Prescription Drugs and Other Illegal Substances

1. Kerry Herndon, MSW, LAC-E Western Montana Addiction Services Project SUCCESS- Sentinel HS Prescription Drugs and Other Illegal Substances

2. 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

3. Why do people abuse Rx Drugs? • a quick-fix • family history/lack of nurturing parents • early aggressive or impulse behavior • peer pressure • low self-esteem • Boredom • escape reality • drug availability, • and belief that drug abuse is o.k.

4. 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

5. 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.

6. 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!

7. 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

8. Heath Ledger • Oxycodone • Hydrocodone • Alprazolam • Diazepam, • Temazepam • Doxylamine • Caused respiratory depression and, when combined, can be deadly.

9. Lortab/Hydrocodone/Vicodin • Lortab 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

10. 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.

11. Michael Jackson • Propofol • Lorazepam • Diazepam • Midazolam • Cardiac arrest

12. Barbiturates • Sedative- Hypnotic • Mild sedation to complete anesthesia • Very dangerous in overdose • Many celebrity accidental overdoses • Depresses or stops central nervous system • Any drug that’s name ends in “barbital”

13. Judy Garland • Barbiturates

14. Methadone • Synthetic opiate • Prescribed mostly to help with opiate withdrawal symptoms and reduce cravings • Controversial for drug treatment • Many reactions with other drugs.

15. 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.

16. 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)

17. 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.

18. 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.

19. 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.

20. 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.

21. 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

22. 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

23. 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.

24. 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

25. 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.

26. Pimp C • Promethazine (Sizzurp) • Codeine syrup (Sizzurp) • Respiratory depression

27. 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

28. 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.

29. Ketamine Special K, Vitamin K, Kit Kat, Cat Valium, K • Horse Tranquilizer/Anesthetic • Can cause loss of memory • Used mostly as a club drug/raves • Injected, consumed or smoked • Sometimes used as a date rape drug • Difficult to move or talk • Floating sensation

30. 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”.

31. 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.

32. Mushrooms • Usually eaten • Cause hallucinations, perception disorder, perceptual disturbances (especially when mixed with marijuana). • Audio, visual, tactile changes

33. Rohypnol • Benzodiazepine • Similar to valium • “Date Rape Drug” • Suppresses CNS • Causes blackouts and unconsciousness • Memory loss

34. Caffeine/Energy Drinks • Stimulant • Found in many drinks & chocolate • Can be taken as a pill • Energy drinks associated with deaths • 5 hr energy – In the news! • Ligament formation • Sports injury • Hip and joint issues

35. Mixing Energy and Alcohol • BAD NEWS! • Energy Drink: Stimulant • Increases heart beat • Increase blood pressure • Alcohol: Depressant • Slows your heart beat • Increases blood pressure • Alcohol Poisoning

36. Nicotine

37. Jimi Hendrix • Secobarbital • Brallobarbital • Antihistamine • Hydroxyzine • Alcohol • Asphyxiated on vomit

38. 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)

39. Anabolic Steroids • Pills or injected • Build muscle • Aggression, Anger, Violence • Changes our hormone balance • Causes problems with our sex hormones and organs

40. Designer Drugs • A lot out there • New stuff all the time • Being mixed with other drugs • Too new to know the long-term effects • Be Smart!

41. Elvis Presley • Fourteen different medications in his system • Including several barbiturates