uppers, downers and all arounders chapter 7 other drugs, other addictions

Uppers, Downers and All Arounders

Chapter 7

Other Drugs, Other Addictions

Copyright, 2004, CNS Productions,

Inc.1

Inhalants

• Used for their stupefying, intoxicating and slight psychedelic effects

• Most widely abused according to popularity are:– Nitrous oxide– Nitrites– Gasoline– Glue– Spray paint– Aerosol spray– Lacquer thinner– Typewriter correction fluid

TYPES OF INHALANTS

Copyright, 2004, CNS Productions, Inc.

2 Copyright, 2004, CNS Productions, Inc.

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Volatile Solvents (hydrocarbons)Volatile Solvents (hydrocarbons)Airplane glue, rubber, or PVC cementAirplane glue, rubber, or PVC cementPaint sprays, especially metallic paintPaint sprays, especially metallic paintHairsprays & deodorantsHairsprays & deodorantsLighter fluid & dry cleaning fluidLighter fluid & dry cleaning fluidNail polish removerNail polish removerPaint remover/thinnerPaint remover/thinnerTypewriter correction fluidTypewriter correction fluidGasoline & fuel gasGasoline & fuel gasCarbon tetrachloride, toluene, butane, Carbon tetrachloride, toluene, butane,

trichloroethylene, Ntrichloroethylene, N--hexanehexane

Inhalants

– Readily accessible to children– Get little attention because of low status of

inhalant abuse as a drug problem– Practice of inhaling substances goes back to

ancient times– Modern version is with abuse began in 1700s

with the discovery of nitrous oxide, chloroform and ether

– After WWII abuse of glue and metallic paints rose dramatically and continues today

– Responsible for 700 – 1,200 deaths each year–

Inhalants

– Abuse is prevalent among adolescents, although adults abuse it too

– Internationally, abuse afflicts the young, poor, and children exposed to chemicals daily, especially children of cleaners and shoemakers

– Inhalant of choice for many countries is gasoline

– More males and females abuse inhalants– High use among Hispanics and Native

Americans–

Inhalants

• Methods of inhalation– Sniffing: breathing the substance from a container

directly into lungs– Huffing: soaking a rag and inhaling from it– Spraying the inhalant into the nose or mouth– Balloons or crackers: suing a tool to puncture a

container that releases the inhaler into a balloon and then is inhaled

• By spraying the pressurized solvent directly into the mouth, a dangerous amount of pressure is put into the lungs and can freeze tissue


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Methods Methods of Inhalationof Inhalation“Sniffing”“Sniffing”“Huffing”“Huffing”“Bagging”“Bagging”“Spraying”“Spraying”“Balloons & “Balloons &

crackers”crackers”Bag over one’s Bag over one’s

headheadSoaking clothingSoaking clothing

Inhalants

• Volatile solvents:– Mostly carbon hydrocarbon based

compounds that turn into gas at room temperature

– Includes, gasoline and its addictives, kerosene, paints, especially metallic, paint thinner, nail polish remover, spot removers, glues and plastic cements, lighter fluid and variety of aerosols

– Quick acting because they are absorbed almost immediately, then moves to heart, brain, liver and other tissues

Inhalants

• Short-term Effects:– Temporary stimulation– mood elevation– Reduced inhibitions– Reward/reinforcement center is affected like cocaine

does– Soon depressive effects takes over

• Dizziness• Slurred speech• Unsteady gait• Drowsiness• High does may cause illusions, delusions and hallucinations

Inhalants• Prolonged inhalation causes

– Delirium with confusion– Psychomotor clumsiness– Emotional instability– Impaired thinking– Coma

• Long-term Effects– Lack of coordination– Weakness– Disorientation– Loss of weight– Impaired memory– Can cause injury to brain, liver, kidney, bone marrow

and particularly the lungs

Inhalants

• Toulene (methyl benzene)– Most abused solvent– Found in glues– Drying agents– Solvents– Thinners,– Paints– Inks and cleaning agents– In one study, 65% of chronic abusers of spray

paint had neurological damage– m

Inhalants

• Trichloroethylene: – Common solvent found in typewriter

corrections fluids, paints, metal degreasers and spot removers

– Causes overall depressive effects and some hallucinations

• N-Hexane & methyl butyl ketone (MBK)– Used in glues and adhesives and diluents for

plastics and rubber– Recovery from brain damage can take three

years

Inhalants

• Alkanes;– Methane, ethane, butane and propane

• Gasoline sniffing is common on some Native American reservations– Effects include insomnia, tremors, anorexia,

and sometimes paralysis– When leaded gas is inhaled, symptoms

include hallucinations, convulsions, and chronic irreversible effects of lead poisoning

• Alcohol inhalants include ethanol, methanol, isopropanol

Inhalants• Warning signs of solvent abuse include:

– Headaches– Chemical order on body, clothes or room– Red, glassy or watery eyes and dilated pupils– Inflamed nose and/or Nosebleed– Rashes around the nose and mouth– Slow, thick or slurred speech– Staggering gait, Disorientation, Lack of coordination– Pains in chest and stomach– Nausea & Fatigue– Shortness of breath– Loss of appetite– Intoxication– Irritability and aggression– Seizure & Coma

Inhalants

• Volatile Nitrites– Amyl Nitrate (1857)– Dilate blood vessels so heart and brain

receive more blood– Effects start in 7-10 seconds and last 30

seconds to 1 minute– One inhalation there is:

• a feeling of fullness in head, • Rush of mild euphoria• Dizziness• Giddiness• ,

Inhalants• Effects wear off, user experiences

– Headaches– Vomiting– Nausea– Chills

• Thought to enhance sexual activity• Sought by male homosexuals for their euphoric

and psychological effects• Viagra and methamphetamine combination can

dangerously lower blood pressure• Tolerance develops rapidly• Variants sold as room odorizer, tape head

cleaners and sneaker cleaners

Inhalants• Anesthetics

– Chloroform, Ether, Oxygen and nitrous oxide– Found to have euphoric effects as wells as anesthetic effects – Abused by young people, middle class, affluent groups like

doctors, anesthesiologists, hospital workers, and healthcare professionals

• Nitrous Oxide discovered in 1776– Immediately used as a recreational drug– Common abused form is whipping crème bottles– Source container is used to fill a balloon then inhaled– 7-10 seconds effects begin– Dizziness, giddiness and disorientation– Lasts 2-3 minutes– Long-term exposure can cause central and peripheral nerve

damage and brain cell damage due to lack of oxygen since nitrous oxide replaces oxygen in blood

Inhalants

• Halothane– Prescription surgical anesthetic gas (Fluothane)– Because of limited availability, abuse tends to be with

anesthesiologists and hospital personnel

• Dependence– DSM-IV-TR classifies inhalant disorders as inhalant

dependence and abuse, intoxication, induced delirium, dementia, psychotic disorder, mood disorder and anxiety disorder

• Breaking habit or treating compulsion difficult due to users being young and immature, combined with cognitive impairment that hinders comprehension and recovery


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SPORTS AND DRUGS• Three main categories of drugs:

– Therapeutic used for medical problems– Performance enhancing (ergogenic drugs) that are

mostly banned– Recreational or mood altering drugs

• History– Greek Olympic athletes ate large amounts of

mushrooms or meat to improve performance– 1800s cyclists, swimmers and other athletes used

morphine, opium, cocaine, caffeine, nitroglycerin, sugar cubes soaked in ether and low doses of strychnine

– Boxers drank water laced with cocaine between rounds

SPORTS AND DRUGS• During Cold War era, Soviet weightlifting team

used steroids in the 1952 Olympics initiating a “steroid race” for medals

• 1958 steroids were widely abused by athletes• Commercialization of sports pressured athletes

to improve their performance• 2001 estimates that 400,000 junior high and high

school students had tried steroids – High school athletes encouraged to use steroids to

bulk up and then go clean in college– Anabolic Steroids stunt bone development and disrupt

hormonal function in adolescents

SPORTS AND DRUGS• Therapeutic Drugs

– Used for medical problems– Four main groups: Anesthetics, Muscle relaxants,

Anti-inflammatory & Asthma medications

• Anesthetics– Used to deaden pain– Topical anesthetics desensitize nerve endings on skin – Most common are opioids, including:

• Vicodin (most prescribed), Demerol, Morphine, Codeine, Darvon

– Danger is the drugs block pain without repairing damage

– Compulsive use and dependence and result

SPORTS AND DRUGS• Muscle relaxants

– Depresses neural activity within skeletal muscles

– Used to treat muscle and ligament damage– Some athletes use relaxants to control anxiety– Abused occasionally for mental effects– Benzodiazepines are highly addictive, with

tolerance and tissue dependence

SPORTS AND DRUGS• Anti-inflammatory drugs

– Controls inflammation and lessen pain– Nonsteroid = aspirin, ibuprofen, butazoliden– Corticosteroids = cortisone & prednisone

• High doses cause severe psychosis

• Asthma medications– Affects 10% of population– Aggravated by heavy exercise– Exercise induced asthma found in 11-23% of athletes– Permission given to use certain asthma medications– Ephedra is banned due it stimulant quality

SPORTS AND DRUGS• Anabolic-androgenic steroids (AASs)

– Very broad category of drugs– Most are banned by Olympic Committee– Most abused performance enhancing drugs– Derived from male testosterone or are synthesized– Anabolic means “muscle building”– Androgenic means “producing masculine

characteristics.”– Clinically used to treat:

• testosterone deficiency• Osteoporosis, • Certain types of anemia• Breast cancer• Endometriosis


– Athletes use to:• Increase body weight• Lean muscle mass• Muscular strength• Increases aggressiveness and confidence

– Patterns of use• Steroid users may take 20-200 times the clinically

prescribed dose• Stacking: practice of taking 3 or more kinds of

inject able or oral steroids and alternating cycles of use and non-use

• ,


– Cycling means taking steroids for 4-18 weeks during intensive training, then stopping for weeks or months to give body a rest

• 82% who used steroids took 3 or more different types of steroids

• 30% took 7 or more during training


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Anabolic Steroid EffectsAnabolic Steroid EffectsIncreased muscle massIncreased muscle massIncreased confidence & Increased confidence &

aggressivenessaggressivenessMood elevationMood elevationAngerAngerTendon & bone damageTendon & bone damageCystic acneCystic acneMasculinizationMasculinization of womenof womenBreast enlargement in menBreast enlargement in menGenital size reductionGenital size reductionLiver cancerLiver cancer


– Side Effects• Increased masculinization• Increased muscle mass and muscle tone• Bloated appearance• Long-term use causes suppression of body’s own

natural testosterone• Long- term use in men causes feminine

characteristics– Swelling breasts– Nipple changes– Decreased size of sexual organs– Impairment in sexual function


– Side Effects Women• Gain in muscular development occur with masculinizing

effects, including• Increased facial hair• Decreased breast size• Lowered voice• Clitoral enlargement

• Mental & emotional effects– Confidence and aggressiveness– Emotional instability– Rage– Depression– psychosis


– Compulsive use and addiction• Initially feels a sense of euphoria and wellbeing that

contributes to continued use and compulsive use

– Studies show that steroids increase body mass and muscle strength when combined with diet and exercise

– Athletes obtain steroid from• Black market through gyms, mail order companies or friends• From doctors, veterinarians, or pharmacists• Serious users spend $200-$400 weekly• Some professional athletes spend $20,000-$30,000 year

SPORTS AND DRUGS• Other drugs used by athletes

– Stimulants like amphetamines, caffeine, – Ephedra and ephedrine (banned by NFL, IOC, and

NCAA, but not the NBA, NHL or major league baseball

– Chewing tobacco– Human growth hormone (HGH)

• Used by athletes to increase muscle strength and growth• Reduces fat• Increases muscle mass, skin thickness and connective

tissue• Gigantism and abnormal bone growth reported• Metabolic and endocrine disorders reported• Abuse associated with cardiovascular disease• Decreases life span by up to 20 years• Banned by U.S. Olympic Committee, NCAA• Difficulty to detect because it is found naturally in the body

SPORTS AND DRUGS• Recreational/mood-altering use of drugs

by athletes– Peer pressure– Help to fit in social situations– Help cope with heavy schedule– Reduce stress– Fill up time on long road trips

• Stimulants– Amphetamines, caffeine and tobacco

SPORTS AND DRUGS• Recreational/mood-altering use of drugs by

athletes– Sedatives-hypnotics

• Xanax, Barbiturates, Opioids taken as self-rewards• Used to unwind after competition• Counter-act use of stimulants

– Alcohol– Marijuana (NCAA bans use)

• Testing– NCAA uses two drug-testing programs

• One for all championships and post season football games


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OTHER ADDICTIONS• Compulsive behaviors

– Gambling, overeating, shopping, sexual behavior, Internet use and TV watching, compulsive lying, hair pulling, fire setting

– Impulsive control disorders• Failure to resist an impulse that is harmful to the

individual or others• Often starts off as being pleasurable• Increasing sense of tension or arousal before

actually committing the act• Often followed by gratification, pleasure, relief• Then remorse and guilt over the consequences of

the act


– Obsessive compulsive disorders• Excessive hand washing, checking things,

ordering, and counting• Repetitive activity whose goal is to reduce anxiety

or distress….not pleasure or gratification

– Addictive behaviors change brain chemistry in much the same way as psychoactive drugs

– People change their behaviors much like those who are recovery from alcohol or other drugs

– Many 12 Step groups are formed around compulsive behaviors


– Can be triggered by:• Genetic predisposition, • Environmental stresses

– Comfort and reassurance or escape provided by repetitive behaviors

– Increased dopamine levels suggest biochemical thread

– Twin studies show a connection between compulsive behaviors and heredity

– Compulsive over-eating shown to be partly hereditary

OTHER ADDICTIONS• Compulsive behaviors• Mid-1990s genetic connections between alcohol,

drug and compulsive behaviors shown• Genetic predisposition indicated a genetic

marker in the “reward deficiency syndrome” in severe cases of alcohol, drug and compulsive behaviors

• Researchers propose that carriers of the A1 allele gene have a deficiency of dopamine receptors in the reward/reinforcement center

Compulsive Gambling• Compulsive Gambling

– 125 million Americans gamble and of those, 2.2 million are pathological gamblers, and 5.3 million are problem gamblers

– 1.1 million are teenagers– Male compulsive gamblers outnumber

females 2 or 3 to 1– College students have a higher rate of

gambling– Gamblers anonymous formed in 1957


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Gambling, Alcohol Use, & Drug Use Among Adolescents 1999

Past year pathological gambling

Past year pathological or problem gambling

Alcohol use once per month or ever had alcohol problems

Past month marijuana use

Past month other drug use

10 List of the four phases that lead to compulsive gambling.• In the winning phase, gamblers are confident they can make a living

gambling.• In the losing phase, they start to chase their losses and gamble poorly.• In the desperation phase, their debts mount, they gamble foolishly and will

do anything to keep gambling.• In the giving up phase, they feel they can never win and all they want to do

is stay in action and will do anything to stay there. Mania, depression, and suicide thoughts are common.


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1. Winning phase 1. Winning phase

2. Losing phase2. Losing phase

3. Desperation phase 3. Desperation phase

4. Giving4. Giving--up phaseup phase

Compulsive Shopping (Oniomania)

• Compulsive Shopping (Oniomania)– Inability to handle money in a responsible manner is a

hall mark of almost any addict– Shopping addicts report relief from depression and

subsequent high when buying similar to a cocaine high

– Both result in a subsequent crash accompanied by depression and guilt than felt before buying

– More than 400 debtors Anonymous groups in U.S.– Depression seems a major part of compulsive

shopping


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Anorexia Anorexia nervosanervosa

Bulimia nervosaBulimia nervosa

BingeBinge--eating eating disorder disorder (includes (includes compulsive compulsive overeating)overeating)

Anorexia Nervosa• Eating Disorders

– Anorexia Nervosa addiction to weight loss, fasting and control of body size

• Maintains weight by limiting food intake through fasting, dieting, excessive exercise, use of amphetamines and other diet pills

• Bulimia symptoms appear in 30-80% of all anorexics• Have distorted perceptions of their body’s shape and size• Often feels overweight even when emaciated• Anorexics have a tendency to be concerned with following

directions and people pleasing• May be considered to be good girls, model students,

academically talented, but lack self-esteem.• Refusal to eat gives the anorexic sense of control over their

lives

Anorexia Nervosa

• Semi-starvation strains all the body systems, especially the heart, liver & brain– Death rates are 4-20%

• Most severely ill anorexics have to admitted to the hospital due to:– Extreme weight loss– Disturbed heart rhythms– Extreme depression– Often suicide ideation– Loss of menstruation – Takes 10-12 weeks for full nutritional recovery– Rate for full recovery is 40%– Prozac and other antidepressants help anorexics

improve eating behaviors

Bulimia Nervosa

• Characterized by eating large amounts of food in one sitting, followed by inappropriate methods of ridding self of food– Self-induced vomiting– Use of diuretics, laxatives, fasting and

excessive exercise– Often are ashamed of their behavior, doing it

in secret– During binge episodes, there may be a feeling

of frenzy, not feeling in control and sense of being disconnected from one’s surroundings

Bulimia Nervosa

• Causes include:– Social pressure to look thin– Socialization of girls to look thin– Biochemical changes that reward bingeing and

purging • Problems

– Dental complications and propensity towards alcohol and drug abuse

– High rate of depression– Greater risk of suicide– Risk of stomach acid burns to esophagus and throat

resulting in chronic sore throat and risk of cancer– Heart arrhythmias, electrolyte imbalances and

irregular or loss of menstruation

Binge Eating Disorder

• Marked by recurrent episodes of binge eating without vomiting, laxatives or other compensatory activities

• People eat in response to emotional states rather than hunger

• Used to modify emotions, especially anxiety, solitude, stress, and depression

• Generally overweight• May suffer from high cholesterol, diabetes, high

blood pressure, gall bladder disease, heart disease and high rates of depression

• Allows their self-esteem to suffer

Binge Eating Disorder

• Both physiological and psychological causes underlie the disorder

• Treatment is addressed through counseling, psychiatric treatment and behavioral therapy and self-help groups

• Diet pills that contain amphetamines are used for short-term periods

• Diet pills may work initially, but lose their effectiveness

SEXUAL ADDICTION

• Sexual behavior which the addict has little control over

• Practiced by males, females, gay, straight, young and old

• Includes masturbation, pornography, serial affairs, phone sex, visits to topless bars and strip shows

• Practiced as a way to cope with anxiety, solitude, low self-worth

• Can be the person’s all-consuming activity

INTERNET ADDICTION

• Survey of 18,000 people by ABC News found that almost 6% of participants met criteria for serious compulsive problem

• Symptoms include:– Logging in on every chance there is– Thinking about the internet constantly– Needing progressively more time online to get

same satisfaction– Losing track of time while online– Neglecting responsibilities– Checking email constantly

INTERNET ADDICTION

• Cybersexual addiction– Over 10 million internet users log onto 10

popular sex sites in 1 month

• Computer Relationship Addiction– Pursuit of online relationships to the neglect of

real-life relationships

uppers, downers and all arounders chapter 7 other drugs, other addictions

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