2. Types of Drugs Classified by Psychoactive Effect  Stimulants  Depressants  Hallucinogens  Antidepressants  Antipsychotics 2

3. Stimulants  increase activity by stimulating the central nervous system  reverse the effects of fatigue and elevate a person’s mood  nicotine and caffeine are the most common drugs 3

4. Depressants  slow down body activity by depressing central nervous system  induce sleep, coma and even death  sleeping pills (barbiturates), tranquilizers (benzodiazepines), antispasmodics and alcohol are most common depressants  opiates such as heroin and morphine can be thought of as a special class of depressants, as can neuroleptics such as neurontin & gabapentin 4

5. Hallucinogens  cause user to see hear or feel things that aren’t there yet without causing serious disturbances to CNS  LSD (acid), psilocybin (magic mushrooms) and mescaline are common examples of drugs  inhalants and marijuana have characteristics of depressants and hallucinogens 5

6. Antidepressants  Antidepressants are psychiatric medications given to patients with depressive disorders to alleviate symptoms. They correct chemical imbalances in the brain which probably cause changes in mood and behavior. 6

7. Antipsychotics  A psychiatric medication primarily used to manage psychosis (including delusions or hallucinations, as well as disordered thought), particularly in schizophrenia and bipolar disorder 7

8. What is “addiction”? What is first word that comes to mind if you are asked that question? 8

9. Addiction  Addiction is defined as a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.

10. Current concepts in understanding meaning of “substance abuse” and “addiction”  Physical dependence Drug tolerance Withdrawal  Psychological dependence  Harm 10

11. Physical Dependence  state in which the body has adapted to the presence of the drug at a particular level  when the drug concentration falls, withdrawal results 11

12. PHYSICAL DEPENDENCE Tolerance  the need for an increased amount of a given drug to achieve intoxication or desired effect  or the reduction of a drug’s effect with continued use of the same dose over time 12

13. PHYSICAL DEPENDENCE Withdrawal  Occurs when a drug is abruptly removed, or dose is significantly decreased  Cluster of symptoms often accompanied by directly overt physical signs 13

14. Withdrawal... cont’d  Withdrawal generally looks opposite to the intoxication.  Unpleasantness of withdrawal may be so severe that the individual fearing it may use drug again just to avoid or relieve symptoms 14

15. Psychological Dependence  a state in which stopping or abruptly reducing the dose of a drug produces non-physical symptoms  characterized by emotional and mental preoccupation with the drug’s effects and a persistent craving for the drug 15

16. Harm  Central concept in understanding both addiction and substance abuse  Types of harm: Physical Psychological Social (e.g., family, friends, job, financial, legal system) Spiritual 16

17. Abbreviated List of Criteria for Abuse and Dependence  Preoccupation with substance  Increased use of substance beyond expected  Inability to control use  Withdrawal symptoms  Signs of tolerance  Restricted activities  Impaired functions  Harmful or hazardous use 17

18. Why do people use drugs?  Brainstorm a list of reasons people give for using drugs.  What are some of the positive, beneficial or desirable effects that people might experience when using drugs 18

19. Some reasons people give for using drugs  Fun/enhance pleasurable activities/intensify feelings  Experiment, explore new experiences  Unwind, cope with stress  Escape reality, numb feelings  Deal with emotional pain or discomfort  Respond to social pressure or norms  Make social contact easier  Enhance artistic creativity  Spiritual or meditative pursuits  Self-medicate for anxiety, depression, cognitive dysfunction 19

20. Factors related to addictive & abuse potential of drugs Biochemical & biological  Central Nervous System effects  Rout of transmission  Rate of absorption/metabolizing  Rate of elimination  Side effects 20

21. Factors related to addictive & abuse potential of drugs…cont’d Personal  Neurochemistry  Developmental history  Aspects of personality  Experiences in use of this & other drugs  Values, beliefs & expectations  Some types of disorders & disabilities  Age & health 21

22. Factors related to addictive & abuse potential of drugs… cont’d Environmental  Availability of drug  Immediate social group (e.g., family & peers) and community with whom the person identifies  Societal norms & sanctions re use of the drug(s) in question 22

23. Higher incidence of drug use among people with:  Mental illnesses  Learning disabilities  Acquired brain & spinal cord injuries  Painful conditions 23

24. Primary drugs of concern among people with disabilities  Tobacco  Alcohol  Painkillers  Marijuana 24

25. Values Clarification Activity  Individually review the list of drug users on the next slide and make note of the first thought, feeling and or image that comes into your mind.  As a group discuss and rank the harms associated with the list on the next slide. 25

26. Values Clarification Activity  Coffee drinker  Teen smoker  Person on Methadone  Crack addict  Person addicted to oxycontin  Valium user  Pregnant heroin user  Social drinker  Raver  Marijuana smoker 26

27. Stats 79% of general population drink, 14% use cannabis. (CAS 2004) 18% exceeded drinking guidelines. 14% reported hazardous drinking. Majority of acute problems are the result of average drinkers who drink too much on single drinking occasions. (Rehm 2003) Alcohol, tobacco and other drugs cost Canadians over $18 billion annually. (Single, 1996) 27

28. More Stats  Over 90% of the alcohol consumed by males aged 15 to 24 years and over 85% consumed by young females exceeded Canadian guidelines. (Stockwell 2005)  Close to 60% of those between 15 and 24 have used cannabis at least once; 38% used cannabis in the past year. (CAS 2004)  Over 80% of Grade 12 students drink and almost half of these students report hazardous drinking. (Adlaf 2005)  Daily cannabis use has increased significantly and 1 in 5 students report driving after using cannabis. (Adlaf 2005)  Although smoking has gone down, 1 in 7 students still smoke. (Adlaf 2005) 28

29. Society’s most common, serious & neglected problems. 1 in 4 Canadians will experience addiction or mental illness during their lifetime (1/10 in a year). 2/3 who need care receive none affect more people than heart disease – more than cancer, arthritis & diabetes combined. Costs Canada $32-billion a year, 14% of the net operating revenue of all Canadian Business (33% of short-term disability claims). 20% of Ontario children require help (only 4% currently receive help). 29

30. OSDUS 2005 HIGHLIGHTS… The good news The following drugs declined in use  cigarettes:from 19.2% to 14.4%  alcohol: from 66.2% to 62.0%  LSD: from 2.9% to 1.7%  PCP: from 2.2% to 1.1%  hallucinogens: from 10.0% to 6.7%  methamphet: from 3.3% to 2.2%  heroin:from 1.4% to 0.9%  Ketamine:from 2.2% to 1.3%  barbiturates: from 2.5% to 1.7% 30

31. OSDUS 2005 HIGHLIGHTS…The good news More students in 2005 reported being drug free (including alcohol and tobacco) during the past year compared to 2003 (35.9% vs. 31.6%) 31