symptoms which permit an accurate diagnosis

67  Can be short or long acting Acute versus Chronic  Potentially fatal Or not  Treatable Or not  Curable Or not

68 Acute Disease  Rapid onset  Short course  May be severe Chronic Disease  Gradual onset  Lifetime course  May have “acute” episodes

69  What is the “affected cell tissue or organ?” The Brain, and it is expressed in the form of “compulsive behavior.”  Is it a “primary condition?” Yes, it is not the effect of any other disease.  Is there a “predictable, progressive course?” Yes  Are there “recognizable, measureable signs and symptoms?” Yes, outlined in the DSM IV

70  Is it Chronic or Acute “Gradual onset with acute episodes” accurately describes it, chronic.  Is it a “potentially fatal?” Yes.  Is it “treatable?” Yes, with abstinence and lifestyle / behavioral modification changes  Is it “curable?” At present No.

71 Brain disorders are characterized by uncontrollable involuntary behaviors.  Schizophrenia – Hallucinations  Depression – Mood swings  Parkinson’s Disease – Muscle Tremors  Addiction- Drug seeking, Antisocial behaviors

72  Since the causes are usually multi-factorial, treatments must usually be multi-modal.  Response rates are variable and depend on the patient, the treatment itself, and outside factors.

73 Diabetes Genetic predisposition Lifestyle choices are a factor in development of the disease Severity is variable There are diagnostic criteria Once diagnosed, you’ve got it Addiction Genetic predisposition Lifestyle choices are a factor in development of the disease Severity is variable There are diagnostic criteria Once diagnosed, you’ve got it

74 Diabetes Primary treatment is lifestyle modification Small percentage of patients comply with same Medications can help Patients often don’t comply with medical regimen Addiction Primary treatment is lifestyle modification Small percentage of patients comply with same Medications can help Patients often don’t comply with medical regimen

75 Diabetes Patients who are partially compliant are the rule, and outcomes are better than those who do not get treatment Support systems improve outcomes Addiction Patients who are partially compliant are the rule, and outcomes are better than those who do not get treatment Support systems improve outcomes

76 Diabetes Since suboptimal patient compliance is expected, medication use is titrated to maximize outcome Addiction Since suboptimal patient compliance is expected…….wait till motivated? let them do more “research”? withhold medication till they try harder?

77 Diabetes Even in highly motivated patients, only a small percentage will succeed without medication. “Abstinence” from medication is lowest priority Addiction Abstinence is still often the underlying goal, without which treatment (and the patient) is judged a failure???

78  Chronic disease may be controllable, but not usually curable  Medications, if available, are useful to promote this “disease control”  Results will be suboptimal  There is a “disconnect” between treatment of addiction vs. other chronic diseases

79 How do we deal with “moral failures” or “crimes?’ Punishment, “consequences”, Incarceration. How do we deal with “diseases?” Medical care, treatment, meeting the patient “where they are at”, helping them to move toward a healthier life

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