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Drugs, Addiction, Abuse and Treatment

treatment
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prevention

addiction

Physiology of Drug Abuse

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The Reward Pathway and Addiction

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Addiction
A state in which an organism engage in a compulsive behavior:
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behavior is reinforcing (rewarding or pleasurable) loss of control in limiting intake

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TOLERANCE
A state in which an organism no longer respond to a drug A higher dose is required to achieve the same effect
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DEPENDENCE
A state in which an organism functions normally in the presence of a drug Manifested as a physical disturbance when the drug is removed (withdrawal)
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DRUG

ADDICTION IS A COMPLEX ILLNESS

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Categories of Drugs
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Categories of Drugs
Stimulants - uppers - stimulate the central nervous system - amphetamines, amyl nitrite, cocaine, crack, ecstasy Depressants - downers - depress the central nervous system - alcohol, barbiturates, benzodiazepines Analgesics - powerful painkillers - from opium poppy or synthetically produced Hallucinogens - psychedelics - dramatically alter perception - LSD, psilocyn, psilocybin, cannabis, ecstasy
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CLUB DRUGS

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Club Drugs
ECSTASY
Drug Class: CNS stimulant, hallucinogen Other names: MDMA, XTC, X, E, Adam, Clarity, Essence, Stacy, Lovers Speed Developed in WWI but became illegal in 1985 Today: a designer drug White form, crystalline powder + buffed & pressed = pills

Usual dose: 1 to 2 mg/kg body weight

Ingested orally, placed under the tongue, added to juice or carbonated beverage, snorted or injected
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Club Drugs
ECSTASY
Candyflipping combined used of ecstasy and LSD Stacking taking 3 E tablets at once, mixing it with other drugs How Ecstasy Works Half-life is 6 hours Onset action vary from person to person

Serotonin and dopamine released into the brain perception of pain, body temperature overheat without feeling any discomfort
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Club Drugs
ECSTASY
The E Rush Instantaneous rush 30-45 sec, lasting to 15-30 mins Sudden clarity, intensification of perceptions Inner sensation of happiness, sense of loving booster dose hope to prolong the sensations tolerance: desired effects; in adverse effects

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bubble bursting anxiety, paranoia, nausea, panic 30 mins3 hrs after initial rush: plateau phase of > intense feelings trance-like movements long lasting ecstatic trance-dancing

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Club Drugs
ECSTASY
The After Rush coming down: 3 6 hrs after initial ingestion feelings of disappointments: anxiety, depression sluggishness & residual effects: lasts up to several days 6-7 hours to fall asleep after returning to normal Tuesday blues from depletion of serotonin Long term effects still uncertain BUT subsequent depression may occur due to short-circuit of serotonin pathway & serotonin shortage

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Club Drugs
ECSTASY
Adverse Effects addiction to concurrently used substance anorexia, nausea, vomiting, insomnia visual blurring, confusion jaw-clenching, teeth grinding, muscle spasms dehydration, electrolyte imbalances heat exhaustion and injury (Saturday night fever) acute renal failure, hepatic toxicity tachychardia, fatigue, convulsions coma, death Sunday, May 13, 2012

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ecstasy

Stacy

lovers speed

xtc
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E
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Essence

Club Drugs
HERBAL ECSTASY
Other names: Ma huang, ephedra, Cloud 9, Herbal Bliss, Rave Energy Combination of stimulants to stimulate effects of XTC
Common use: stimulant or weight loss agent

Available: many health food stores or by mail order

Present in food supplements: Metabolift or Metabolife 356 In US: No regulation from US-FDA

Found in many OTC cold preparations Adverse Effects

Tachycardia, hypertension, stroke, seizure, heart attack, death
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Club Drugs
METHAMPHETAMINE
other names: Ice, speed, tweak, crank , glass, shabu white powder or clear, crystal rock release large amounts of dopamine = highly addictive stimulant

enhance mood and body movement taken orally, intranasally, intravenously, rectally
Desired effects smoking, intravenous: intense, very pleasurable sensation intranasal and oral: high feeling 3 5 mins (intranasal); 15-20 mins (oral); can last: 24 hours
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Club Drugs
METHAMPHETAMINE
Adverse effects wide variety or physical and psychological effects wakefulness, increased physical activity (hyper, alertness) appetite headache, sensation of hair standing on end dry mouth, tremors, tachycardia, hypertension, palpitations stroke, seizures euphoria, irritability, insomnia, anxiety hallucinations, paranoia, psychosis, death degeneration of neurons underlying cause of Parkinsons disease
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Methamphetamine
shabu

Speed

ICE

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Drug OPIUM

Street Names black stuff, chandu

Effects Withdrawal symptoms, e.g. aches, spasms, stomach cramps & convulsions, shaking & vomiting, runny nose, watery eyes Withdrawal symptoms, e.g. aches, spasms, stomach cramps & convulsions, shaking & vomiting, runny nose, watery eyes

MORPHINE

M, white stuff, white powder

HEROIN

White, junk, powder, putih, medicine

marijuana, ganja, pot, grass, joints Ice, glass, crystal, quartz, icecream, hirropon, shabu

Withdrawal symptoms, e.g. aches, spasms, stomach cramps & convulsions, shaking & vomiting, runny nose, watery eyes
Loss of concentration and memory, heart rate increases, poor balance & coordination, anxiety or panic, depression, confusion Ice has a strong effect on the nervous system and is highly addictive. Loss of weight, impotency, severe convulsions (fits), hallucinations, liver & kidney damage, damage to the heart, stroke & death. Blood pressure and increase in pulse rate, false feelings of confidence & closeness with others, dehydration, convulsions, vomiting & anxiety. Hallucination, Altered sensation, mood and consciousness, Affected judgment and co-ordination, distorted hearing, touch, smell, taste and visual sensation, nausea and vomiting, memory loss Increased heart beat, dehydration, paranoid feeling, 23 sweating, insomnia, irritability, depression

CANNABIS originated from the hemp plant, Cannabis Sativa METHAMPHETAMINE HYDROCHLORIDE

METHYLENEDIOCYMETHAMPHETAMINE (MDMA) KETAMINE

Ecstasy, Pink or Pink Lady, Snow White, Playboy, Apple, XTC Also known as "K", Special K, Vitamin K, Ket, Kit kat Methamphetamine tablet, crazy horse, mad medicine

YABASunday, May 13, 2012

Cocaine Powder Cracked cocaine

cocaine

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Amphetamines in various capsules

Barbiturate Pills

Benzodiazepine Pills

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Marijuana leaves

seeds
In joint rolling

In plastic bag

In block

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Cannabis

Codeine in various form

Coca leaves and powder

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Hashish Oil

Downers (various)

Depressant Pills
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LSD in Blotter Paper

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LSD in forms

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Heroin in plastic Heroin in various forms with balloons

Heroin in off white powder form

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Ketamine - special

Ketamine

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Morphine Methadone

Morphine in various forms

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Opium

Opium pod & derivatives

oxycontin
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Drug User Paraphernalia

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Drug User Paraphernalia

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Drug Laboratory

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Identification of a Drug User

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Identification of a Drug User

excitable, hostile, violent, destructive behavior, outbreaks of temper unsteadiness, clumsiness slurred speech, talking to oneself in a state of confusion dreamy, hallucinations lack of personal hygiene loss of concentration or attention loss of interest in personal care & appearance, food, family activity social withdrawal sudden decline in attendance or performance in school frequent job hopping frequents places like storage rooms, toilets, isolated corners sores on nose & mouth (glue sniffers), runny nose, bloodshot eyes smell solvents on breath, clothes, hair (glue sniffers)

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Drug Abuse is a preventable behavior

and

Drug Addiction is a treatable disease

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Reason Why People Turn to Drugs.

Poverty-the prevalent factors that prompts pushers and
abusers alike to indulge in dangerous drugs.

Ignorance-

Luck of knowledge and information about how dangerous look like, their bad effects, legal ramifications & other aspect of prohibited drugs.

Loss of Family Values and SolidarityParents being busy bodies, their children are being neglected.
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Other Factors Contributory to Drug Abuse.

Family Aspect School Aspect Community Aspect Influence Made by the Media Biological Factors Psychological Factors Parental Negligence Sociological Factors
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Prevention Programs should . . . .

Reduce Risk Factors
ineffective parenting

chaotic home environment

lack of mutual attachments/nurturing inappropriate behavior in the classroom failure in school performance poor social coping skills affiliations with deviant peers perceptions of approval of drug-using behaviors in 13, school, peer, and community environments Sunday, May 2012
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Prevention Programs should . . . .

Enhance Protective Factors
strong family bonds parental monitoring parental involvement success in school performance prosocial institutions conventional norms about drug use
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Prevention Programs should . . . . . .Target all Forms of Drug Use

. . . and be Culturally Sensitive

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Prevention Programs should . . . .

Include Interactive Skills-Based Training
Resist drugs Strengthen personal commitments against drug use Increase social competency Reinforce attitudes against drug use

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Prevention Programs should . . . . Be Family-focused

Provides greater impact than parentonly or child-only programs Family: included at each stage of development Involve effective parenting skills

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Prevention Programs should . . . .

Involve Communities and Schools

Media campaigns and policy changes
Strengthen norms against drug use Address specific nature of local drug problem

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Components of Comprehensive Drug Addiction Treatment

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Matching Patients to Individual Needs

No single treatment is appropriate for all individuals

Effective treatment attends to multiple needs of the individual, not just his/her drug use
Treatment must address medical, psychological, social, vocational, and legal problems
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Duration of Treatment
Depends on patient problems/needs Less than 90 days is of limited/no effectiveness for residential/outpatient setting

A minimum of 12 months is required for methadone maintenance

Longer treatment is often indicated

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Medical Detoxification
Detoxification safely manages the physical symptoms of withdrawal

Only first stage of addiction treatment

Alone, does little to change long-term drug use

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Self-Help and Drug Addiction Treatment

Complements and extends treatment efforts Most commonly used models include 12-Step (AA, NA) and Smart Recovery Most treatment programs encourage self-help participation during/after treatment

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Counseling and Other Behavioral Therapies

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Motivation to Enter and/or Sustain Treatment

Effective treatment need not be voluntary Sanctions/enticements (family, employer, criminal justice system) can increase treatment entry/retention Treatment outcomes are similar for those who enter treatment under legal pressure vs voluntary
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HIV/AIDS, Hepatitis and Other Infectious Diseases

Drug treatment is disease prevention Drug treatment reduces likelihood of HIV infection by 6 fold in injecting drug users Drug treatment presents opportunities for screening, counseling, and referral

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Effectiveness of Treatment
Goal of treatment is to return to productive functioning
Treatment reduced drug use by 40-60% Treatment reduces crime by 40-60% Treatment increases employment prospects by 40% Drug treatment is as successful as treatment of diabetes, asthma, and hypertension
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Cost-Effectiveness of Drug Treatment

Treatment is less expensive than not treating or incarceration Savings can exceed costs by 12:1 when health care costs are included Reduced interpersonal conflicts Improved workplace productivity Fewer drug-related accidents

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The Philippine Drug Scene

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The Philippine Drug Scene

RA 9165 Comprehensive Dangerous Act of 2002 signed June 7, 2002 stiffer penalties for illegal drug possession and pushing RA 7624 Integrated Drug Prevention Control in the Intermediate & Secondary Curricula signed July 22, 1991 Drug users: 300% annually 2001: 2 million Filipinos are drug dependents 1.2 million are 15 17 years old Growing number of executives hooked on drugs Growing problem: production of shabu in the country Philippines: serves as a transit point strategic location 60 Sunday, May 13, 2012

The Philippine Drug Scene

Shabu favored drug; mass appeal, poor mans cocaine, most popular drug of abuse XTC rich mans hug drug previously: designer drug among the rich kids now: caught on by the middle class originally expensive; but now, affordable before: only in bars and dance clubs now: streets, malls, schools, internet chat rooms popular among kids: easy to use, looks like any other pill, take it like ordinary medicine, no incriminating evidence
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The Philippine Drug Scene

Phil. Drug Enforcement Agency (PDEA) recent Drug Act 2002: life imprisonment to death for people caught with more than 10g of drugs choice of drug users: shabu info from: drugs addicts in the rehab centers 2001: Revenue from sales of illegal drug trade expected to hit 300 billion pesos (50% national budget in 2001)
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SUMMARY
Most drugs of abuseincluding nicotine, alcohol, marijuana, cocaine, and heroin activate a part of the brain called the reward system, and that makes you feel good. But just for a little while.

Drug abuse has serious consequences. The most serious consequence is that prolonged drug use changes the brain in fundamental and long-lasting ways. Eventually, it becomes difficult to experience other pleasures.

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After repeated drug use, you reach a point when deciding to use drugs is no longer voluntary. Scientists have proof now that drugs literally change your brain. Its as if a switch goes off in the brain. At that point, the drug abuser becomes a drug addict.

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Is it worth the risk?

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t he end
Group I
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