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Kırşehir Ahi Evran Üniversitesi
Sağlık Bilimleri Enstitüsü
‘substance abuse and prevention’
Prepared by :
 Alı Falh abdlhasan
201217154
Supervised by :
Dr. Öğr. Üyesi HİLAL SEKİ ÖZ
Objectives
• Recognize the different types of substances and their effects.
• Draw a distinction between mild, moderate, and extreme drug
use disorders.
• Recognize the underlying chemistry of drug use disorders in
the brain.
• Recognize the signs and symptoms of substance use.
• Identify treatment modalities and the continuum of care
• Prevention & control of drug abuse.
Substance abuse
• Substance abuse, also known as drug abuse, is the use of a drug
in amounts or by methods which are harmful to the individual
or others. It is a form of substance-related disorder. Differing
definitions of drug abuse are used in public health, medical and
criminal justice contexts. In some cases, criminal or anti-social
behavior occurs when the person is under the influence of a
drug, and long-term personality changes in individuals may
also occur.
(Ksir, Ray& Charles 2002)
Individual Factors Associated with Substance Abuse
• Developmental
• Environmental
• Social
• Genetic
• Co-occurring mental disorders
(U.S. Department of Health and Human Services, 2016)
Drug Epidemics of the Decades
1970s 1980s–1990s
2000s
2010s
Drug Classifications
• Stimulants
• Central Nervous System Depressants
• Hallucinogens
Stimulants
• Medications that increase alertness, attention, energy, blood pressure,
heart rate, and breathing rate
• Short-term effects: Increased alertness, attention, energy;
increased blood pressure and heart rate
• Long-term effects: Heart problems, psychosis, anger, paranoia
Central Nervous System Depressants
• Medications that slow brain activity, which makes them useful for
treating anxiety and sleep problems
• Short-term effects: Drowsiness, slurred speech, poor
concentration, confusion, dizziness, problems with movement and
memory, lowered blood pressure, slowed breathing.
• Long-term effects: Unknown
Hallucinogens
• Substances that distort the perception of reality
• Short-term effects: increased heart rate, nausea, intensified
feelings and sensory experiences, changes in sense of time
• Long-term effects: speech problems, memory loss, weight loss,
anxiety, depression and suicidal thoughts
Common Drugs
Substance
abuse
Alcohol
Opioids
Marijuana
Metha
mpheta
mine
Heroin
Cocaine
Alcohol
• A depressant, which means it slows the function of the central
nervous system
• Short-term effects: Reduced inhibitions, slurred speech, motor
impairment, confusion, memory problems, concentration
problems
• Long-term effects: development of an alcohol use disorder, health
problems, increased risk for certain cancers.
(National Institute on Alcohol Abuse and Alcoholism; National Institute on Drug Abuse, 2018a)
cocaine
• A powerfully addictive stimulant drug made from the leaves of the
coca plant native to South America
• Short-term effects: Narrowed blood vessels, enlarged pupils,
increased body temperature, heart rate, and blood pressure,
headache, abdominal pain and nausea, euphoria
• Long-term effects: Loss of sense of smell, nosebleeds, nasal
damage and trouble swallowing from snorting, infection and
death of bowel tissue from decreased blood flow.
(National Institute on Alcohol Abuse and Alcoholism; National Institute on Drug Abuse, 2018a)
Heroin
• An opioid drug made from morphine, a natural substance extracted
from the seed pod of various opium poppy plants
• Short-term effects: Euphoria, dry mouth, itching, nausea,
vomiting, analgesia, slowed breathing and heart rate
• Long-term effect: Collapsed veins, abscesses (swollen tissue with
pus), infection of the lining and valves in the heart, constipation
and stomach cramps, liver or kidney disease, pneumonia.
(National Institute on Alcohol Abuse and Alcoholism; National Institute on Drug Abuse, 2018a)
Methamphetamine
• A stimulant drug chemically related to amphetamine but with
stronger effects on the central nervous system
• Short-term effects: Increased wakefulness and physical activity,
decreased appetite, increased breathing, heart rate, blood
pressure, temperature, irregular heartbeat
• Long-term effects: Anxiety, confusion, insomnia, mood problems,
violent behavior, paranoia, hallucinations, delusions, weight loss.
(National Institute on Drug Abuse, 2018a)
Marijuana
• Made from the hemp plant, Cannabis sativa. The main psychoactive
(mind-altering) chemical
in marijuana is delta-9-tetrahydrocannabinol, or THC.
• Short-term effects: Enhanced sensory perception and euphoria
followed by drowsiness/relaxation; slowed reaction time;
problems with balance and coordination
• Long-term effects: Mental health problems, chronic cough,
frequent respiratory infections.
(National Institute on Drug Abuse, 2018a)
Opioids
• Pain relievers with an origin similar to that of heroin. Opioids can
cause euphoria and are often used non-medically, leading to
overdose deaths.
• Short-term effects: Pain relief, drowsiness, nausea, constipation,
euphoria, slowed breathing, death
• Long-term effects: Increased risk of overdose or addiction if
misused.
(National Institute on Drug Abuse, 2018a)
Signs and Symptoms of Substance Abuse
Physical
Signs
Behavioral
Signs
By Drug
Physical Signs
• Inability to sleep, awake at unusual times, unusual laziness.
• Loss of or increased in appetite, changes in eating habits
• Cold, sweaty palms; shaking hands.
• Red, watery eyes; pupils larger or smaller than usual
• Unusual smells on breath, body or clothes.
• Extreme hyperactivity; excessive talkativeness.
• Slowed or staggering walk; poor physical coordination.
• Needle marks on lower arm, leg or bottom of feet.
Physical Signs (cont’d)
• Nausea, vomiting or excessive sweating.
• Tremors or shakes of hands, feet or head.
• Irregular heartbeat.
• Runny nose; hacking cough
• Puffy face, blushing, or paleness
• Frequent rubbing of the nose
• Frequent twisting of the jaw, back and forth
• Deterioration of hygiene or physical health.
Behavioral Signs
• Change in overall attitude/personality with no other identifiable cause.
• Drop in grades at school or performance at work; skips school or is late for
school.
• Change in activities or hobbies.
• Chronic dishonesty.
• Sudden oversensitivity, temper tantrums, or resentful behavior.
• Difficulty in paying attention; forgetfulness.
• General lack of motivation, energy, self-esteem, “I don’t care” attitude.
• Change in habits at home; loss of interest in family and family activities.
• Paranoia
• Silliness or giddiness.
• Moodiness, irritability, or nervousness.
Behavioral Signs (cont’d)
• Excessive need for privacy; unreachable.
• Secretive or suspicious behavior.
• Car accidents.
• Change in personal grooming habits.
• Possession of drug paraphernalia.
• Changes in friends; friends are known drug users.
• Unexplained need for money, stealing money or items
• Possession of a false ID card
• Missing prescription pills
• Complaints of a sore jaw (from teeth grinding during an ecstasy high)
• Presence of unusual number of spray cans in the trash.
Signs of Intoxication, by Specific Drug
• Marijuana
Glassy, red eyes; loud talking and inappropriate laughter followed by sleepiness; a
sweet burnt scent; loss of interest, motivation; weight gain or loss.
• Alcohol
Clumsiness; difficulty walking; slurred speech; sleepiness; poor judgment; dilated
pupils.
• Cocaine, Crack, Meth, and Other Stimulants
Hyperactivity; euphoria; irritability; anxiety; excessive talking followed by
depression or excessive sleeping at odd times; go long periods of time without
eating or sleeping; dilated pupils; weight loss; dry mouth and nose.
• Heroin
Needle marks; sleeping at unusual times; sweating; vomiting; coughing and
sniffling; twitching; loss of appetite; contracted pupils; no response of pupils to
light.
Signs of Intoxication, by Specific Drug (cont’d)
• Depressants (including barbiturates and tranquilizers)
Seems drunk as if from alcohol but without the associated odor of alcohol;
difficulty concentrating; clumsiness; poor judgment; slurred speech; sleepiness;
and contracted pupils.
• Inhalants (Glues, aerosols, and vapors)
Watery eyes; impaired vision, memory and thought; secretions from the nose or
rashes around the nose and mouth; headaches and nausea; appearance of
intoxication; drowsiness; poor muscle control; anxiety; irritability
• Hallucinogens
Dilated pupils; bizarre and irrational behavior including paranoia, aggression,
hallucinations; mood swings; detachment from people; absorption with self or
other objects, slurred speech; confusion.
The Brain Science of Addiction
• American Society of Addiction Medicine (ASAM)
“Addiction is a primary, chronic disease of brain reward, motivation,
memory and related circuitry. Dysfunction in these circuits leads to
characteristic biological, psychological, social, and spiritual
manifestations. This is reflected in an individual pathologically
pursuing reward and/or relief by substance use and other behaviors.”
Drug Use and Addiction
Brain imaging studies show physical changes in areas of the brain
when a drug is ingested that are critical to:
• Judgment
• Decision making
• Learning and memory
• Behavior control
These changes alter the way the brain works and help explain the
compulsion and continued use despite negative consequences.
(National Institute on Drug Abuse, 2018b)
Effects of Cocaine on the Brain
Treatment for drug addiction
 Hospitalization,
 Behavioral Therapies,
 Occupational Therapy,
 Change in addict’s social environment.
Prevention and Control of Drug Abuse
Requires knowledge of :
 Causes of drug-taking behavior,
 Sources of illicit drugs,
 Drug laws,
 Treatment programs,
 Community organizing skills.
Persistence and cooperation of various individuals
and agencies.
Elements of Prevention
• Education,
• Treatment,
• Public policy,
• Law enforcement.
 Education and treatment goals same:
Reduce demand for drugs
 Public policy and law enforcement goals same:
Reduce supply and availability of drugs.
Thank you

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‘Substance abuse and prevention’

  • 1. Kırşehir Ahi Evran Üniversitesi Sağlık Bilimleri Enstitüsü ‘substance abuse and prevention’ Prepared by :  Alı Falh abdlhasan 201217154 Supervised by : Dr. Öğr. Üyesi HİLAL SEKİ ÖZ
  • 2. Objectives • Recognize the different types of substances and their effects. • Draw a distinction between mild, moderate, and extreme drug use disorders. • Recognize the underlying chemistry of drug use disorders in the brain. • Recognize the signs and symptoms of substance use. • Identify treatment modalities and the continuum of care • Prevention & control of drug abuse.
  • 3. Substance abuse • Substance abuse, also known as drug abuse, is the use of a drug in amounts or by methods which are harmful to the individual or others. It is a form of substance-related disorder. Differing definitions of drug abuse are used in public health, medical and criminal justice contexts. In some cases, criminal or anti-social behavior occurs when the person is under the influence of a drug, and long-term personality changes in individuals may also occur. (Ksir, Ray& Charles 2002)
  • 4. Individual Factors Associated with Substance Abuse • Developmental • Environmental • Social • Genetic • Co-occurring mental disorders (U.S. Department of Health and Human Services, 2016)
  • 5. Drug Epidemics of the Decades 1970s 1980s–1990s 2000s 2010s
  • 6. Drug Classifications • Stimulants • Central Nervous System Depressants • Hallucinogens
  • 7. Stimulants • Medications that increase alertness, attention, energy, blood pressure, heart rate, and breathing rate • Short-term effects: Increased alertness, attention, energy; increased blood pressure and heart rate • Long-term effects: Heart problems, psychosis, anger, paranoia
  • 8. Central Nervous System Depressants • Medications that slow brain activity, which makes them useful for treating anxiety and sleep problems • Short-term effects: Drowsiness, slurred speech, poor concentration, confusion, dizziness, problems with movement and memory, lowered blood pressure, slowed breathing. • Long-term effects: Unknown
  • 9. Hallucinogens • Substances that distort the perception of reality • Short-term effects: increased heart rate, nausea, intensified feelings and sensory experiences, changes in sense of time • Long-term effects: speech problems, memory loss, weight loss, anxiety, depression and suicidal thoughts
  • 11. Alcohol • A depressant, which means it slows the function of the central nervous system • Short-term effects: Reduced inhibitions, slurred speech, motor impairment, confusion, memory problems, concentration problems • Long-term effects: development of an alcohol use disorder, health problems, increased risk for certain cancers. (National Institute on Alcohol Abuse and Alcoholism; National Institute on Drug Abuse, 2018a)
  • 12. cocaine • A powerfully addictive stimulant drug made from the leaves of the coca plant native to South America • Short-term effects: Narrowed blood vessels, enlarged pupils, increased body temperature, heart rate, and blood pressure, headache, abdominal pain and nausea, euphoria • Long-term effects: Loss of sense of smell, nosebleeds, nasal damage and trouble swallowing from snorting, infection and death of bowel tissue from decreased blood flow. (National Institute on Alcohol Abuse and Alcoholism; National Institute on Drug Abuse, 2018a)
  • 13. Heroin • An opioid drug made from morphine, a natural substance extracted from the seed pod of various opium poppy plants • Short-term effects: Euphoria, dry mouth, itching, nausea, vomiting, analgesia, slowed breathing and heart rate • Long-term effect: Collapsed veins, abscesses (swollen tissue with pus), infection of the lining and valves in the heart, constipation and stomach cramps, liver or kidney disease, pneumonia. (National Institute on Alcohol Abuse and Alcoholism; National Institute on Drug Abuse, 2018a)
  • 14. Methamphetamine • A stimulant drug chemically related to amphetamine but with stronger effects on the central nervous system • Short-term effects: Increased wakefulness and physical activity, decreased appetite, increased breathing, heart rate, blood pressure, temperature, irregular heartbeat • Long-term effects: Anxiety, confusion, insomnia, mood problems, violent behavior, paranoia, hallucinations, delusions, weight loss. (National Institute on Drug Abuse, 2018a)
  • 15. Marijuana • Made from the hemp plant, Cannabis sativa. The main psychoactive (mind-altering) chemical in marijuana is delta-9-tetrahydrocannabinol, or THC. • Short-term effects: Enhanced sensory perception and euphoria followed by drowsiness/relaxation; slowed reaction time; problems with balance and coordination • Long-term effects: Mental health problems, chronic cough, frequent respiratory infections. (National Institute on Drug Abuse, 2018a)
  • 16. Opioids • Pain relievers with an origin similar to that of heroin. Opioids can cause euphoria and are often used non-medically, leading to overdose deaths. • Short-term effects: Pain relief, drowsiness, nausea, constipation, euphoria, slowed breathing, death • Long-term effects: Increased risk of overdose or addiction if misused. (National Institute on Drug Abuse, 2018a)
  • 17. Signs and Symptoms of Substance Abuse Physical Signs Behavioral Signs By Drug
  • 18. Physical Signs • Inability to sleep, awake at unusual times, unusual laziness. • Loss of or increased in appetite, changes in eating habits • Cold, sweaty palms; shaking hands. • Red, watery eyes; pupils larger or smaller than usual • Unusual smells on breath, body or clothes. • Extreme hyperactivity; excessive talkativeness. • Slowed or staggering walk; poor physical coordination. • Needle marks on lower arm, leg or bottom of feet.
  • 19. Physical Signs (cont’d) • Nausea, vomiting or excessive sweating. • Tremors or shakes of hands, feet or head. • Irregular heartbeat. • Runny nose; hacking cough • Puffy face, blushing, or paleness • Frequent rubbing of the nose • Frequent twisting of the jaw, back and forth • Deterioration of hygiene or physical health.
  • 20. Behavioral Signs • Change in overall attitude/personality with no other identifiable cause. • Drop in grades at school or performance at work; skips school or is late for school. • Change in activities or hobbies. • Chronic dishonesty. • Sudden oversensitivity, temper tantrums, or resentful behavior. • Difficulty in paying attention; forgetfulness. • General lack of motivation, energy, self-esteem, “I don’t care” attitude. • Change in habits at home; loss of interest in family and family activities. • Paranoia • Silliness or giddiness. • Moodiness, irritability, or nervousness.
  • 21. Behavioral Signs (cont’d) • Excessive need for privacy; unreachable. • Secretive or suspicious behavior. • Car accidents. • Change in personal grooming habits. • Possession of drug paraphernalia. • Changes in friends; friends are known drug users. • Unexplained need for money, stealing money or items • Possession of a false ID card • Missing prescription pills • Complaints of a sore jaw (from teeth grinding during an ecstasy high) • Presence of unusual number of spray cans in the trash.
  • 22. Signs of Intoxication, by Specific Drug • Marijuana Glassy, red eyes; loud talking and inappropriate laughter followed by sleepiness; a sweet burnt scent; loss of interest, motivation; weight gain or loss. • Alcohol Clumsiness; difficulty walking; slurred speech; sleepiness; poor judgment; dilated pupils. • Cocaine, Crack, Meth, and Other Stimulants Hyperactivity; euphoria; irritability; anxiety; excessive talking followed by depression or excessive sleeping at odd times; go long periods of time without eating or sleeping; dilated pupils; weight loss; dry mouth and nose. • Heroin Needle marks; sleeping at unusual times; sweating; vomiting; coughing and sniffling; twitching; loss of appetite; contracted pupils; no response of pupils to light.
  • 23. Signs of Intoxication, by Specific Drug (cont’d) • Depressants (including barbiturates and tranquilizers) Seems drunk as if from alcohol but without the associated odor of alcohol; difficulty concentrating; clumsiness; poor judgment; slurred speech; sleepiness; and contracted pupils. • Inhalants (Glues, aerosols, and vapors) Watery eyes; impaired vision, memory and thought; secretions from the nose or rashes around the nose and mouth; headaches and nausea; appearance of intoxication; drowsiness; poor muscle control; anxiety; irritability • Hallucinogens Dilated pupils; bizarre and irrational behavior including paranoia, aggression, hallucinations; mood swings; detachment from people; absorption with self or other objects, slurred speech; confusion.
  • 24. The Brain Science of Addiction • American Society of Addiction Medicine (ASAM) “Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social, and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.”
  • 25. Drug Use and Addiction Brain imaging studies show physical changes in areas of the brain when a drug is ingested that are critical to: • Judgment • Decision making • Learning and memory • Behavior control These changes alter the way the brain works and help explain the compulsion and continued use despite negative consequences. (National Institute on Drug Abuse, 2018b)
  • 26. Effects of Cocaine on the Brain
  • 27. Treatment for drug addiction  Hospitalization,  Behavioral Therapies,  Occupational Therapy,  Change in addict’s social environment.
  • 28. Prevention and Control of Drug Abuse Requires knowledge of :  Causes of drug-taking behavior,  Sources of illicit drugs,  Drug laws,  Treatment programs,  Community organizing skills. Persistence and cooperation of various individuals and agencies.
  • 29. Elements of Prevention • Education, • Treatment, • Public policy, • Law enforcement.  Education and treatment goals same: Reduce demand for drugs  Public policy and law enforcement goals same: Reduce supply and availability of drugs.