Alcohol and Drug Abuse FINAL

what are some examples of drug-related harm reduction strategies?

• supervised injection sites/overdose prevention centers

• syringe exchange programs

• naloxone

what are some benefits of supervised injection sites/overdose prevention centers?

• decreased overdose deaths and decrease in health care costs 

• Includes: sterile supplies, secure environment, lifesaving support 

• Provides: critical services, withdrawal management, referrals to specialized services, and primary care 

what are some benefits of syringe exchange programs?

• provide access to sterile needles and syringes

• facilitate safe disposal of used syringes

• play an important role in reducing transmission of viral Hepatitis, HIV and other infections

• provides education in a non coercive environment

what are some benefits for naloxone?

• rapidly reverses an opioid overdose

• can quickly restore normal breathing to a person if their breathing has slowed/stopped because of an opioid overdose

• has no effect on someone who does not have opioids in their system

Describe how HIV and Hepatitis C rates have changed with syringe exchange programs

• Syringe exchange programs play an important role in reducing the transmission of Hepatitis C and HIV

• HIV infections cut in half (48%) for those who inject drugs and use a syringe exchange program 

how does naloxone work in the body to reverse an opioid overdose?

• It acts in the brain to immediately block the effects of the opioid the person has taken 

• Naloxone attaches to the same receptors in the brain as opioids but has a stronger bond

• Naloxone knocks the opioids off of the receptors and blocks any additional opioids from bonding with the receptors for 30-90 minutes

• Reverses the overdose and can allow the person to breathe again 

what situations can naloxone be effectively used?

• overdoses caused by: 

  • Heroin, morphine, hydromorphone (dilaudid), oxycodone (oxycontin, percocet), hydrocodone (norco, vicodin), fentanyl, carfentanil, buprenorphine, codeine, methadone

what situations can naloxone not be effectively used?

•  an overdose caused by: 

  • Stimulants (cocaine, methamphetamines, adderall, etc.) 

  • Alcohol 

  • Benzodiazepines (anti-anxiety medications like valium, ativan, xanax, klonopin) 

  • Antidepressants (paxil, prozac, lexapro, wellbutrin, zoloft) 

  • Other substances 

what is Steve’s Law?

MN’s naloxone access and Good Samaritan expansion

what implications does Steve’s Law have on the public?

• Allows first responders and laypeople to carry and administer naloxone 

• Expands naloxone access through pharmacies and third-party prescriptions 

• Provides civil and criminal immunities when providing assistance for suspected opioid overdose 

What are the signs and symptoms of an opioid overdose?

• Unconscious or unresponsive, difficult to wake up 

• slow/shallow breathing 

• Struggling to breathe and making gasping or gurgling sounds 

• Very small (pinpoint) pupils that are unresponsive to light 

• Slow heartbeat or lowered BP 

• Skin discoloration d/t lack of oxygen (varies based on skin tone)

What has been the general trend in smoking tobacco prevalence since the first Surgeon General’s report in 1964?

steady decline in smoking tobacco

what is mainstream smoke?

smoke exhaled by smokers

what is sidestream smoke?

smoke that comes from the device itself

What is the relationship between the age at which someone begins smoking tobacco and the likelihood they will become dependent?

Smoking regularly at age 18-20 was associated with higher odds of nicotine dependence

describe the effects of nicotine

• Helps to calm and reduce anxiety 

• May aid alertness, concentration, and memory formation 

• Used to suppress appetite 

• Adolescents who are smokers are 2x as likely as non smoking adolescents to suffer an episode of major depression 

describe the effects of tobacco

Can cause certain types of cancers

describe the effects of secondhand smoke

Exposure has been causally linked to cancer, respiratory, and cardiovascular diseases, and to adverse effects on health to children 

what does MPOWER stand for and what is it?

M: monitor tobacco use and prevention policies 

P: protect people from tobacco smoke 

O: offer help to quit smoking 

W: warn about the dangers of tobacco 

E: enforce bans on tobacco advertising, promotion, and sponsorship

R: raise taxes on tobacco

• effective tobacco prevention/cessation strategies

what are the 3 types of inhalants?

Nitrates, anesthetics, and solvents

what are nitrates?

• Yellow, volatile, flammable liquids that have a fruity odor 

• Physical sense of warmth, giddy feeling, pounding heart, removal of inhibitions 

• EX: nitroglycerin and Amyl Nitrate 

what are anesthetics?

• 3 main purposes: pain relief, muscular relaxation, and loss of consciousness 

• Used for surgeries 

• Sequence of responses: brief period of excitation/stimulation, pain relief, dizziness, weakness, general function depression

• Negatively impacts: eye blinking, swallowing, vomiting reflexes, heart fluctuation, and respiration 

• EX: laughing gas (nitrous oxide)

what are solvents and propellents?

• Two characteristics in common: form gasses that can be inhaled AND produce similar feelings to those caused by alcohol and anesthetics 

• Should never be used because there are many severe health consequences and can even cause death after one use. 

  • Can cause brain damage, asphyxiation, coma, etc. 

List reasons inhalants are popular among youth

• Readily available in homes 

• Inexpensive 

• Easy to conceal 

• Legally obtained 

• Feelings of intoxication and euphoria 

List common signs of inhalant misuse

• Breath occasionally smells of solvents 

• Often have sniffles like a cold but without other symptoms 

• Hiding rags, clothes, or empty containers 

• Watery eyes, nausea, nausea, headaches, nosebleeds

List effects of sedatives

• Produce a sense of relaxation and a reduction of anxiety 

• At higher doses: lightheadedness, vertigo, drowsiness, slurred speech, muscle incoordination

• Impaired learning and memory 

• Overdose → drowsiness, muscle incoordination, slurred speech, deep sleep, loss of reflexes, suppressed breathing, death 

what are the different types of sedatives?

general sedatives, benzodiazepines, drugs designed specifically to induce sleep, GHB, and Xylazine

what are general sedatives?

• Almost all used for recreational purposes (not prescribed) 

• Barbiturates (phenobarbital, pentobarbital) 

• Increase inhibitory function of GABA 

what are benzodiazepines?

• Among the most prescribed drugs on earth 

• Can provide significant relief from anxiety without disrupting normal functioning

what sedatives that are designed specifically for sleep?

• Act on benzodiazepine receptors to induce sleep

• Do not seem to reduce anxiety, less rewarding than other sedatives, less likely to cause dependence

what is GHB?

• Odorless and colorless liquid 

• Produces relaxation, mild euphoria, then headache, nausea, drowsiness, loss of consciousness, seizures, coma, even death 

what is Xylazine?

• Animal sedative/tranquilizer 

• Increasingly being found mixed in with other drugs 

what are some potential positive effects of cannabis use?

general relaxation and elevation in mood, lethal overdose is virtually impossible

what are some potential negative effects of cannabis use?

drowsiness and sedation, increased appetite (could be good or bad)

what are some potential short-term effects of cannabis use?

increases in heart rate, reduces hearts pumping efficiency, Impairs judgement and complex coordination, inhibits memory formation and storing new information 

what are some potential long-term effects of cannabis use?

decreases lung air flow, effects brain systems controlling vision and regulating physical movement, suppresses production of reproductive system hormones, impairs learning and memory

what is THC?

the substance in cannabis that makes people feel high, found in the plants resin 

what is CBD?

• CBD determines drug quality by to what extent CBD is converted to THC 

  • Does not cause a high 

  • All 50 states have laws legalizing CBD with varying restrictions 

How long does THC remain in the body after smoking? How much THC remains in the body?

About ½ of THC remains in the body 24 hours after smoking ~30% may remain in body a full week later and may continue to affect mental and physical functions 

Describe the disparities that exist with cannabis use and cannabis arrests

Cannabis is used at similar rates by black and white people across the US but black/brown people are more likely to get arrested for cannabis possession 

Describe the Lower-Risk Cannabis Use Guidelines

• The most effective way to avoid cannabis use-related health risks is abstinence 

• Avoid early age initiation of cannabis use 

• Choose low-potency THC or balanced THC to CBD ratio cannabis products 

• Abstain from using synthetic cannabinoids 

• Avoid combusted cannabis inhalation and give preference for nonsmoking methods 

• Avoid deep or other risky inhalation practices 

• Avoid daily cannabis use 

• Abstain from cannabis-impaired driving 

• Populations at higher risk for cannabis use related health problems should avoid use and 

• Avoid combining previously mentioned risk behaviors 

what are policies?

a standard set of principles that guide a course of action

what are public policies?

• Established by the government, may be enacted by federal, state, or local governments

• If created by a lower level of government it must agree with policies created by a higher level of government 

what are public health policies?

laws, regulations, actions, and decisions implemented within society in order to promote wellness and ensure that specific health goals are met

what are some substance use policies we learned about in class?

• Minimum purchase/possession/use ages 

• Restrictions on where products can be used 

• Restrictions on where products can be sold 

• costs/taxes

Describe multiple ways public policy impacts health

• Creation and regulation of public goods (ex: funding, planning, maintaining state roads/highways)

• Regulation of natural resources (ex: regulating air/water quality)

• Requirements and mandates to protect citizens (ex: seat belt laws, minimum use age) 

• Direct support (ex: government aid programs)

• Creation of opportunities and incentives (ex: tobacco taxes)

Identify the three factors that change attitudes and laws

culture, time, money

what are some positive effects of the herbal drug St. Johns Wort?

• has a historic use of treating things like mental health disorders, nerve pain, malaria and today's use is to treat depression, anxiety, and sleep disorders. 

  • Not useful in treating depression 

what are some negative effects of the herbal drug St. Johns Wort?

may cause anxiety, dry mouth, dizziness, GI symptoms, sexual dysfunction; NOT a proven therapy for depression

what are some positive effects of the herbal drug melatonin?

can be used to adjust sleep-wake cycles in people with shift changes and to help with jetlag; also used for alzheimers, IBS, anti-aging agent 

what are some negative effects of the herbal drug melatonin?

shouldn’t be taken with sedative medications, might cause sleepiness/drowsiness, taking with birth control may cause excessive melatonin in the body

what are some negative effects of the herbal drug kratom?

can cause addiction, many possible side effects, deaths reported

what are some positive effects of the herbal drug kratom?

purported use is to help with chronic pain, some people to ease opioid withdrawal 

Describe FDA responsibility for regulating herbal drugs

• Regulates both finished dietary supplement products and dietary ingredients 

• Regulates dietary supplements under a different set of regulations than those covering “conventional” food and drug products 

Why should a buyer be cautious when using herbal drugs or dietary supplements? 

• Most dietary supplements offer no benefits to healthy people and can be harmful 

• Supplements can contain prescription drugs/pharmaceutical agents 

How do anabolic steroids work in the brain?

• Steroids do not trigger rapid increases in neurotransmitter dopamine 

• Long term use can affect some of same brain pathways and chemicals including dopamine, serotonin and opioid systems affected by other drugs 

what are some negative effects for anabolic steroids?

• Stunted growth in adolescents 

• Deepening of voice in females

• Changes in skin and hair 

• Persistent unpleasant breath odor 

• Swelling of feet and limbs

what are some misuse concerns for anabolic steroids?

• Individuals who misuse can experience withdrawal symptoms when they stop which can contribute to continued misuse 

• Some misusers turn to other drugs such as opioids to counteract the negative effects of steroids 

• May lead to serious, even irreversible health problems 

  • Kidney failure, damage to liver, cardiovascular problems 

what is stacking?

use of several types of steroids at the same time 

what is plateauing?

developing tolerance to a particular steroid 

what is pyramiding?

beginning steroid use with low doses moving into higher doses, then reducing the dosage at the end of the cycle

what is array?

use of other drugs while taking anabolic steroids to avoid possible side effects (EX: anti acne meds to try to prevent getting acne) 

what is cycling?

use of multiple doses of a steroid over a specific period of time, stopping for awhile, and starting again