1. Copyright © 2008 Delmar. All rights reserved. Chapter 28 Populations with Substance Abuse

2. Copyright © 2008 Delmar. All rights reserved. 2 Population with Substance Abuse Healthy People 2010 primary goal 19.4 million have a substance abuse disorder

3. Copyright © 2008 Delmar. All rights reserved. 3 Population with Substance Abuse Substance abuse –Marijuana, cocaine, inhalants, heroin –Steroids, ecstasy, methamphetamines Primary substances –Alcohol, marijuana, tobacco

4. Copyright © 2008 Delmar. All rights reserved. 4 Alcohol Use Affects various organ systems –Cardiovascular Hypertension, arrhythmias, cardiomyopathy, stroke –Liver Hepatitis C Cirrhosis, cancer

5. Copyright © 2008 Delmar. All rights reserved. 5 Increased Risk Cancers of mouth, pharynx, larynx, esophagus, breast Fetal alcohol syndrome Motor vehicle accidents Mental illness Depression, panic disorder, mania, hypomania, phobia, anxiety

6. Copyright © 2008 Delmar. All rights reserved. 6 Marijuana Use Most common illicit drug use Physiological effects –Impact brain, heart, lungs, respiratory and immune system –Difficulties in learning, memory, problem- solving, distorted perceptions, loss of coordination

7. Copyright © 2008 Delmar. All rights reserved. 7 Marijuana Use Long-term effects –Change in stress response system –Activity of dopamine containing nerve cells –Myocardial infarction –Triple risk of developing cancer of head and neck –Mental disorders

8. Copyright © 2008 Delmar. All rights reserved. 8 Tobacco Use Number one preventable cause of heart disease Related to: –Cardiovascular disorders Atherosclerosis, CHF, AAA, MI –Lung, mouth, pharynx, larynx, stomach, kidney, bladder, pancreas, cervical cancers

9. Copyright © 2008 Delmar. All rights reserved. 9 Tobacco Use Periodontitis, gum disease, COPD, emphysema, bronchitis, pneumonia Asthma, airway obstruction, respiratory infection, peptic ulcers, cataracts

10. Copyright © 2008 Delmar. All rights reserved. 10 Tobacco Use Ectopic pregnancy, premature rupture of membranes, preterm delivery, perinatal mortality, SIDS, growth retardation

11. Copyright © 2008 Delmar. All rights reserved. 11 Tobacco Use Environmental Tobacco Smoke (ETS) Treating tobacco use and dependence Clinical practice guideline –Eight key findings –(See box 28-1)

12. Copyright © 2008 Delmar. All rights reserved. 12 Tobacco Use Five-R’s model 1.Relevance 2.Risk 3.Rewards 4.Roadblocks 5.Repetition

13. Copyright © 2008 Delmar. All rights reserved. 13 Populations at Risk Intergenerational transmission Hispanic youth Black youth American Indian Alaska Native women