Substance Use Disorders & The implications of Addiction Marjorie F Withers, LCPC

We need our brain

Why are we here today: The High price of Substance Use Estimated cost of Substance Use is $700 Billion Dollars Major public health Issue Destructive to the individual Destructive to families Major impact for employers In rural areas 100% of the community can be effected by SU

Understanding Substance Use Disorders and addiction Chronic relapsing brain disease Compulsive seeking and use Changes brain functioning and structure Derails development Hereditary, environmental and social/environmental factors-role of trauma Multigenerational effects No one intends to become an addict or have a substance use disorder If I could stop…I would stop

Risk Factors

Substance use and Substance dependence: Impaired control Social Impairment Risky Use Pharmacological criteria (Tolerance and withdrawl Biological basis…genetic predisposition Social…learned, peer pressure Psychological…self medicating, becomes a coping mechanism Loss of choice…craving, seeking (tolerances and withdrawl) Becomes the major relationship in the users life Correlates with increased trauma Complicates relationships Co-morbidity

Brain Changes

Nation Wide Trends 8,400 new users per day Greatest percentage of new uses are adolescents Increase in opiate abuse and Heroin Treatment gap is widening (21.6 million need treatment) Less than one percent of users receive treatment Drug use is epidemic in the United States Alcohol remains the most frequently abused substance Impact of alcohol across time has been underestimated

Types of Drugs Tobacco Alcohol Marijuana and Hashish Opioids Stimulants Club drugs Hallucinogens Dissociative drugs Different types of drugs have different impact on the person with different implications for the consumer

Signs and Symptoms by Category of Drug Alcohol: (Depressant) Low doses: euphoria, relaxation, lowered inhibitions Higher doses: affects behavior : increases in emotional volatility, increases violent behavior Symptoms include: Visual distortions, slurred speech, impaired memory Can lead to loss of consciousness and death Health risks include: Increased risk of injuries, violence, fetal damage, depression, neurologic deficits, hypertension, liver failure, heart disease, addiction and fatal overdoses.

Cannabinoids Marijuana and Hashi Smoked or swallowed Psychologically addictive

Signs and symptoms Heightened perception Cough, respiratory infections Increased appetite Impaired memory & learning Sense of euphoria Time confusion Paranoia & anxiety Slowed thinking Increased heart rate Slowed reaction time Depressant Red eyes Impaired balance/coordination

Central Nervous System Depressants Swallowed or injected Barbiturates (Phenobarbital, Amytal, Membutal, Seconal) Benzodiazepines(Ativan, Librium, Valium, Zanax, Clozipine) Methaqualone (Quaalude, Sopor, Parest) Ecstasy (GHB Gamma-hydroxybutyrate)

Signs and Symptoms Slowed pulse Respiratory depression or arrest Slow breathing Death Lowered blood pressure Reduced anxiety Lowered inhibitions Withdrawal must be supervised medically. Impaired coordination Fatigue/confusion Can include: seizures, DTS Impaired concentration Barbiturates require tapering Memory impairment Judgment impaired Can be dangerous.

Hallucinogens LSD Mescaline Psilocybin Bath Salts Signs and Symptoms Altered state Hallucinations Flashbacks Increased temperature, heart rate, blood pressure Sleeplessness, tremors, paranoia Can cause persistent mental health disorders

Opioids and Morphine Derivatives Injected, swallowed, smoked or snorted Codeine Methadone Fentanyl Heroin Morphine Opium Oxycodone Hydrocodone Bitartrate (Vicodin) Percocet

Signs and Symptoms Pain relief Unconsciousness Euphoria Addiction Drowsiness Coma Nodding off Death Confusion Extremely addictive Sedation Staggering gait Tolerance Nausea Constipation

Heroin effects

Replacement Therapy Opiate treatment Utilizes replacement opiate that does not have the same effects as drug that was abused Used as a means to reduce harm Often step in weaning off drug Keeps parent from withdrawal symptoms Treatment of choice for pregnant mothers (safer than using street drugs or stopping use during pregnancy)

Stimulants Smoked, swallowed, injected, snorted depending on the drug. Amphetamine (Dexedrine, Biphetamine) Cocaine MDMA (Ecstasy) Methamphetamine (Crystal, Crank, Meth, Speed) Nicotine Ritalin

Signs and Symptoms Increased heart rate Rages Increased blood pressure Acting out Increased metabolism Impulsive behavior Exhilaration Irritability Energy Panic attacks Mental alertness Psychosis Rapid Irregular heart beat Irregular heart beat Reduced appetite Headaches Weight loss Heart failure Malnutrition Strokes Nervousness Seizures Paranoia Insomnia

Specific Symptoms Methamphetamine: Increased aggression Violence Memory loss Neurological damage Learning problems Tolerance Addiction Psychotic behavior

Remember No one intends to become an addict The person who is using is still our employee, our child, our partner, a friend, oneself People can stop using: Be a support for a person stopping Addiction requires action and intervention: Care enough to do something.