This document contains information about drugs and substance abuse presented at a youth conference. It includes facts about various commonly abused drugs like cannabis, kush, tobacco, alcohol, tramadol, benzodiazepines, cocaine and their effects and risks. Signs and symptoms of drug abuse and addiction are outlined. The document also discusses why people use drugs, drug problems, and the impact of drug use on social issues. Brain physiology and the effects of drugs on the central nervous system are explained.
1. BY
2LT DR BRO VIDAL HENRY DESMOND DUPIGNY
TOPIC: YOUTH & DRUG ABUSE/MISUSE, ANGER &
DEPRESSION MANAGEMENT
NATIONAL ARMOR BEARERS YOUNG PEOPLE’S UNION (NABYPU)
COOLJC - SL
ANNUAL NATIONAL YOUTH CONGRESS 2023
THEME: “YOUTH AFLAME”
1
5. Total Number Male Female Substance Disorder
JULY 2134 1533 601 860
AUGUST 2230 1612 618 911
SEPTEMBER 2355 1703 652 974
OCTOBER 2488 1786 702 1038
NOVEMBER 2219 1479 740 1103
DECEMBER 2998 1886 1112 1223
JANUARY 3499 2197 1302 1343
FEBRUARY 4593 2890 1703 1674
MARCH 5083 3180 1903 1834
APRIL 5556 3453 2103 1888
MAY 6023 3751 2271 1998
JUNE 6586 4100 2483 2117
Total 45764 29570 16190 16963
5
6. TOTAL NUMBER MALE FEMALE
JUL 66 52 14
AUG 70 54 16
SEP 69 55 14
OCT 69 51 18
NOV 80 60 20
DEC 87 63 24
JAN 89 67 22
FEB 61 49 12
MARCH 68 53 15
APRIL 76 60 16
MAY 73 62 11
JUNE 60 50 11
TOTAL 868 676 193
6
0
10
20
30
40
50
60
70
80
90
100
INPATIENT
Total Number Male Female
7. Addiction.
a chronic relapsing brain disease characterised by compulsive
psychoactive drug seeking and use despite harmful
consequences
Criteria are: Urges & cravings, compulsion to use, loss control,
tolerance, withdrawal, neglect and failed responsibilities.
Psychoactive substances affect CNS and changes user mood,
thoughts, behaviour and perception
Psychoactive drug use alters the normal brain structure and
functions to affect mental state
Psychoactive substance use disorders (SUDs) is a problematic
pattern of drug use leading to clinically significant impairment
in the person
Increase morbidity and mortality but unmet need for drug
prevention, treatment & care
Route effects:
Snorting & Inhaling (5 sec)
Smoking (7 sec)
IV (15 sec)
IM ( 3 mins)
Swallowing (20 mins)
The more risk factors, the more
the vulnerability to Substance
Use Disorders.
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8. GROUP EXERCISE
GROUP 1:
Match each of the following substances with its
route of administration on a paper.
Present and display
a. Alcohol
b. Marijuana
c. Kush
d. Diaper tea (pampass)
e. Tramadol
f. Cocaine
g. Cigarette
h. Diazepam (Daizee)
Note: One substance may have more than one
ROA
GROUP 2: Indicate on a paper the
order in which the following
substances reach the brain
(fastest to slowest)
Present and display
Alcohol
Kush
Heroin
8
9. Why do people use drugs?
• Curiosity
• Euphoric high feeling
• Enhance performance
• Experiment
• Belonging ( peer pressure)
• Celebrate
• Relax
• Feel better ( pain relief)
• Escape coping to stress and boredom
• Satisfy urges and cravings
9
10. Drug problems
• Lost productivity
• Infections such as HIV, Hep. gangrene,
septicaemia
• Overdose deaths
• Mental illness
• Violence
• Impaired control
• Reduced functioning
• Risky behaviour
• Tolerance
• Withdrawal
10
11. Signs and Symptoms
• Anxiety
• Blackouts, dizziness
• Depression
• Disorientation
• Mood swings
• Falls, bruises, burns
• Family problems
• Financial problems
• Headaches
• Incontinence
• Increased tolerance
• Legal difficulties
• Memory loss
• New problems in
decision making
• Poor hygiene
• Seizures, idiopathic
• Sleep problems
• Social isolation
• Unusual response to
medications
11
12. CNS : The Brain
Brain has billions of nerve cells (sending & receiving neurons)
used for communication within the brain.
Neurotransmitters are the messengers and each operates with its
receptors as lock & key.
Brain parts mostly affected in the communication are: brain stem,
cerebral cortex & Limbic system.
Brain is protected by the blood- brain barrier (tightly- pressed
cells).
Only small fat-soluble molecules such as psychoactive drugs
enter the brain but not large water-soluble molecules.
12
13. Brain Physiology
• Psychoactive substances pass the
blood-brain barrier, affect brain
functioning, and alter biochemical
processes of tissues and organs
• Neurotransmitters cause brain
communication through key & lock
process
• The sending neuron releases a
neurotransmitter from its axon
terminal across a space between
neurons called a synapse.
• A neurotransmitter attaches to a
specialized site on the receiving
neuron called a receptor.
• Messages only pass through
receptors of the correct
neurotransmitters.
• After binding to its specific receptor
on the receiving neuron, the
neurotransmitter is taken back into
the sending neuron, a process
called REUPTAKE, or degraded by
another chemical within the
synapse.
• Reuptake and degradation lead
to termination of the action of the
neurotransmitter.
• Psychoactive drugs do not have
re-uptake and therefore remain
within the synapses to bounce
causing effect reaction and affect
the Limbic system for reward and
pleasure
13
14. Drug use and social problems
• Low educational attainment because of impaired concentration and memory
• Increase difficulty to maintain employment because of time spent out of work to seek drug and use
due to craving
• Financial instability because of huge amount of money spent on drugs to satisfy urges and cravings
• Poverty because of loss of control to drug use and failure of responsibility to meet essential life
demands.
• The impact of harmful drug use can extend beyond individuals to affect the health and well-being of
others, including their families, neighbourhoods and the community at large.
• Urbanisation expands the drug market-rise in drug use.
14
15. Cannabis: Marijuana; Weed; Ganja; Puff;
Blow, Jamba, Tie.
• Cannabis is a natural substance derived from Cannabis Sativa Plant
• There is Cannabis Indica and Rudelis plant.
• Different forms of the plant can be used as drugs.
• It may be Resin or ‘Grass’ or as sticky oil
• It can be rolled on its own ( spliff); with tobacco (joint) and smoked.
• It can be smoked on its own in a pipe or cooked and eaten as sauce, brewed into
drink.
• Different strengths based on the varied chemicals such as THC, CBN, CBD, CBG.
15
16. Cannabis
Effects
• Relaxed
• Talkative
• Blood-shot eyes
• Heighten the senses of colours, taste and sound
• Lethargy, tiredness and reduced energy
• Drowsy or sleepy
• Dizziness
• Increased hunger
• Craving for other food or drugs
• Giggle fits or fatuous laughter.
• Nausea or Vomiting
• Loss of motivation.
• Anxiety in withdrawal
• Difficulty sleeping in withdrawal
Risk
• Psychosis
• Mood swings
• Amnesia
• Poor concentration
• Impaired coordination
• Paranoia
• Anxiety
• Respiratory disorders
• Lowers sperm production
• Changes in ovulation cycle
• Decreased blood pressure
• Impaired coordination
• Impaired judgment 16
17. Kush: K2, Spice
Stain of cannabis Indica
Sprayed with dangerous
substances to enhance effect
Has a long-lasting effect.
Stronger effect than cannabis
17
18. KUSH
Effects
• Increase appetite
• Euphoria ( heighten feelings)
• Paranoia
• Drowsiness
• Drooling
• Suspiciousness
• Irritation and aggression
• Visual Hallucination
• Agitation
• Restlessness
• Impaired coordination
• Impaired concentration
• Vomiting at first use
• Slurred speech
• Disorientation of places and persons
• Depersonalisation.
• Reduced energy or fatigue
Risks
• Increase hear rate
• Increase blood
pressure
• Thought disorder
• Mental Illness
• Increase urges and
cravings
• Insomnia in
withdrawal
• Seizure in
withdrawal
• Low mood in
withdrawal
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19. Tobacco
Dried leaves of tobacco plant
Contains highly addictive ingredients of over 20 poisons such as Arsenic, Lead,
Formaldehyde, Turpetine, benzopyrene, Acetone, Propylene Glycol, Cadmium, Ammonia,
Butane, Benzene, Nicotine etc.
• Over 4,000 chemicals found in the tobacco products including smokeless.
• Smokeless tobacco such as snuff, chewing tobacco
Nicotine triggers release and increase dopamine levels causing addiction.
•
Nicotine stimulates the adrenal glands to discharge adrenaline causing increase blood
pressure and heart rate
•
A pack and half of cigarettes gets about 300 hits of nicotine to the brain.
There are 1 to 2 milligram of nicotine per cigarette
•
Tobacco use kills more than any other drugs because of the numerous physical health
problems
19
20. Tobacco
Effects
• Increased concentration
• Reduced worry or boredom
• Dizziness
• Bad breath
• Stained fingers and teeth
• Coughs
• Chest infection.
• Irritability (Nicotine withdrawal)
• sleep disturbance (Nicotine withdrawal)
• Increase appetite (Nicotine withdrawal)
• Anxiety (Nicotine withdrawal)
• Low mood (Nicotine withdrawal)
• Attention deficit (Nicotine withdrawal)
Risk
• Increase blood pressure
• Heart disease
• Lung and throat Cancer.
• Emphysema and bronchitis
• Reduce Oxygen supply in the brain
and blood
• Increase risk of stroke and heart
disease
• Increase cholesterol levels
• Early wrinkling and ageing
• Risk of osteoporosis
• Worsen asthma
• Impair eye sight
• Damage blood vessels
• Neurodegenerative diseases
20
21. Alcohol: bevvy, booze, drink, jar,
• Form of beer, stout, lager, cider, wine,
fortified wine, spirit, shots, alcopop
•
Sedative drug: acts on the brain parts
that control judgment and perception and
slows them down.
•
Effects depends on the strength of the
drink, gender, age, physical built; how fast
consumed
• Effects also depend on when last food
was eaten and person’s mood
.
• Moderate drinking is 3-4 units ( Men) and 2-3 Unit
(women) a day
• 1 unit of alcohol is removed from the body in an hour
A unit is the Vol. of alcohol divide by 1,000 multiply by
its percentage.
• For eg 15mg of alcohol =1 unit
• It is advisable to eat before drinking and alternating
alcohol drinks with water or soda;.
•
Withdrawal symptoms:
• Irritability
• low mood
• insomnia
• visual hallucination
• fits
• tremors but treatable with disulfiram and naltrexone
21
22. ALCOHOL
Effects
• Sociable to relax
• Escape from problem
• Slur speech
• Clumsy
• Double vision
• Impaired coordination
• Heighten emotions
• Hangover
Risks
• Depressed mood
• Loss of consciousness
• Overdose
• Suffocation through choking on own
vomit
• Alcoholic poisoning
• Liver cirrhosis and liver cancer
• Anxiety
• Sexual difficulties
• Slow breathing
• Brain damage
• Heart disease
• Stomach Ulcers
• Unprotected sex
• Aggression
22
23. Tramadol:
Analgesic prescribed drug for chronic and muscle pain relief.
Ingested
Similar effect to codeine.
It stays in the body system for 72 hours
start dose is 25mg but titrated to 50-100mg a day. However, abused.
Effects
• Sedation
• Drowsiness
• Dizziness
• Paranoia
• Itching
• Increased sweating
• headaches
• Running Nose
• Tremor
• Nervousness ( withdrawal)
• Insomnia ( withdrawal)
• Hallucination ( withdrawal)
• Panic attack ( withdrawal)
Risk
• Vomiting
• Constipation
• Nausea
• Breathing difficulty
• Headaches
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24. Trifluoperazine: Stelazine, blue boat
Round blue film-coated tablet
ingested
Effective for the treatment of short-tern non-psychotic anxiety
Not to be administered at does of more than 6mg per day but abused.
Effect
• Drowsiness
• Dizziness
• Dry mouth,
• Rash
• Insomnia
• Blurred vision
• Fatigue
• Muscular weakness.
Risk
• Tardive
dyskinesia
• Jaundice
• Liver damage
• Anemia
• Thrombocytos
is
24
25. Benzodiazepines
Minor tranquilisers such as temazepam, Valium,
Librium, Ativan, Blue - Blue.
Prescribed sedatives for anxiety and treat
insomnia in the short-term.
Swallow Pills and capsules but temazepam
capsule which is gel is injected by drug user.
Depress mental activity and alertness
Ease ‘come down’ from stimulants
Effects last 3-6 hours
25
26. Benzodiazepines
Effects
• Calmness
• Aid to relax
• Mild euphoria
• Relives tension
• Drowsiness (high dose)
• Insomnia ( withdrawal)
• Tremor ( withdrawal)
• Irritability (withdrawal)
• Nausea withdrawal)
• Vomiting (withdrawal)
• Loss of appetite (withdrawal)
• Convulsions (withdrawal)
Risk
• Psychological dependence
• Tolerance
• Overdose with high doses
• Death when used with alcohol
• Choke on vomit
• Abscesses ( when injected)
• Collapsed veins ( when injected)
• HIV and Hepatitis ( when
injected)
26
27. Cocaine:
Coke, charlie, snow, blast, blow, white dust
Powerful stimulant but effects last for 30 min
White powder made from coca plant
chopped and crushed leaved mixed with petrol and treated
with sulphuric acid
Kerosine used to extract the crude cocaine and chemically
treated to get cocaine salt.
Chemicals used to convert the cocaine salt to Freebase
cocaine
Powder usually chopped up with a credit card or razor
blade and snorted using straw or rub on gum
Sometimes dissolved to be injected but quick come down
Cocaine is cut with other chemicals to enhance effect.
Mixed with Heroine ( speedball)
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28. Cocaine:
Effects
• Euphoria
• Excitement
• Increase confidence
• Talkative and arrogant
• Sweating
• Increase alertness
• Sexually aroused
• Lack or reduce hunger
• Agitation with repeated use
• Restlessness
• Confusion
• Paranoia
• Fits ( convulsions)
• Breathing difficulties
• Low mood ( withdrawal)
• Fatigue ( withdrawal)
Risk
• Damage to the nervous system
• Damage to the nose through snorting
• Nose bleeds
• Diarrhoea
• Heat disease
• Heart problem
• Increase body temperature
• Increase blood pressure
• Breathing difficulties
• Constrict the blood vessels
• Coma and Death through overdose
• Cocaine and alcohol causes sudden
death
• Cocaine induced psychosis
• Vein damage through injecting.
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29. Crack:
Rock, wash, stone.
Small raisin-sized crystals that are smoked in pipes.
Treated with chemicals for it to be smoke easily
Intense feeling than cocaine.
Highly addictive and its use difficult to control but euphoric
high last for only 10 mins
Crack and heroin can be mixed and smoked known as
speed ball to reduce craving.
Crack induces increase levels of adrenaline, serotonin and
dopamine
29
30. Crack:
Effects
• Confidence
• Alertness,
• Talkativeness
• Restless
• Anxious
• Confused
• Shaking and hand tremors
• Nausea
• paranoid
• Difficulty sleeping
• Decrease appetite
• Depressed (withdrawal)
Risk
• Heart problem
• Convulsions
• Lung problem
• Chest pains
• Overdose cause death.
• Sudden increase in blood
pressure
• High temperature
• Seizure and fits
• Stroke
• Heart attack
• HIV, Hep B and Hep C
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31. Heroin: smack, brown, horse, gear, H, skag, jack
• .
Analgesic made from morphine and codeine
that relieves emotional and physical pain
• Semi-synthetic drug which is a product of
opium poppy.
• Fluffy white powder when pure but usually
brownish-white, pinkish cream
• Swallowed, snorted, smoked or injected to
maximise euphoric high
• Highly addictive and euphoric high of 3 mins
• It could be heated in a silver foil and the
smoke inhale known as chasing the dragon
• Dissolved with water and citric acid and
solution heated in a spoon for injecting
• Used as ‘come down’ from the high of crack.
31
32. Heroin: smack, brown, horse, gear, H, skag, jack
Effects
• Feeling of warmth and well-being
• Drowsy
• Sleepy
• Itchy (first use)
• Nausea ( first Use)
• Vomiting (first use)
• Dizziness (first use).
• Severe constipation
• Decreased hunger
• Depressed breathing
• Yawning
• Stomach cramp
• Dilated pupils
• Aching limbs
• Running nose
• Piloerection ( goose flesh)
• Lacrimation
Risk
• Habituation
• Damage veins through injecting ( collapse vein)
• Ulceration
• Blood poisoning through injecting
• Infection such as HIV, Hep C ( shared needles)
• Coma ( overdose)
• Death ( overdose)
• Tolerance
• Physical dependence (sick when stopped)
• Psychologically addictive( strong desire to use)
• Withdrawals ( flu-aches, sweating, chills,
insomnia shaking)
• Thrombosis and Abscesses,
• Endocarditis
• Septicaemia
• Gangrene
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33. Solvents: gases, petrol, glues, aerosols, urine, ammonium, paint, thinners, correcting
fluids
• Vapour substances that are sniffed to
get euphoric high but instant and
short-lived feeling
• Solvent vapours are absorbed through
lungs and rapidly reach the brain.
• Vapour depresses bodily function
• Deep inhaling causes disorientation,
loss of control and unconsciousness.
• Addictive and psychological
dependence
• Effects similar to alcohol or
anaesthetics of being in a dream.
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35. MANAGEMENT
• How are cases of SUD handled in
your locality?
• Let’s discuss!!
35
36. Management
• Medication to detox and
stabilise mental state
• Motivational Counselling
• Recreational activities
• Vocational and Social Skills
training
• Relapse prevention
• Family and other practical
support.
36
37. Management
What services do we have in
Sierra Leone for the management
of Substance use disorders?
Let’s brainstorm.
37
38. Management
Services in Sierra Leone
• SL Psychiatric Teaching Hospital
• City of Rest
• Private Counselling services
• Church
• Traditional Healers
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