1. Substance Use Disorders & The implications of Addiction
Marjorie F Withers, LCPC

2. We need our brain

3. Why are we here today: The High price of Substance Use
Estimated cost of Substance Use is $700 Billion Dollars
Major public health Issue
Destructive to the individual
Destructive to families
Major impact for employers
In rural areas 100% of the community can be effected by SU

4. Understanding Substance Use Disorders and addiction
Chronic relapsing brain disease
Compulsive seeking and use
Changes brain functioning and structure
Derails development
Hereditary, environmental and social/environmental factors-role of trauma
Multigenerational effects
No one intends to become an addict or have a substance use disorder
If I could stop…I would stop

5. Risk Factors

6. Substance use and Substance dependence:
Impaired control
Social Impairment
Risky Use
Pharmacological criteria (Tolerance and withdrawl
Biological basis…genetic predisposition
Social…learned, peer pressure
Psychological…self medicating, becomes a coping mechanism
Loss of choice…craving, seeking (tolerances and withdrawl)
Becomes the major relationship in the users life
Correlates with increased trauma
Complicates relationships
Co-morbidity

7. Brain Changes

8. Nation Wide Trends 8,400 new users per day
Greatest percentage of new uses are adolescents
Increase in opiate abuse and Heroin
Treatment gap is widening (21.6 million need treatment)
Less than one percent of users receive treatment
Drug use is epidemic in the United States
Alcohol remains the most frequently abused substance
Impact of alcohol across time has been underestimated

9. Types of Drugs Tobacco Alcohol Marijuana and Hashish Opioids
Stimulants
Club drugs
Hallucinogens
Dissociative drugs
Different types of drugs have different impact on the person with different implications for the consumer

10. Signs and Symptoms by Category of Drug
Alcohol: (Depressant)
Low doses: euphoria, relaxation, lowered inhibitions
Higher doses: affects behavior : increases in emotional volatility, increases violent behavior
Symptoms include: Visual distortions, slurred speech, impaired memory
Can lead to loss of consciousness and death
Health risks include: Increased risk of injuries, violence, fetal damage, depression, neurologic deficits, hypertension, liver failure, heart disease, addiction and fatal overdoses.

11. Cannabinoids Marijuana and Hashi Smoked or swallowed
Psychologically addictive

12. Signs and symptoms Heightened perception Cough, respiratory infections
Increased appetite
Impaired memory & learning
Sense of euphoria
Time confusion
Paranoia & anxiety
Slowed thinking
Increased heart rate
Slowed reaction time
Depressant
Red eyes
Impaired balance/coordination

13. Central Nervous System Depressants
Swallowed or injected
Barbiturates (Phenobarbital, Amytal, Membutal, Seconal)
Benzodiazepines(Ativan, Librium, Valium, Zanax, Clozipine)
Methaqualone (Quaalude, Sopor, Parest)
Ecstasy (GHB Gamma-hydroxybutyrate)

14. Signs and Symptoms Slowed pulse Respiratory depression or arrest
Slow breathing
Death
Lowered blood pressure
Reduced anxiety
Lowered inhibitions
Withdrawal must be supervised medically.
Impaired coordination
Fatigue/confusion
Can include: seizures, DTS
Impaired concentration
Barbiturates require tapering
Memory impairment
Judgment impaired
Can be dangerous.

15. Hallucinogens LSD Mescaline Psilocybin Bath Salts Signs and Symptoms
Altered state
Hallucinations
Flashbacks
Increased temperature, heart rate, blood pressure
Sleeplessness, tremors, paranoia
Can cause persistent mental health disorders

16. Opioids and Morphine Derivatives
Injected, swallowed, smoked or snorted
Codeine
Methadone
Fentanyl
Heroin
Morphine
Opium
Oxycodone
Hydrocodone Bitartrate (Vicodin)
Percocet

17. Signs and Symptoms Pain relief Unconsciousness Euphoria Addiction
Drowsiness
Coma
Nodding off
Death
Confusion
Extremely addictive
Sedation
Staggering gait
Tolerance
Nausea
Constipation

18. Heroin effects

19. Replacement Therapy Opiate treatment
Utilizes replacement opiate that does not have the same effects as drug that was abused
Used as a means to reduce harm
Often step in weaning off drug
Keeps parent from withdrawal symptoms
Treatment of choice for pregnant mothers (safer than using street drugs or stopping use during pregnancy)

20. Stimulants Smoked, swallowed, injected, snorted depending on the drug.
Amphetamine (Dexedrine, Biphetamine)
Cocaine
MDMA (Ecstasy)
Methamphetamine (Crystal, Crank, Meth, Speed)
Nicotine
Ritalin

21. Signs and Symptoms Increased heart rate Rages Increased blood pressure
Acting out
Increased metabolism
Impulsive behavior
Exhilaration
Irritability
Energy
Panic attacks
Mental alertness
Psychosis
Rapid Irregular heart beat
Irregular heart beat
Reduced appetite
Headaches
Weight loss
Heart failure
Malnutrition
Strokes
Nervousness
Seizures
Paranoia
Insomnia

22. Specific Symptoms Methamphetamine: Increased aggression Violence
Memory loss
Neurological damage
Learning problems
Tolerance
Addiction
Psychotic behavior

24. Remember
No one intends to become an addict
The person who is using is still our employee, our child, our partner, a friend, oneself
People can stop using: Be a support for a person stopping
Addiction requires action and intervention: Care enough to do something.