Prescription Drugs and Other Illegal Substances

Kerry Herndon, MSW, LAC-EWestern Montana Addiction ServicesProject SUCCESS- Sentinel HS

A few facts first…. (Tip: Rx= Prescription)

Mixing substances is NEVER a good idea 300 die in MT per yr from Rx drug use MT ranks #3 in the nation for Rx drug abuse Rx drugs are easy to obtain Street value is high, so those who have them are

making $ U.S. consumes 80% of the worlds opiate supply ER’s: alcohol & Rx drug use in combination 50% most DUI related blood draws contain other

substances in addition to alcohol 20% of people in the U.S. have used Rx drugs for

non-medical purposes Everyday (in the U.S.) about 2,000 teens use Rx

drugs for recreation for the first time

Why do people abuse Rx Drugs?a quick-fix family history/lack of nurturing

parentsearly aggressive or impulse behavior peer pressure low self-esteemBoredomescape realitydrug availability, and belief that drug abuse is o.k.

Ways Rx Drugs are Abused Taking drugs prescribed to someone else Using old, unfinished prescriptions to treat

a condition for which the drug was not originally prescribed.

Taken in ways other than as directed Not waiting long enough between doses Taking more than what is prescribed Crushing/scrapping pills and snorting

them Chewing them rather than swallowing

them Injecting them

Anna Nichole Smith Chloral hydrate Clonazepam Lorazepam Oxazepam Diazepam Diphenydramine An antihistamine Topiramate Anticonvulsant The doses of each substance alone does not

cause death; however, combining them causes respiratory depression and death.

Skittles Parties

What is in the bowl?How will your body will react?How it will interact with other drugs

or medications you are taking?Very dangerous!Turn and Run!

Oxycodone/Oxycontin “Oxy” Opiate Used for pain relief Lots of existing health conditions can be

complicated by taking these drugs. Interacts negatively with many other substances Abuse can cause:

Nausea Dizziness Loss of Appetite Dry Mouth Mood Swings Difficulty Breathing Headache Withdrawal

Heath Ledger

Oxycodone HydrocodoneAlprazolamDiazepam, TemazepamDoxylamine

Caused respiratory depression and, when combined, can be deadly.

Lortab/Hydrocodone/VicodinLortab and Vicodin are a combination

of acetaminophen (Tylenol) and hydrocodone.

Hydrocodone Opiate Used for pain relief & sometimes cough Causes:▪ Respiratory Depression▪ Depresses Central Nervous System▪ Has a long list of possible side effects

Benzodiazepine “Benzos” Used as a muscle relaxant, to treat

anxiety, insomnia, agitation, seizures, muscle spasms, alcohol withdrawal, and premedication for medical procedures.

Examples: Xanax, Valium, Diazepam, Klonopin

Many possible side effects from misuse or combining with other substances.

Michael Jackson

Propofol LorazepamDiazepamMidazolam Cardiac arrest

Barbiturates

Sedative- HypnoticMild sedation to complete anesthesiaVery dangerous in overdose

Many celebrity accidental overdosesDepresses or stops central nervous

systemAny drug that’s name ends in “barbital”

Judy Garland

Barbiturates

Methadone

Synthetic opiatePrescribed mostly to help with opiate

withdrawal symptoms and reduce cravings

Controversial for drug treatmentMany reactions with other drugs.

Amphetamines Examples: Adderall, Ritalin, Concerta Physical effects: hyperactivity, blood shot eyes,

headache, heart rate increases, blood pressure increases or decreases, heart palpitations, insomnia, tremors, fever, blurred vision, tremors, dry mouth, skin issues/acne, convulsions, seizure, stroke, coma, heart attack or death.

Psychological effects: euphoria, anxiety, alertness, concentration, sociability, irritability, energy, changes in self-esteem or confidence, aggression, obsessive behaviors, paranoia.

Brittany Murphy

Primary cause of death was thought to be pneumonia and iron deficiency anemia

Hydrocodone (for cough and chest pain), Acetaminphen (for fever), Chlorpheniramine (an antihistamine for

runny nose) L-methamphetamine (possibly from the

decongestant pseudoephedrine)

Huffing Inhalants Whippits Deliberate inhalation of fumes, vapors, or gases Over 2.6 million children, aged 12 – 17, use an Inhalant

each year 1 in 4 students in America has intentionally huffed by the

time they reach the eighth grade. Inhalants tend to be the drug that is tried first by children. 59% of children are aware of friends huffing at age 12. Inhalants are the fourth most-abused substance after

alcohol, tobacco, and marijuana.

Huffing (part 2) The number of lives claimed by Inhalant Abuse

each year is unknown because these deaths often are attributed to other causes.

Death can occur the first time -Sudden Sniffing Death Syndrome, suffocation, choking, or a fatal injury.

Effects the brain, heart, kidneys and liver, and other organs

Inhalants can be addictive Progression to illegal drugs or alcohol abuse.

Cocaine Crack, Coke, Dust, Toot, Snow, Blow, Sneeze, powder, Lines, Rock Comes from the leaves of a coca plant Used by: Smoking, Snorting, Eating, Injecting Rapid intense high followed by intense feelings of

depression, edginess and craving for more Difficulty sleeping, increased heart rate, muscle

spasms, convulsions, damage to nasal cavity/tissue, loss of appetite, heart attacks, seizures, strokes, respiratory failure and blood shot eyes.

Makes you feel paranoid, angry, hostile, anxious even when you are not high.

Interferes with the brain processes Feelings of pleasure diminished (need to use

more) Combining with other drugs or alcohol can be

deadly.

Cocaine (Part 2) Expensive! Risk of disease from sharing needles –

hepatitis, HIV/AIDS, etc. Increased risk of sexual assault,

unplanned pregnancy. Increased feelings of depression Gives the illusion of power and energy Most often leaves users feeling

emotionally, physically and sexually unable to function.

Heroin Smack, H, Skag, Junk, Dope, Shot, Dragon, Tar, White, Snow, Mexican Mud

Opiate Used by: Injecting, snorting, smoking Usually a white or brown powder Sometimes a black sticky substance

“black tar heroin” Converted to morphine in the brain Withdrawal: restlessness, muscle/bone pain,

insomnia, diarrhea, vomiting, cold flashes, kicking movement

Sometimes treated w/ other medication, such as methadone

Heroin

Surge of euphoria, dry mouth, flush skin, heavy extremities, clouded head

Slows breathing, sleep patterns affected, blood pressure

Prolonged use: collapsed veins, infection of heart lining and valves, abscesses, liver disease, kidney disease, heart problems, pneumonia, clogged blood vessels, brain damage

Infectious diseases from needle use

Ecstasy/Molly/MDMA Psychedelic drug MDMA active substance Ecstasy usually a pill form Often mixed with other things Molly powered or crystalline form (pure) Euphoria, sense of intimacy with others, decreased anxiety,

and is usually followed by fatigue. Difficulty concentrating, jaw clenching, grinding of teeth,

no appetitie, dry mouth, increased anxiety/paranoia, depression, irritability, emotional sensitivity, dizziness, vertigo, hyperactivity, hypertension, heart attack, damage to the heart, hyperthermia, stroke, loss of consciousness, coma or death.

Reduction of serotonin and dopamine Some studies show positive effects for some health

conditions, but so far the risks outweigh the benefits.

Bath Salts Designer drug (synthetic/man made) Most use in the USA was discovered between 2010 and

2011, use increased after it was reported in the news Effects similar to amphetamine and cocaine White crystals resemble salts made for bathing States on package “not for human consumption” Can be swallowed, snorted, smoked or injected Symptoms include: headache, heart palpitations, nausea,

cold fingers, hallucinations, paranoia, panic attacks, violent behavior, heart attack, kidney failure, liver failure and suicide.

Increases pain tolerance Those using have dilated pupils, involuntary muscle

movement, rapid heartbeat and high blood pressure. Most users have a history of mental health issues

Sizzurp/Dextromethorphan Cough suppressant Dissociative hallucinogen Causes visual distortion, distorted body perception,

feelings of dissociation, excitement, loss of sense of time, stimulant like-euphoria

Side effects for recreational users: vomiting, blurred vision, blood shot eyes, dialated pupils, sweating, fever, hypotension, slowed breathing, diarrhea, muscle spasms, passing out and blacking out.

SIZZURP/PURPLE DRANK: Cough syrup (usually with codeine) Fruit flavored soda Jolly Rancher Mentioned in a lot of music and popular in hip-hop culture Many deaths associated with using Drowsiness, hallucinations, vision changes, nausea, confusion, difficulty

breathing RED SOLO CUP! Cough syrup frozen in the cup and then soda inside.

Pimp C

Promethazine (Sizzurp) Codeine syrup (Sizzurp) Respiratory depression

Meth Amphetamine/Stimulant Originated in 1919 in Japan --- military use Taken by just about any means imaginable Called by many names Distributed in many colors Very addictive Serotonin/Dopamine receptors damaged Bugs in skin Significant withdrawal symptoms Long-term complications form minimal use Causes: Alertness, euphoria, improved

concentration, mania, anxiety, increased self-esteem, aggressiveness, obsessive behaviors, paranoia

Meth (part 2) Can induce: anorexia, hyperactivity, dilated

pupils, flushed skin, excessive sweating, restlessness, dry mouth, headache, increased or slowed heart beat, irregular heart beat, rapid breathing, high/low blood pressure, fever, diarrhea, constipation, vision changes, dizziness, twitching, insomnia, numbness, tremors, skin issues, convulsions, and heart attack.

Ketamine Special K, Vitamin K, Kit Kat, Cat Valium, KHorse Tranquilizer/AnestheticCan cause loss of memoryUsed mostly as a club drug/raves Injected, consumed or smokedSometimes used as a date rape drugDifficult to move or talkFloating sensation

LSD/ Acid Usually taken orally, but can also be injected Altered thinking, different visual experiences, altered sense

of time, spiritual experiences, increased appetite, wakefulness, numbness, weakness, nausea, hypo/hyperthermia, elevated blood sugar, chills, heart rate increases, sweating, increased saliva production, tremors, and metallic taste.

Can cause anxiety, paranoia, and delusions. May result in personality changes, see colors differently, seeing patterns or movement in solid things, los of identity, ability to process emotion, panic attacks, psychosis, and “flashbacks”.

PCP Angel dust or wet Used by: ingesting, smoking or inhaling Powder and liquid forms often sprayed onto a

leafy material such as cannabis, mind, oregano, parsley, etc. then smoked.

Causes numbness, staggering, slurred speech, bloodshot eyes, loss of balance, convulsions, changes in body image, paranoia, hallucinations, aggressive behavior, euphoria, suicidal impulses, animated, detached, feelings of strength or power, dilated pupils, amnesia, delusions, and skin dryness.

Mushrooms

Usually eatenCause hallucinations, perception

disorder, perceptual disturbances (especially when mixed with marijuana).

Audio, visual, tactile changes

Rohypnol

BenzodiazepineSimilar to valium“Date Rape Drug”Suppresses CNSCauses blackouts and

unconsciousnessMemory loss

Caffeine/Energy Drinks

StimulantFound in many drinks & chocolateCan be taken as a pillEnergy drinks associated with deaths5 hr energy – In the news!Ligament formationSports injuryHip and joint issues

Mixing Energy and AlcoholBAD NEWS!Energy Drink: Stimulant

Increases heart beat Increase blood pressure

Alcohol: Depressant Slows your heart beat Increases blood pressure

Alcohol Poisoning

Nicotine

Jimi Hendrix

SecobarbitalBrallobarbitalAntihistamineHydroxyzineAlcoholAsphyxiated on vomit

Salvia Divinorum A psychoactive mint, used in traditional spiritual practices

by the Mazatec people of Mexico Contains a naturally occurring hallucinogen Most potent when smoked and is comparable in potency to

LSD (powder form) Can be ingested in a liquid extract form. Green plant leaves or liquid extract Causes dramatic and scary states of mind Can be subtle to a full-psychedelic experience Can cause intense hallucinatory experience (particularly

when smoked)

Anabolic Steroids

Pills or injectedBuild muscleAggression, Anger, ViolenceChanges our hormone balanceCauses problems with our sex hormones and organs

Designer Drugs

A lot out thereNew stuff all the timeBeing mixed with other drugsToo new to know the long-term

effectsBe Smart!

Elvis Presley

Fourteen different medications in his system

Including several barbiturates