Substance Abuse

A drug is any chemical that produces a therapeutic or non-therapeutic effect in the body. The group of "illegal" drugs includes dangerous chemicals that have only toxic actions.

Kids may be involved with legal or illegal drugs for many reasons, including curiosity, because it feels good, to reduce stress, to feel grown up or to fit in. It is difficult to know which kids will experiment and stop and which will develop serious problems. Unfortunately, teenagers often don’t see the link between their actions today and the consequences tomorrow. They also have a tendency to feel indestructible and immune to the problems that others experience.

Using alcohol and tobacco at a young age increases the risk of using other drugs later. Some kids will experiment and stop, or continue to use occasionally, without significant problems. Others will develop a dependency, moving on to more dangerous drugs and causing significant harm to themselves and possibly others.

• Substance abuse is the misuse of drugs and other products for non-medical reasons.
  
• Substance abuse can lead to dependence. Your mind or body starts to need the substance even though it is hurting you.
  
• Children as young as 5 years old can become involved with drugs.
  
• Drug use can lead to many problems, such as problems with school, friends and family, arrest, violence, unplanned or unprotected sex, and driving accidents.

Examples: Beer, Wine, Whiskey, Vodka, Gin, Scotch

The abuse of alcohol contributes to many deaths per year in the Caribbean. One of the most common drug overdoses leading to death is ingestion of a large amount of alcohol. Chronic alcoholism leads to liver disease. Liver disease can be manifested as fatty change. Excessive alcohol ingestion for many years can lead to micronodular cirrhosis. A cirrhotic liver leads to portal hypertension and the complication of bleeding esophageal varices with massive, life-threatening gastrointestinal hemorrhage. There is also an increased risk for hepatocellular carcinoma arising in a cirrhotic liver. In the brain, alcoholism can lead to Wernicke's disease.

Signs and Symptom

• Odor on the breath.
• Intoxication.
• Difficulty focusing: glazed appearance of the eyes.
• Uncharacteristically passive behavior; or combative and argumentative behavior.
• Gradual (or sudden in adolescents) deterioration in personal appearance and hygiene.
• Gradual development of dysfunction, especially in job performance or school work.
• Absenteeism (particularly on Monday).
• Unexplained bruises and accidents.
• Irritability.
• Flushed skin.
• Loss of memory (blackouts).
• Availability and consumption of alcohol becomes the focus of social or professional activities.
• Changes in peer-group associations and friendships.
• Impaired interpersonal relationships (troubled marriage, unexplainable termination of deep relationships, alienation from close family members).

Street Names: Cigarettes, cigars, pipe tobacco, chewing tobacco, and snuff.

Smoking leads to the greatest number of problems of any drug in use in the world today. These deaths are mainly the result of increased numbers of lung cancers as well as increased numbers of cases of atherosclerotic heart disease and emphysema of the lung. Smoking increases the risk for cancers of the bladder, pancreas, kidney, and cervix. There is an increased risk for gastritis and gastric ulceration in persons who smoke. Cataracts of the crystalline lens of the eye occur with increased frequency in smokers.

Young women who are pregnant and who smoke put their fetuses at increased risk for decreased birth weight, premature birth, and perinatal mortality. The risk for spontaneous abortion is increased with maternal smoking. Fetal deaths late in gestation are increased 50% in mothers who smoke more than 3 cigarettes per day.

Signs and Symptom

• Smell of tobacco.
• Stained fingers or teeth.
• The more one smokes, the greater the health risks.
• There is no safe level of exposure; someone who smokes occasionally (1 to 4 cigarettes a day) is still at greater risk for health problems than nonsmokers.
• An average smoker smokes 15 to 20 cigarettes a day.

Other Names: Pot, grass, weed, bud, jay, reefer, joint, ganja, herb, dope, red hair, chronic, the green, the kind, mary jane, skunk, sens, thai sticks, hash, hashish, mowie wowie, J, hooter, toke, yesca, budah, bionic, shwag, indica, mex, herbage, doobage, wacky tobacky, hemp.

Marijuana is a green or gray mixture of dried, shredded flowers and leaves of the hemp plant Cannabis sativa. There are over 200 slang terms for marijuana including "pot," "herb," "weed," "boom," "Mary Jane," "gangster," and "chronic." It is usually smoked as a cigarette (called a joint or a nail) or in a pipe or bong. In recent years, marijuana has appeared in blunts, which are cigars that have been emptied of tobacco and refilled with marijuana, often in combination with another drug, such as crack. Some users also mix marijuana into foods or use it to brew tea.

Signs and Symptom

• Rapid, loud talking and bursts of laughter in early stages of intoxication.
• Sleepy or stuporous in the later stages.
• Forgetfulness in conversation.
• Inflammation in whites of eyes; pupils unlikely to be dilated.
• Odor similar to burnt rope on clothing or breath.
• Tendency to drive slowly - below speed limit.
• Distorted sense of time passage - tendency to overestimate time intervals.
• Use or possession of paraphernalia including roach clip, packs of rolling papers, pipes or bongs.

Examples: Barbiturates, Tranquilisers

As the name implies, depressants interact to depress the activities of the central nervous system. Depressants have three categories; hypnotics which induce sleep; sedatives which do not induce sleep but produce a relaxing effect to help one fall asleep, and tranquilizers, such as Valium and Xanax, which are used to alleviate anxiety, tension, and relax muscles. Depressants can be synthesized, or occur naturally in the plants such as belladonna and curare.

Signs and Symptom

• Symptoms of alcohol intoxication with no alcohol odor on breath (remember that depressants are frequently used with alcohol).
• Lack of facial expression or animation.
• Flat affect.
• Flaccid appearance.
• Slurred speech.

Examples: Crack, Powdered Cocaine, Methamphetamine. Speed, Crank

Cocaine can exert a variety of effects. The major acute effects producing pathologic conditions result from the increased circulating catecholamine levels with cocaine use. These increased catecholamines can produce vasoconstriction. The lesions can include acute hemorrhages and infarction in the brain. Ischemic changes in the heart from small artery narrowing and sclerosis lead to contraction band necrosis of the myocardium and possible sudden death. Combining cocaine use with ethanol use can compound the myocardial damage. Pregnant mothers who use cocaine can affect their fetuses from abnormalities of placental function leading to low birth weight babies or an increased risk for placental abruption. Maternal cocaine use increases the risk for spontaneous abortion.

Signs and Symptom

• Dilated pupils (when large amounts are taken).
• Dry mouth and nose, bad breath, frequent lip licking.
• Excessive activity, difficulty sitting still, lack of interest in food or sleep.
• Irritable, argumentative, nervous.
• Talkative, but conversation often lacks continuity; changes subjects rapidly.
• Runny nose, cold or chronic sinus/nasal problems, nose bleeds.
• Use or possession of paraphernalia including small spoons, razor blades, mirror, little bottles of white powder and plastic, glass or metal straws.

Examples: LSD, Peyote, Psilocybin, Mushrooms

LSD (lysergic acid diethylamide) is one of the major drugs making up the hallucinogen class. LSD was discovered in 1938 and is one of the most potent mood-changing chemicals. It is manufactured from lysergic acid, which is found in ergot, a fungus that grows on rye and other grains.

LSD, commonly referred to as "acid," is sold on the street in tablets, capsules, and, occasionally, liquid form. It is odorless, colorless, and has a slightly bitter taste and is usually taken by mouth. Often LSD is added to absorbent paper, such as blotter paper, and divided into small decorated squares, with each square representing one dose.

Signs and Symptom

• Extremely dilated pupils.
• Warm skin, excessive perspiration and body odor.
• Distorted sense of sight, hearing, touch; distorted image of self and time perception.
• Mood and behavior changes, the extent depending on emotional state ofthe user and environmental conditions
• Unpredictable flashback episodes even long after withdrawal (although these are rare).

Other Names: Angle Dust

PCP is a white crystalline powder that is readily soluble in water or alcohol. It has a distinctive bitter chemical taste. PCP can be mixed easily with dyes and turns up on the illicit drug market in a variety of tablets, capsules, and colored powders. It is normally used in one of three ways: snorted, smoked, or eaten. For smoking, PCP is often applied to a leafy material such as mint, parsley, oregano, or marijuana.

PCP has stimulant, depressant, hallucinogenic and analgesic effects. Which of these will be most pronounced is unpredictable and depends on users personality, psychological state and the setting at time of use.

Signs and Symptom

• Unpredictable behavior; mood may swing from passiveness to violence for no apparent reason.
• Symptoms of intoxication.
• Disorientation; agitation and violence if exposed to excessive sensory stimulation.
• Fear, terror.
• Rigid muscles.
• Strange gait.
• Deadened sensory perception (may experience severe injuries while appearing not to notice).
• Pupils may appear dilated.
• Mask like facial appearance.
• Floating pupils, appear to follow a moving object.
• Comatose (unresponsive) if large amount consumed. Eyes may be open or closed.

Slang or Street Names: Ecstasy, XTC, X, Adam, Clarity, Lover’s Speed, MDMA, MDA, MDEA, Pills, Love Doves

The adverse effects of ecstasy use may include hyperthermia, liver toxicity, and neuropsychiatric effects. Severe dehydration leading to excessive fluid intake and water intoxication. Long term use may be accompanied by memory deficits. A syndrome including hyperthermia, disseminated intravascular coagulation, rhabdomyolysis, hepatic failure, and renal failure has been reported with MDMA use, findings similar to the excited delirium of cocaine use. In addition persons using MDMA may develop acute fulminant hepatitis with liver failure, and possible death, that can occur days to weeks following drug use.

Signs and Symptom

• Psychological difficulties, including confusion, depression, sleep problems, drug craving, severe anxiety, and paranoia - during and sometimes weeks after taking MDMA.
• Physical symptoms such as muscle tension, involuntary teeth clenching, nausea, blurred vision, rapid eye movement, faintness, and chills or sweating.
• Increases in heart rate and blood pressure, a special risk for people with circulatory or heart disease.
• Also, there is evidence that people who develop a rash that looks like acne after using MDMA may be risking severe side effects, including liver damage, if they continue to use the drug.

Examples: Opium, Heroin, Dilaudid, Methadone

Street Names: Smack, Junk, Skag, 'H', Brown, Horse, Harry, Boy

Though commonly used to refer to all drugs, narcotics are in fact those drugs which are derived from opium, opium derivatives, or opium synthetics. Opium is collected from the sap of unripe seed pods from the Palaver somniferous poppy.

The following are commonly encountered narcotics, opium, morphine, codeine, heroin, hydromorphine (diluadid), meperidine (Demerol), percodan, methadone, darvon.

Signs and Symptom

• Lethargy, drowsiness.
• Constricted pupils fail to respond to light.
• Redness and raw nostrils from inhaling heroin in power form.
• Scars (tracks) on inner arms or other parts of body, from needle injections.
• Use or possession of paraphernalia, including syringes, bent spoons, bottle caps, eye droppers, rubber tubing, cotton and needles.
• Slurred speech.

Examples: Glues, Paints, Dry Cleaning Fluids, Aerosols and Propellant Gasses, Fuels, and Cigarette Lighter Gas

Inhalants are breathable chemical vapors that produce psychoactive (mind-altering) effects. Although people are exposed to volatile solvents and other inhalants in the home and in the workplace, many do not think of inhalable substances as drugs because most of them were never meant to be used in that way. Inhalants are a common substance of abuse among teenagers. Their popularity is largely a matter of availability. Inhalants, which include certain glues, aerosols, and solvents, are easily and cheaply obtained at a local hardware store.

Signs and Symptom

• Substance odor on breath and clothes.
• Runny nose.
• Watering eyes.
• Drowsiness or unconsciousness.
• Poor muscle control.
• Prefers group activity to being alone.
• Presence of bags or rags containing dry plastic cement or other solvent at home, in locker at school or at work.
• Discarded whipped cream, spray paint or similar chargers (users of nitrous oxide).
• Small bottles labeled "incense" (users of butyl nitrite).

Examples: Anabolic and Androgenic Steroids

Anabolic steroids are synthetic derivatives of the male hormone testosterone. The full name is androgenic (promoting masculine characteristics) anabolic (building) steroids (the class of drugs). These derivatives of testosterone promote the growth of skeletal muscle and increase lean body mass. Anabolic steroids were first abused nonmedically by elite athletes seeking to improve performance. Today, athletes and others use steroids to enhance performance and also to improve physical appearance.

The major side effects of anabolic steroid use include:

• liver tumors
  
• jaundice
  
• fluid retention
  
• high blood pressure
  
• severe acne
  
• trembling
  
• FOR MEN: shrinking of the testicles, reduced sperm count, infertility, baldness, development of breasts
  
• FOR WOMEN: growth of facial hair, changes in or cessation of the menstrual cycle, enlargement of the clitoris, deepened voice
  
• FOR ADOLESCENTS: growth halted prematurely through premature skeletal maturation and accelerated pubertal changes.

• Behavior characteristics associated with substance abuse
• Abrupt changes in work or school attendance, quality of work, work output, grades, discipline.
  
• Unusual flare-ups or outbreaks of temper.
  
• Withdrawal from responsibility.
  
• General changes in overall attitude.
  
• Deterioration of physical appearance and grooming.
  
• Wearing of sunglasses at inappropriate times.
  
• Continual wearing of long-sleeved garments particularly in hot weather or reluctance to wear short sleeved attire when appropriate.
  
• Association with known substance abusers.
  Unusual borrowing of money from friends, co-workers or parents.
  
• Stealing small items from employer, home or school.
  
• Secretive behavior regarding actions and possessions; poorly concealed attempts to avoid attention and suspicion such as frequent trips to storage rooms, restroom, basement, etc.

source: http://www.addictions.org; http://www.teenchallenge.com; http://www.cornerdrugstore.org/CommonDrugsPage.htm