DRUG EDUCATION

LEONARDO T GARCIAOct 5, 2014

DRUGEDUCATION

A. RA 9165 An Overview B. Drug introductionC. Drug Abuse and AddictionD. Rehabilitation of Drug Dependents E. The Role of the Citizens F. Examination

DRUG INTRODUCTIONI.DRUGII.PHARMACOLOGYIII.COMMON PARAPHERNALIA FOR DRUG USEIV.WHY DO PEOPLE DRUG ABUSEV.COMMON SIGNS OF DRUG ABUSEVI.RA 6425 AND RA 9165

I. DRUG any substance whether natural or synthetic that

stimulates, depresses or irritates specialized cells.

any substance that brings about physical, psychological and behavioural changes in person

taking it. ABUSE

use to bad effect or for a bad purpose. DRUG ABUSE the use of drugs contrary to its purpose.

the use of any chemical substance, licit or elicit,

which results in an individual’s physical, mental, emotional or social impairment.

DRUG ADDICTION Addiction is a value-laden catchword popularly used to described dependence on drug. Originally associated with narcotics, the word “addiction” has become prejorative term because addiction has been used in so many different ways. It is being replaced by the term “Drug Dependence” in technical circles.

ADDICTS

Are persons who abuse the use of drug. A drug dependent person.

DEPENDENCE

the state of being dependent. DRUG DEPENDENCE

a state of psychic or physical dependence, or both, in a dangerous drug, arising in a person following administration or use of that drug on a periodic or continuous bases.

KINDS OF DRUG DEPENDENCE

1)PHYSICAL DEPENDENCE an adaptive state caused by repeated drug use that reveals itself by developing intense physical symptoms when the drug is stopped; formerly called addiction.

2) PSYCHOLOGICAL DEPENDENCE an attachment to drug use, which arises from the drug’s ability to satisfy some emotional or personality need of an individual; formerly called habituation.

DRUG EXPERIMENTER

one who illegally, wrongfully or improperly uses any drugs for reason curiosity, peer pressure or other similar reasons.

POTENTIATION

is the combined action of two or more drugs whereby there is greater effect than the sum of effects of each drug rather when taken alone.

POLYDRUG USE abuse by taking all sort of drugs.

TOLERANCE

the increasing of dosage of drugs to maintain the desired effects of the drugs.

WITHDRAWAL PERIOD

refers to the period from the point of drug dependence up to the point when the drug dependent is totally or

gradually deprived of the drug. TREATMENT

a medical service rendered to client for the effective management of his total condition related to drug abuse.

PHARMACOLOGY

the science of drug preparation, uses and effects.

PHARMACOLOGICAL CLASSIFICATION OF DRUGS (HaNDS)

HALLUCINOGEN Also called “psychedelics” Drugs that affect thinking, sensation, self-awareness and emotions. Produces hallucination and delusion Examples are: marijuana, LSD, mescaline, ketamine, psylocybin, phenicyclidine (PCP)

Ex 1: Marijuana Commonly called “grass”, “damo”, “tsongki” “ganja”, “bhang” Botanical name is cannabis satival L Has three major components:

1) Tetrahydrocannabinol (THC) – purple; the most active alkaloid; the one causing the hallucinogenic effect

2) Cannabinol – red (physiologically inactive)3) Cannabidol – pink (physiologically inactive)

Legal definition of marijuana all parts of the plant whether growing or not, the seeds

thereof, the resin extracted from any parts of such plant, every compound, manufactured, salt derivative, mixture or preparation of such plant, its seeds or resin.

Identifying Marijuana1)Leaves

• green, spotted brown in color• with cystolith hairs on the underside• presence of effervescene (giving off bubbles) when diluted with hydrochroric acid

2) Lulls (deceptive)• green, brown or brownish-spotted in color• characteristically shaped• with cystolith hairs

3) Fruits (seeds)• greenish-yellow to brown in color

• inside similar to coconut meat• ovoid in shape

Forms of Marijuana1)Marijuana joint or cigarettes – made from dried leaves, tops and flowers of the plant; the most available form.2)Hashish or hash – made from the extracted resin (a sticky flammable organic substance) of the plant; usually granular or solid chunky in form, ranging from a mustardly yellow (brownish) to dark brown; stronger than crude marijuana and may be smoke or eaten.3)Hashish oil – higher form of marijuana and not usually available because it is expensive; brown in color; considered as concentrated cannabis. Immediate effects of marijuana use1)Faster heartbeat and pulse rate2)Blood eyes3)Dry mouth and throat

4) Altered sense of time and disorientation5) Forgetfulness6) Inability to coordination and slower reflexes Long term effects of Marijuana use1) Chest pain2) Irregular menstrual cycle3) Temporary loss of fertility for both sexes4) Premature babies and low birth weights5) Cancer of the lungs Ex 2: LYSERGIC ACID DIATHYLAMIDE (LSD)

Colorless and tasteless semi-synthetic alkaloid substance extracted from ergot fungus which grown on rye, wheat and other grains Popular in the 1960’s and 1970’s at the height of the hippie culture

Ex 3: MESCALINE Primary ingredient of the peyote cactus, a plant known as

lophoria wiliamsii lemaire (a small, soft blue-green spineless cactus) Produces illusions and hallucinations lasting from 5 to 12

hours

Ex 4: KETAMINE Chemical name is hydrochloride Common name include “special K” or “K” Getting popular as “Party Drug” that produces tripping

effects the whole night teenagers who are fond of “techno parties” or “raves” take the drug because the user

feels uncontrollable urge to dance upon hearing sound of music

originally created for use of human anaesthetic and is still used as a general anaesthetic for children, persons of poor health and veterinary medicine

usually comes as liquid in small pharmaceutical bottles and is most often cooked into a white powder for snorting

at lower doses produce hallucinogenic effect and may cause the user to feel very far away from his body; such experience is referred to as entering “k” hole

when snorted, the effect comes on within 5 to 10 minuteswhen ejected into the muscle, effect can be felt within 4 minutes; it is never injected into vein

if ingested, effect can be felt within 10 to 20 minutes Effects when taken in large dose are as follows: dizziness,

Impairment of motor function, breathing problem resulting to death, convulsion and depression resulting to death

Recently, Ketamine Hydrochloride is mixed with Shabu and marketed as” KETABU”

Ex 5: PSILOCYBIN derived from psilocibe mushroom grown by Indians for

centuries when the mushroom is eaten, it produces effect similar to

mescaline and LSD Ex 6: PHENCYCLIDINE (PCP)

sold under different names such as: Angel, Dust, Crystal, Superglass, Killer Weed, Rocket Fuel, Embalming Fluid

and many others GENERAL EFFECTS OF HALLUCINOGENS:

1)Increased heart rate and pulse rate2)Elevated or increase blood pressure3)Increase activity of the body due to the effect on the brain4)Enlarge or dilated pupils of the eyes5)Increased body temperature6)Paleness of the face and skin of the body

PSYCHOLOGICAL EFFECTS OF HALLUCINOGEN1) Strong emotional feeling 2) Recalling previously suppressed ideas and thoughts 3) A feeling of great creativity and imagination4) Very lucid and astonishingly clear thoughts5) Intensification of sensory impressions6) Changes in sensation. Sounds are “seen”, simple

things appear very beautiful and colors seems to be “heard”

7) A mood of joy and strong feeling of religious awareness

8) A feeling of oneness with the universe 1.NARCOTICS

In its medical meaning refer to opium and opium derivatives or synthetic substitutes

Drugs that relieve pain and often induce sleep

Kinds of Narcotics:1)Narcotics of natural origin – produced directly from the poppy plant. Examples are: Opium, Morphine, Codeine and Thebaine) Ex 1: OPIUM

• Derived from the plant opium poppy, botanical name is papaver somniferum• Papaver is Greek for poppy, somniferum is Latin for “ to

dream or induce sleep”• Originally intended for medicinal purposes• Opium poppy grows from 2 to 5 feet with flowers of different colors• Raw opium is obtained by making incision either vertically

or horizontally which allows the milky juice to seep from the plant

• Raw opium is then formed into balls or chunks and shipped to a laboratory for cooking

• Raw opium is then refined into morphine

Ex 2: MORPHINE• A derivative of opium• Comes from the name of Greek god of dreams, “ Morpheus”• Most effective drug to relief pain. Its legal use is restricted

in hospitals.• It is odourless, tasteless and darkens with age• Approximate 10 kilograms of raw opium will produce 1

kilogram of morphine• Addicts administer it intravenously, but can be smoked or

taken orally• Both physical and psychological dependence is rated high

Ex 3: CODEINE

• The chemical compound derive from morphine• It produces less analgesic, sedation and respiratory depression than morphine.

Comes from two forms:1. Tablets (aspirin)2. Liquid (Rubitussin AC and Cheracon)

Ex 4: THEBAINE

• principal alkaloid present in a specie of poppy. By it self it is not used medically, but it is converted into a variety of medically important compounds including codeine

2) Semi-synthetic Narcotics – Synthesized from narcotics of natural origin. Examples are: Heroin, Hydromorphone and Oxycodone Ex 1: HEROIN

• The chemical compound derived from morphine• Chemical name is diacetylmorphine• Pure heroin is white powder with a bitter taste • Method of administering are injected, sniffed or smoked

Ex 2: HYDROMORPHONE• Commonly known as Dilaudid• It is about eight (8) times as potent as morphine and is

sought after by drug addicts Ex 3: OXYCODONE

• It is synthesized from thebaine • More potent than codeine

3) Synthetic Narcotics – produced entirely in the laboratory. Examples are: Meperidine, Methadone,and Pentazocine (Talwin) Ex 1: MEPERIDINE

• The first synthetic narcotic produced a generation ago.• It is chemically different from morphine but resembles its

pain killing effect. • It is used for the relief of moderate to severe pain

Ex 2: METHADONE• German scientists synthesized Methadone during

World War II because of the shortage of Morphine• Although chemically unlike Morphine and Heroin, it

produces many of the same effects as pain killer• Also used as a treatment of narcotic addict

Danger of Narcotic Abuse:1)Narcotic Abusers neglect themselves and usually suffer from malnutrition, infections, diseases and injuries.2)The body of the abuser is prone to toxic reactions due to impurities in the narcotic3)Fatal infections can be readily transmitted to the abuser’s body. Effects of the use of Narcotics:1)Pen point pupils (sharp vision)2)Drowsiness (sleepy)3)Exphoria (excited)

4) Reduced vision5) Respiratory depression6) Nausea (a feeling of sickness with an inclination to vomit) Withdrawal Symptoms:1) Watery eyes2) Runny nose3) Yawning4) Loss of appetite5) Irritability6) Tremors (shake or tremble with a slight rapid motion)7) Panic8) Chills and sweating9) Nausea Effects of overdose:1) Shallow breathing2) Clammy (slightly wet and sticky) skin3) Convulsions

4) Possible death DEPRESSANTS/SEDATIVES

Drugs which decrease body functions and nerve activities Also called “downers” which are drugs that act on the nervous systems promoting relaxation and sleep. Used in excessive amounts, depressants induce a state of

intoxication similar to that of alcohol Intoxication doses result in impaired judgement,

disorientation, slurred (unclear) speech, drunken behaviour without the odor of alcohol, and loss of motor coordination.

Examples are: barbiturates, methaqualone, meprobamate and benzodiazepines Ex 1: BARBITURATES

• Prescribed to induce sedation and sleep (Sleeping pills)• small dosage tends to calm down nervous conditions

• Larger dosage can cause sleep twenty to sixty minutes after taking it orally

• An overdose of barbiturates may progress through stages of sedation, sleep and comatose to death from respiratory arrest to cardiovascular complications

• Can produced both physical and psychological dependence• Classified as:

1) Ultra Short-Acting (Hexobarbital)2) Intermediate-Acting (Secobarbital/Seconal)3) Short-Acting (Pentobarbital/Nembutal)4) Long-Acting (Methobarbital/Mebaral)

(Phenobarbital/Luminal)

• Barbiturate are abused in two ways:1) The user of the drug had developed a tolerance to

the drug thus increasing dosage; and

2) The user of the drug had developed a tolerance to the drug thus increasing dosage; and For added thrill, barbiturate is injected as a substitute to other drugs being abused, especially Amphetamines.

Ex 2: METHAQUALONE

• A synthetic sedative which has been widely abused and often cause serious poisoning

• It is taken orally and is rapidly absorbed in the digestive tract

• Large doses can cause comatose accompanied by convulsion• Heavy use of this drug leads to tolerance and dependence• It is known in the US as Qualude, Parest, Mequin, Optimol, Somnafac and Sofor• Its European equivalent is Mandrax• It is widely-abused because it was once mistaken taught

of to be non-addictive and very effective as aphrodisiac

Ex 3: MEPROBAMATE • A muscle reluctant prescribed mainly for the relief of

anxiety tension and muscle spasms• First synthesized in 1950 and introduced as mild tranquilizers (i.e.: Miltown and Equanil)

Ex 4: BENZODIAZEPINES

• Relieve anxiety, tension and muscle spasms as well as producing sedation and preventing convulsions

• Have slow onset but have long duration of action• To obtain “high”, they are taken with marijuana or alcohol

i.e.: Diazepam (Valium); Lorazepam (Ativan) and Chlordiazepoxide (Librium)

Valium and Librium are widely prescribed in the Philippines

EFFECTS OF DEPRESSANTS1)A usual dose of a barbiturate causes a calming, relaxing effect which promotes sleep2)Relief of anxiety and excitement3)Reduced mental and physical activity4)A marked decreased in breathing 4. STIMULANTS

Drugs which increases alertness, mental activity and physical disposition, relieve fatigue and offset drowsiness

Also called “uppers” Examples are: cocaine, shabu and ecstacy

Ex 1: COCAINE

• It is called “the king’s habit” because it is expensive• White crystalline alkaloid found in the leaves of the coca

bush• Erythroxylon coca is the botanical name of the plant coca

bush

• It take 125 pounds of dried leaves to produce one pound of cocaine

• Medically used as a tropical local anesthetic• Can be taken by ingestion, by rubbing it directly to gums,

by applying it directly to sex organs during intercourse, by injection or snorting

• When ingested, the “high” can last from 15 to 30 minutes• When injected, the “high” can last from 45 to 90 minutes • Comes from different forms:

1) cocaine hydrochloride – the most readily available from, fine, white crystal –like powder that is medically known as anesthetic

2) street or rock – largest pieces of cocaine hydrochloride3) freebase – purified substance of rock4) coca paste – crude product smoked in South America;

more dangerous because it has contaminants such as kerosene

• The following are its immediate effects:1) dilated (become wider, larger, or more open )pupils2) increase blood pressure, heart rate, breathing rate,

body temperature3) euphoric (a feeling of intense happiness and elation)

effect/light feeling4) feeling of being energetic5) loss of appetite6) slurred speech

• The following are its long term effects1)Psychosis (mental disorder)2)lung damage3)runny nose and ulcerated mucous membrane of the nose4)confusion

Ex 2: METHAMPHETAMINE HYDROCHLORIDE

• Commonly called “shabu”• Other names such as: Ubas, S, Siopao, Sha and Ice

• Also called “poor man’s cocaine” because it is cheaper than cocaine• White, colorless crystalline substance with a bitter,

numbing taste• First synthetic stimulant developed by the Japanese• Originally called “kakuzeizai”, from the Japanese term “kakuzei”, which means “waking” and “zai”, which means drug

“kakuzeizai” – waking drug• Can be ingested, snorted or injected (intravenous or

intramuscular) The following are its immediate effects:1)Produce anxiety (nervous disorder), irritability, irrational behaviour, talkativeness and loss of self-control2)Loss of appetite and inability to sleep3)Produces violent and destructive behaviour and recklessness

4) Produces chest pain, irregularity of heartbeat and hypertension The following are its long term effects:1.Psychosis2.Convulsion3.Death from cardiac arrest Ex 3: METHYLENE DIOXYMETHAMPHETAMINE (MDMA)

• Commonly referred to ecstacy, “X” and party drug• Also known as XTC, ADAM, or Eden tablet. “hug drug”

or “yuppie drug”• A designer drug• It is usually marketed in tablet form, but it also available in liquid or powder form• The following are its immediate effects:1)Euphoria2)Feeling energetic and hyperactive3)Sense of well being

• The following are its long term effects:1) Brain damage2) Heart complications3) Death

GENERAL EFFECTS OF STIMULANTS:1.Gives a feeling of being stronger, more decisive and self-possessed2.Extended wakefulness and increased mental alertness3.It may induce irritability, anxiety and fear4.Loss of appetite resulting in decreased of body weight5.Pregnant women who abused shabu can cause mental retardation to their unborn babies6.Loss of sexual desire; lack of interest towards work7.User suffers “Schizophrenia” or split personality leading to violent behaviour8.Chronic user experience loss of memory

9. Chronic snorters suffer from irritation of the nose leading to frequent nose bleeding

10. Injecting shabu using dirty needles can lead to various infections, such as Hepatitis-B (infection of the liver), Blood Poisoning and AIDS

5. OTHER SUBSTANCES ABUSED INHALANTS

• Are volatile substances derived from ether or chloroform (a pleasant-smelling, volatile, highly flammable) • It is inhaled through the nose to experience intoxication• These substances include the following:

1) Quick-drying glue or plastic cement like rugby2) Paint remover and lacquer as thinner and solvent3) Gasoline and gasoline-based products4) Kerosene5) Nail polish or polish remover “acetone”6) Lighter fluid and dry cleaning fluid

EFFECTS OF INHALANTS1) Unsteadiness and restlessness2) Drunkenness with depression leading to

unconsciousness3) Irritability and highly-agitated condition4) Initial excitement thereby losing emotional control5) Irritation of throat and nasal passages

ALCOHOL

• Refers to beverages whose effects are related to their substance contents which are extracted from chemical compound ethyl and hydrocarbon that triggers the control nervous system and may damage vital human organs through misused

• It is the most abused recreation drug• Physical dependence exist if taken regularly in

large quantities

STAGES OF ALCOHOLISM Early Stage

• Fatigue, filters and nausea• Avoidance of contact with superiors• Changes of behaviour style by the person – more outgoing and increased self confidence

Middle Stage

• Increase nervousness, irritability, red or bleary eyes and flushed face

• Individual working in performance cycles where some cycles have great output and others have very little.

Last Stage

• Prolonged absences• Further decline in work performance with many different

kinds of excuses being offered• Increase financial problems

Alcoholism• continued drinking despite suffering alcohol-related

problems also known as alcohol dependence• a disease that includes alcohol craving• commonly available to the convenient store i.e.: wine,

vodka, brandy, whisky, gin, beer, etc • considered drug because of its depressing effects in the

body. MAJOR SYMPTOMS OF ALCOHOLISM

• Craving – strong compulsion to drink• Impaired control• Inability to control drinking urge• Physical withdrawal symptoms like sweating, shakiness,

anxiety and nausea• Need for increased doses of Alcohol to maintain same

level of intoxication

COMMON PARAPHERNALIA FOR DRUG USE1.Spoon2.Syringe3.Eyedropper with rubber suction device4.Needle5.Tourniquet6.Matches7.Lighter8.Razor blades9.Foil10.Wine bottle cap WHY DO PEOPLE DRUG ABUSE Peer pressure Curiosity Pleasurable feeling Want to forget Pain killer

Working at night For added strength To lose weight COMMON SIGNS OF DRUG ABUSE Change in attendance at work or school Change from normal capabilities (work habits, efficiency

etc.) Poor physical appearance including inattention to dress

and personal hygiene Wearing sunglasses constantly at inappropriate times Unusual effort made to cover arms in order to hide needle

marks Association with known drug abusers Stealing items which can readily be sold for cash 9to

support drug habit) Changes in mood-depending on the drug taken. Ex:

depressed or elated and euphoric

DRUG SYNDICATE – any organized group of two or more persons forming or joining together with the intention of committing any offense prescribed under RA 9165. DRUG TRAFFICKING – the unauthorized manufacture, distribution or unlawful possession of any controlled substance, for the purpose of selling. DRUG DISTRIBUTION PROCESS1.THE GROWER

• The one responsible for the planting, harvesting and maintenance of the original plant from which the drug

is derive from .• The source of crops or contact to other sources from

whom crops can be obtained.• Sees to it that the plant produced in the highest quality possible in sufficient quantity.

2. THE MANUFACTURER• The one responsible for the processing of the raw

materials supplied by the grower • Maintains a manufacturing laboratory• The one who makes contact or is contacted so that the

distribution can begin 3. THE IMPORTER

• The client or contact of the manufacturer • The primary seller of the drugs• The importer devices the plan or procedure by which the

now-refined drug will reach its destination, whether that be another country, state or other geographical area.

4. THE SMUGGLER

• Has the task of smuggling the drugs into the designated area

• Must device techniques by which the drugs evade the scrutiny of inspection

5. THE DISTRIBUTOR• The source of drugs in their respective areas• The smuggler has different distributors in different

geographical areas 6. THE DEALER

• Most commonly called “PUSHERS”• They make drugs easily available to users• Some dealers are satisfied with selling drugs to already

known addicts, while some engage in addicting new customers

7. THE CONSUMER

• The buyer and user of drugs• The “drug addicts”• The reason why the business of illegal drugs continue to

thrive

DRUG CARTELS

CARTEL – an association of businesses in international monopoly. MEDELLIN CARTEL - Established in 1970’s in Medellin, Columbia Its key members were:Pablo Escobar – the leader of Medellin Cartel; a common street

thief who mastermined the criminal enterprise.Jose Gonzalo Rodriguez Gacha – had prior illegal movement in

the emerald tradeJorge Ochoa, Fabio Ochoa and Juan David Ochoa – belong to a

well-respected ranching familyCarlos Lehder – marijuana smuggler who owned land properties

and air strip in Norman’s clayNorman’s clay is a small island in Bahamas

- Lehder built a runway for the small airplanes that were used in transporting illegal drugs to the US; the r

unway was protected from radar- The island became the stop-over and re-

fuelling hubs for the planes transporting illegal drugs

Its operations started to deteriorate when it started getting violent due to Escobar’s power-hungry activities against the Columbian government. Eventually, both Pablo Escobar and Rodriguez Gacha were gunned down by the Columbian Police, while the Ochoa brothers turned themselves in exchange for lenient prison terms. The Medellin Cartel was neutralized in the early 1990’s CALI CARTEL- Established in 1970’s in Cali, ColumbiaIts key members were:1.Gilberto Rodriguez OrejuelaM2.iguel Rodriguez Orejuela

3. Santacruz Londono

They conducted their operations quietly, reinvesting their profits in legitimate businesses. As rivals of the Medellin Cartel, they secretly supplied information against Escobar to the Columbian Police. In the mid-1990’s, the leaders were arrested and are currently serving prison terms however, it is believed that operations are still going on GOLDEN CRESCENT (Middle East)

Composed of Iran, Afghanistan and Pakistan One of the world’s biggest sources of opium The geographical location is conducive to growing opium

poppies The fields are said to be protected by the Taloban Afghanistan

GOLDEN TRIANGLE (South East Asia)Composed of Thailand, Myanmar and Laos

• World’s leading producer of heroin• The geographical location of said countries are conducive

to growing crops• The fields cover a vast area impossible to monitor completely• Poor farmers choose to plant opium poppies because it is

more lucrative• The fields are said to be protected by the rebel groups,

especially in Myanmar FIRST IMPORTANT DRUG TRAFFIC ROUTEMiddle East – discovery, plantation, cultivation and harvest (Grower)Turkey – operation for distribution (Distributor)Europe – manufacture, refine and synthesis (Manufacturer)US – marketing (Dealer/Pusher)

“IF YOU KNOW THE ENEMY AND KNOW YOURSELF, YOU NEED NOT FEAR THE RESULT OF A HUNDRED BATTLES. IF YOU KNOW YOURSELF BUT NOT THE ENEMY, FOR EVERY VICTORY GAINED YOU WILL SUFFER A DEFEAT. IF YOU KNOW NEITHER THE ENEMY NOR YOURSELF, YOU WILL SUCCUMB IN EVERY BATTLE.”--SUN TZU--

THANK YOU AND HAVE A GOOD DAY AHEAD OF US!