SUBSTANCE ABUSE

Substance Abuse
The use of illicit drugs or the abuse of prescription or over-the-counter drugs for purposes other than those for which they are indicated or in a manner or in quantities other than directed.

Substance Abuse
Illegal drugs, alcohol, prescription and over-the-counter medications, inhalants and solvents, and even coffee and cigarettes, can all be used to harmful excess.
Almost any substance can be abused.

SUBSTANCE ABUSE Any pattern of substance use that results in repeated adverse social consequences. Interpersonal conflicts Failure to meet work, family, or school obligations, or legal problems.

SUSBSTANCE DEPENDENCE (addiction) Physiological and behavioral symptoms related to substance use.

Need for increasing amounts of the substance to maintain desired effects

Withdrawal if drug-taking ceases, and a great deal of time spent in activities related to substance use.

Dependence
Can begin at any age
People aged 18 to 24 have relatively high substance use rates

Dependence often arises sometime during the ages of 20 to 49.

Gender proportions vary according to the class of drugs, but substance use disorders are in general more frequently seen in men.

Seven Criteria
Three must be present during a given 12-month period, for the diagnosis of substance dependence: Tolerance, by the need for increasing amounts of the substance to obtain the desired effect

Withdrawal, by experiencing unpleasant mental, physiological, and emotional changes when drugtaking ceases or by using the substance as a way to relieve or prevent withdrawal symptoms.

Longer duration of taking substance or use in greater quantities than was originally intended.

Persistent desire or repeated unsuccessful efforts to stop or lessen substance use. A relatively large amount of time spent in securing and using the substance, or in recovering from the effects of the substance.

Important work and social activities reduced because of substance use.

Continued substance use despite negative physical and psychological effects of use.

Classes of Substances:
Alcohol Amphetamines (crystal meth, some medications used in the treatment of attention deficit disorder) Cannibis (marijuana and hash)

Cocaine (crack)
Hallucinogens (LSD, mescaline, and MDMA ,ecstasy)

Inhalants (including compounds found in gasoline, glue, and paint thinners)

Meth Video
http://www.youtube.com/watch?v=nl8DYQP4KjQ

Classes of Substances
Nicotine Opioids (morphine, heroin, codeine, methadone, oxycodone) Phencyclidine (PCP, angel dust) Sedative, hypnotic, and anti-anxiety substances (,valium, barbiturates, prescription sleeping medications, and most prescription anti-anxiety medications)

Physical Signs and Symptoms

Amphetamine users may exhibit rapid heartbeat, elevated or depressed blood pressure, dilated (enlarged) pupils, weight loss, as well as excessively high energy, inability to sleep, confusion, and occasional paranoid psychotic behavior. Cannibis users may exhibit red eyes with dilated pupils, increased appetite, dry mouth, and rapid pulse; they may also be sluggish and slow to react.

Cocaine users may exhibit rapid heart rate, elevated or depressed blood pressure, dilated pupils, weight loss, in addition to wide variations in their energy level, severe mood disturbances, psychosis, and paranoia. Users of hallucinogens may exhibit anxiety or depression, paranoia, and unusual behavior in response to hallucinations. Signs include dilated pupils, rapid heart rate, tremors, lack of coordination, sweating.

Users of inhalants experience dizziness, spastic eye movements, lack of coordination, slurred speech, and slowed reflexes. Associated behaviors may include belligerence, violence, apathy, and impaired judgment.

Opioid drug users exhibit slurred speech, drowsiness, impaired memory, and constricted pupils. They may appear slowed in their physical movements.

Phencyclidine users exhibit spastic eye movements, rapid heartbeat, decreased sensitivity to pain, and lack of muscular coordination. They may show belligerence, predisposition to violence, impulsiveness, and agitation.
Users of sedative, hypnotic, or anxiolytic drugs show slurred speech, unsteady gait, inattentiveness, and impaired memory. They may display inappropriate behavior, mood volatility, and impaired functioning.

Angel Dust / PCP video

http://www.youtube.com/watch?v=wLZq5GGPxws&f eature=related

Substance Abuse
Police Officers, Doctors, Nurses, EMSare known as the helping professions. It takes a certain character and disposition to work in these professions

even the most qualified individual will eventually be affected by what they see and hear.
For a strikingly large number of individuals, seeing trauma on a daily basis leads to substance abuse.

Substance Abuse Among Different Occupations?

Doctors: 8% to 12% of physicians were estimated to develop a substance use problem. Emergency medicine, not surprisingly, and anesthesiology, are usually the highest-risk specialties among doctors. Police Officers: almost 90% of police officers consume alcohol to some degree. At least a quarter of officers are dependent upon alcohol. Alcohol is used to cope with the stress related to being on the job.

What is Alcoholism?
is a disease that includes the following four symptoms: Craving: A strong need, or urge, to drink. Loss of control: Not being able to stop drinking once drinking has begun. Physical dependence: Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety after stopping drinking. Tolerance:The need to drink greater amounts of alcohol to get "high."

Is Alcoholism a Disease?
Yes, alcoholism is a disease. The craving that an alcoholic feels for alcohol can be as strong as the need for food or water. An alcoholic will continue to drink despite serious family, health, or legal problems. Like many other diseases, alcoholism is chronic, meaning that it lasts a person's lifetime; it usually follows a predictable course; and it has symptoms. The risk for developing alcoholism is influenced both by a person's genes and by his or her lifestyle

Alcohol Poisoning
Alcohol depresses nerves that control involuntary actions such as breathing and the gag reflex (which prevents choking). It is common for someone who drank excessive alcohol to vomit, alcohol is an irritant to the stomach. Danger of choking on vomit, which could cause death by asphyxiation in a person who is not conscious because of intoxication.

Critical Signs for Alcohol Poisoning

Mental confusion, stupor, coma, or person cannot be roused. Vomiting. Seizures. Slow breathing (fewer than eight breaths per minute). Irregular breathing (10 seconds or more between breaths). Hypothermia (low body temperature), bluish skin color, paleness.

Alcohol
Drinking to get drunk Drinking to become intoxicated as fast as they possibly can.

1997 - Americans drank an average of 2 gallons (7.57 liters) of alcohol per person.
Translates into one six-pack of beer, two glasses of wine and three or four mixed drinks per week.

Drinking on Campus
Men have historically reported higher rates of drinking than women. But the difference now seems to have evaporated Binge drinking was up 22% in women, nearly double the increase in men. The study of 2,000 students on 400 campuses, also found a steep rise in abuse of prescription pain drugs by college students. Nonmedical use of narcotic drugs like OxyContin and Vicodin shot up 343% between 1993 and 2005.

Binge and Extreme Drinking

Binge drinking is defined as at least four drinks per occasion for women and at least five drinks per occasion for men.

Extreme drinking doubles or even triples those minimum amounts

College Life!!

23 percent of college students meet the medical criteria for substance abuse or dependence. That's about triple the proportion in the general population.

Alcohol Video
http://www.youtube.com/watch?v=wavDf59t1YE&fea ture=channel

The CAGE Questionnaire

C -Have you ever felt that you should Cut down on your drinking? A -Have people Annoyed you by criticizing your drinking?

G -Have you ever felt bad or Guilty about your drinking?

E -Have you ever had an Eye opener - a drink in the morning to steady your nerves or get rid of a hangover?

One "yes" answer indicates a risk for abuse /dependence alcohol use problems; more than one "yes" indicates a high likelihood.

Half way mark

Substance abuse to be continued next week!

Smoking
48,000 Canadians die each year from tobacco use. Lung cancer was the leading cause of cancer death for both men and women. The number of health problems linked to smoking continues to increase. Connections are recognized between second-hand smoke and health conditions ranging from SIDS and asthma in children to cancer and heart disease in adults.

Anabolic Steroids
Chemical substance derived from cholesterol. Cortisol and testosterone males Estrogen and progesterone in the female. Anabolic steroids build muscle and bone mass by stimulating the muscle and bone cells to make new protein. Athletes use anabolic steroids because they increase muscle strength by encouraging new muscle growth. They allow the athlete to train harder and longer at any given period.

Anabolic Steroids
Anabolic steroids are mostly testosterone (male sex hormone) and its derivatives. Examples of anabolic steroids include: Testosterone Dihydrotestosterone Androstenedione (Andro) Dehydroepiandrosterone (DHEA) Clostebol Nandrolone

Anabolic Steroids
Side effects:
Jaundice and liver damage because these substances are normally broken down in the liver Mood swings, depression and aggression because they act on various centers of the brain

MALES: Baldness Infertility Breast development

Side Effects

FEMALES: Stimulate hair growth on the face and body Suppress or interfere with menstrual cycle, possibly leading to infertility Thicken the vocal cords, which causes the voice to deepen, possibly permanently If pregnant, interfere with the developing fetus

What Is Addiction?
Addiction is a habit that is often hard to stop and that increasingly interferes with a persons life.

The habit could involve a substance such as alcohol or another drug, or an activity such as gambling.
the substance has become the focus of the persons life

the person continues the use or activity despite severe negative consequences, (e.g., imprisonment or financial disaster).

How Common Is Addiction?

76 million people worldwide have alcohol use disorders 15 million people worldwide have drug use disorders 1/3rd of the worlds population over the age of 15 smoke tobacco. 2004, Canadians gambled roughly $12.4 billion on some form of government-run gambling activity 332,000 people in Ontario are experiencing problems as a result of their gambling.

What Causes Addiction?

It's puzzling why some people become addicted and others do not. No single answer has been found. genes the way a persons brain works difficulties during childhood mental health problems stress

cultural influences.
Nobody chooses to become addicted, and addiction is not simply due to personal weakness or character

Risk Factors for Addiction

alcohol or other drug problems among family members poor school performance poverty

family conflicts, chaos

stress

having friends who drink or use other drugs

not fitting in socially emotional, physical or sexual abuse

Protective Factors for Addiction

having a positive adult role model (e.g., a parent, relative or teacher) having good parental or other caregiver supervision

having a strong attachment to family, school and community

having goals and dreams being involved in meaningful and wellsupervised activities (e.g., sports, music, volunteer work).

Addiction Affects: Mind and Body

Two kinds of dependence: Psychological dependence occurs when a person feels he or she needs the drug to function or feel comfortable.

Physical dependence occurs when a persons body has become used to the presence of a drug. Tolerance has developed, and when the person stops using the drug, symptoms of withdrawal

Do Addictions to Activities vs. Substances

Although addictions to substances and addictions to activities such as gambling follow similar paths and have similar consequences, it is not yet clear if behavioural addictions produce the same mental and physical changes as heavy substance use does.

This is one reason why some prefer to call behavioural addictions compulsive behaviour disorders or impulse control disorders.

What Are the Effects of Addiction?

physical health, brain function, emotional wellbeing, finances, work life and social relationships.
family breakdown unemployment homelessness

imprisonment
permanent health damage death through overdose or suicide.

How Does Addiction Affect Families?

Family members usually learn ways to cope by:

communicate less
avoid talking about the problem or expressing their feelings

hide the addiction from the community

take on responsibilities neglected by the person with the addiction feel frustrated, angry, resentful, lonely, scared and ashamed.

What Are the Signs of Addiction?

The signs of an addiction vary widely, depending on the problem and the person. affects a person's mental and physical health involves breaking the law (e.g., drinking and driving, using illegal drugs or stealing money to gamble) causes financial difficulties harms relationships and friends causes problems at home, work or school.

What Are Concurrent Disorders?

Concurrent disorders is a term used when a person has both a substance related disorder and a mental health disorder.
some of the risk factors for substance use problems are the same as those for developing a mental disorder, e.g., childhood neglect

How Is Addiction Treated?

Treatment programs and support groups can help reduce or eliminate the substance use or the activity. Since different factors lead different people to addiction, no single type of treatment will work for everyone. There are different types of treatment for different substances. Starts by meeting with a trained counsellor

Getting Rid of Stigma

Stigma also affects the families of people with addiction. It makes them hide the problem or pretend it isnt there. There is more to a person than a problem.

Responding to Someone With an Addiction

Dont ignore the problem. Do raise your concerns Dont argue with the person. Do provide factual information about the problem.. Dont judge the person. Do be positive and encourage change Dont push for treatment.

Supporting Someone Recovering from Addiction

express confidence that the person can make the change help with practical problems such as finding housing or a job or getting transportation to support group meetings be a good listener and try not to make judgments work with the person to make plans for handling situations where relapse may occur celebrate small successes.

Getting Help
family service agency
community mental health agency counsellor or therapist family doctor community health centre

religious or spiritual leader

telephone helplines

hospital

Services in London
London Mental Help Crisis Line

24/7 FREE service

519-433-2023

Family Services Thames Valley 519-433-0183

Addiction Services Thames Valley

The Last Word . . .

it is not a simple issue:

Why doesn't everyone who uses drugs or gambles become addicted?

Why is it that so many people find it extremely difficult to quit even when they want to? While the answers to these questions are not yet known Getting rid of the idea that people choose to become addicted is an important step in understanding and helping people with addictions.

Test Review
Chapter 6 muscle strength and endurance Chapter 7 flexibility Chapter 8 anaerobic fitness

Class notes
Protect your life text book

READ pages 23-37 you do not have to do the questions in the text