JUST SAY KNOW: FACTS ABOUT PSYCHOACTIVE DRUGS Rick Csiernik, King’s University College at Western University

Definitions PSYCHOACTIVE DRUG – alter the CNS while also affecting the ANS DEPENDENCY- physical and psychological ADDICTION – physical dependency + psychological dependency + social context of drug use

Psychoactive Drug Substances that alter brain functioning by decreasing, increasing or disrupting central nervous system activity. This in turn produces changes in mood, perception, sensation, need, consciousness, and other psychological functions and ultimately produces changes in behaviour. These substances influence a great number of physiological functions mediated by the autonomic nervous system that are outside the realm of conscious control such as respiration, cardiovascular function and hormonal balance.

Psychoactive Drugs & Addiction.. Biological Social Psychological ADDICTION BiosocialBiopsycho Psychosocial

What Psychoactive Drugs Do

Categories Depressants – Benzodiazepines, Barbiturates, Alcohol, Solvents, Antihistamines - Opioids (Codeine, Morphine, Oxycontin, Heroin, Methadone) Stimulants - Cocaine, Amphetamines, Ritalin, Decongestants, Nicotine, Caffeine Hallucinogens – LSD, Ecstasy, Ketamine, Cannabis Psychotherapeutic Agents – Anti-Depressants, Anti-Psychotics, Mood Stabilizers

What is NOT an addiction Eating Disorders Compulsive Behaviours: Shopping, Internet Use, Sex Problem Gambling Why are these not an addiction? No Psychoactive Change to Brain Different Treatment Approach Different Treatment System Different Policies

STOP │ CONTACT ─────┼────────────┐INTEGRATED (casual/occasional)─────┬──────────┐ WITH DRUG │ │ USE │ │ │ │ │ │ │ │ ┌─STOP │ │ │ │ │ │ │ EXPERIMENTATION └──────EXCESSIVE───┼─RETURN─────────┘ │ (curiosity/peer USE │ │ pressure) ├─STABLE │ │ STATE │ │ ┌─STOP │ │ │ │ └──────ADDICTION│ │ ├─STABLE │ │ STATE │ │ │ ├─PROGRESS │ │ │ └─RETURN────┘

Treatment Philosophy Client Responsibility For Solution highlow Client ResponsibilityhighMORALENLIGHTENMENT For Problem lowCOMPENSATORYMEDICAL

Drug Testing ◦Appropriate selection bias ◦People with positive results  Likely to have issues ◦People are selected for drug testing based on existing parenting concerns ◦Continued use recreational use ◦Substantial negative consequences

Effective use of Drug Tests Drug testing provides an objective basis to demonstrate that drug use or drug involvement has occurred The meaning of the drug test in any one case is dependent on contextual factors ◦What behaviours does this person exhibit while using? ◦How has use affected this person in the past?

What Can Drug Testing Tell Me ? Through hair & urine analysis: ◦That the subject used a drug during a particular period of time ◦That the subject is frequently associating with drugs or heavy users (hair analysis) ◦Determination of passive exposure ◦Child exposures  use in the context of parenting ◦Improving; unchanged; ongoing use ◦What are the implications with prescription drugs (methadone, medical marijuana, sedative-hypnotics)

What Drug Testing Cannot Tell You The exact pattern of drug use How intoxicated the subject gets when using How the drug use impacts the subjects parenting abilities The method of drug administration ◦I.V. / oral / smoked / insufflated Whether someone is abusing a drug that they are prescribed ◦(opioids including methadone, medical marijuana, sedative hypnotics like Ativan, anti-depressants like Prozax) Drug testing does NOT indicate addiction nor dependency

References Csiernik, R. (2014). Just Say Know: A Counselor’s Guide to Psychoactive Drugs. Toronto: Canadian Scholars Press. Csiernik, R. (2011). Substance Use and Abuse: Everything Matters. Toronto: Canadian Scholars Press.