microsoft powerpoint - 18ph2drug1.ppt [compatibility mode]

7/25/2019 Microsoft PowerPoint - 18PH2drug1.Ppt [Compatibility Mode]

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PREVENTION ofDRUG USE and

DRUG USEDISORDERS

Renato M. Espinoza, MD, MHPEd

Dr Francisco Q. Duque Medical Foundation

Preventive Health and Community Medicine


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Goals and Objectives

To understand drug-related roble!s and t"eir

i!lications to co!!unit# "ealt" define ter!inologies$ diagnose drug-related roble!s

To beco!e effective "ealt" %or&ers in t"erevention of drug !isuse and associated disorders

discuss !ultilevel drug abuse reventive !easures

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Drug-relatedproblems are true

masquerades inclinical practice


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Important Facts T"e onset of drug use is !ost co!!on during t"e late

c"ild"ood and adolescent #ears. T"e onset of drug abuse and deendence is !uc" !ore

deendent on genetic variation in co!bination %it" secific

environ!ental factors.

Pro/i!al and distal biological$ s#c"ological$ social andenviron!ental recursors originating as earl# as t"e renatal

eriod la# a large role in %"et"er e/eri!entation occurs

and use ersists.

0or so!e individuals$ t"e initiation of drug !isuse and illicituse of drugs e/tends be#ond adolescence$ even in t"e late

adult"ood.


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PHARMACOLOGY OFDRUGS OF ABUSE 0our rocesses are i!ortant to t"e develo!ent

of drug abuse2 exposure

physical dependence

psychological dependence

tolerance

3n understanding of t"e "ar!acological

roerties of drugs is essential to t"e

understanding of drug abuse and deendence and"ence t"e design of revention interventions.


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Important processes in

Drug Ause an!Drug Depen!ence

"# E$posure - ti!ing and fa!ilial(genetic suscetibilit#

%# P&'sica( !epen!ence - adative state t"at !anifests itself

as intense "#sical disturbance %"en drug use is susended

)# Ps'c&o(ogica( !epen!ence - addiction$ condition under

%"ic" t"ere is a drive to%ard eriodic or continuous

ad!inistration of t"e drug to roduce leasure or avoid

disco!fort

*# +o(erance - t"e need for increasingl# "ig"er doses of a

drug to recature t"e original effects of t"e drug


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Drug 3buse andDrug Deendence Processes o, ause an! !epen!ence re,(ect c&aracteristics o,

t&e !rug- t&e in!i.i!ua( user an! t&e conte$t o, use# Among t&e goa(s o, ps'c&op&armaco(og'- epi!emio(og' an!

etio(og' researc& is to gain a etter un!erstan!ing o, t&e

processes imp(icate! in t&e !e.e(opment o, !epen!ence ase!

on t&e !rug- t&e user an! t&eir interactions /it& one anot&er#

+&e more rein,orcing t&e !rug is t&e more (i0e(' t&e in!i.i!ua(

/i(( see0 t&e !rug an! ause it# +&is is ca((e! abuse liabilityo,

t&e !rug#

Drug ause ma' resu(t ,rom one e$posure on('#

e$amp(e1 binge drinking on t&e ,irst occasion o, a(co&o( use

or !ri.ing a .e&ic(e under the influence of an illicit drug#


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6o!!onl#-abusedGrou of DrugsCannabinoids

Depressants

Dissociative Anesthetics

Hallucinogens

Opioids and Morphine Derivatives

Stimulants

Inhalants

Anabolic Steroids

Overthecounter !O"C# Drugs


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cannabinoids fro! t"e flo%ering to of t"e "e! lant

!ore t"an ,* cannabinoids "ave been isolated delta-7-T86 "as been identified as t"e constituent

resonsible for !ost of t"e c"aracteristic effectssuc" as cognition$ !e!or# and !ood disorders$

!otor incoordination$ errors in ercetion$disorder in t"e sense of ti!e$ feelings of rela/ationand %ell-being$ increased "eart rate$ differentiall#altering standing and suine 9P

%it"dra%al s#!to!s2 irritabilit#$ restlessness$nervousness$ decreased aetite$ %eig"t loss street na!es2 "as"$ resin$ :;$ 3caulco gold$ ot..


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depressants A# ariturates

S&are se!ati.e an! &'pnotic properties

Use! me!ica((' to pro!uce !ro/siness- s(eep- musc(e re(a$ation an! topre.ent con.u(sions

Ha.e anest&etic e,,ects

Dose2!epen!ent e,,ects on re(a$ation- se!ation- &'pnosis an! stupor

B# en3o!ia3epines Hig& an$io('tic propert' an! (o/ C4S !epressant properties

Re(ie.e an$iet' s'mptoms Less impaire! respirator'- cogniti.e- attention an! motor ,unctions

In genera(- !epressants &a.e comp(e$ e,,ects#

+o(erance ,or an! Depen!ence on t&e .arious !rugs o, t&is c(ass

genera(i3e /it&in t&e c(ass an! across c(asses to some opiates an!a(co&o(- ca((e! cross tolerance or cross dependence


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dissociative anesthetics Inc(u!es PCP5p&enc'c(ine6- 7etamine an!

De$tromet&orp&an

PCP De.e(ope! in t&e "89:s as I; genera( anest&etic ,or anima(s Se!ati.e an! anest&etic e,,ects are trance2(i0e

Patients e$perience a ,ee(ing o, out o, o!'

Distorte! perception o, sig&t an! soun!

Fee(ings o, !etac&ment or !issociation ,rom t&e en.ironment

an! se(, 5 not &a((ucinations 6 Mec& o, action1 a(tering t&e !istriution o, t&e

neurotransmitter GLU+AMA+E t&roug&out t&e rain

G(utamate is in.o(.e! in t&e perception o, pain responses toen.ironment an! memor'

7E+AMI4E De.e(ope! in "8ui! ,orm

E.aporate! into an o!or(ess an! taste(ess po/!er an! it is

use! as !ate rape !rug


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hallucinogens No accetable !edical use

Includes2 !escaline$ silocin and


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opioids and morphine Effects2 analgesia$ sedation$ eu"oria

:ec" of action2 sti!ulation of t"e "ig"er centersof t"e brain and slo% do%n t"e activit# of t"e 6NS

Oiod refers to t"e natural drugs roduced fro!

t"e oiu! o# suc" as oiu!$ !or"ine and

codeine

Se!i-s#nt"etic oiates2 "eroine and !et"adone

:edical uses2 ain !anage!ent$ diarr"ea$ coug"

T"ese grou of drugs are "ig"l# addictive


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stimulants E/citator# in recognition of t"eir !ain effects in t"e 6NS

Increases t"e levels of doa!ine and decreases in"ibitor#neurotrans!itter

Includes cocaine$ a!"eta!ines$ and !et"#l"enidate

In lo% doses$ are associated %it" feelings of increasedalertness$ eu"oria$ vigor$ !otor activit#$ and aetite

suression 3t "ig" doses$ t"e# roduce convulsions$ c"anges in t"oug"t

c"aracteri=ed on continuu! fro! "#er-vigilance to susicionto aranoia$ a!"eta!ine and cocaine induced s#c"oses$aranoid ideation$ or to/ic cardiovascular s#!to!s

6ocaine$ %"en co!bined %it" alco"ol$ roduces t"e let"alcocaethylene.


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inhalants Di.erse group o, c&emica(s t&at easi(' e.aporates E$amp(es1 aeroso(s- gases- &'!rocaron in&a(ants suc& as

so(.ents- gaso(ine an! paint t&inner

?&en .apors are in&a(e! an! e$&a(e! air is rereat&e!-

into$ication is pro!uce!# ;apors o, (i>ui! so(.ents can e sni,,e!!irect(' ,rom a container- ma' e poure! on a rag an! &e(! o.ert&e mout&- or ma' e emptie! into a rag t&at is &e(! o.er t&emout& an! nose ,or in&a(ation

Mec& o, action1 in&a(e! .apors enter t&e (oo!stream rapi!('an! are !istriute! to (i.er an! rain an! are asore! >uic0('

into t&e C4S !epressing man' o!i(' ,unctions Genera((' t&e' are categori3e! as C4S !epressants# In mo!erate

!oses- t&e' pro!uce simi(ar e,,ects to t&at cause! ' a(co&o(1

Gi!!iness- Disin&iition an! Musc(e ?ea0ness

Lac0 o, Coor!ination- S(o/e! Re,(e$es an! S(urre!

Speec& Hig& !oses can cause se.ere reat&ing ,ai(ure an! !eat&

C&ronic ause (ea! to irre.ersi(e (i.er or rain !amage an!ot&er &ea(t& pro(ems#


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over-the-counter (OTC) drugs Include variet# of rearations %it" %"ic" eole self

treat for !inor ail!ents fro! t"e co!!on cold to ainrelief or to i!rove erfor!ance in so!e %a#

E/a!les2 sti!ulants$ slee en"ancers$ %eig"t controlroducts

:ost of t"ese roducts co!e in co!bination of drugst"at interact %it" one anot"er to roduce t"e !ost

ositive effect If ta&en as directed$ t"e# are relativel# safe


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other compounds 3re grou of drugs t"at do not fall into t"e

above categories

E/a!les2 anabolic steroids$ !ale se/"or!ones

:edical uses2 Dela#ed ubert#$ %"en t"e bod# roduce ver# lo%

a!ounts of testosterone Treating bod# %asting in 3IDS and related diseases

8ealt" conse>uences associated %it" abuse2 Reduced ser! roduction$ s"rin&ing of t"e testicles$

i!otence$ difficult# and ainful urination$ baldnessand irreversible breast enlarge!ent in !ales

Develo!ent of !asculine c"aracteristics li&edecreased bod# fat and breast si=e$ deeening of t"evoice$ e/cessive bod# "air$ and loss of scal "air infe!ales


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other compounds Anao(ic steroi!s are in=ecte!- ta0en ora((' or are rue! into

t&e s0in in an ointment ,orm

+&e use o, t&ese sustances are /i!esprea! among at&(etesmoti.ate! ' t&e !esire to ui(! musc(e an! impro.eper,ormance

Most ausers ta0e !oses o, up to "::$ greater t&an at&erapeutic !ose

Hea(t& conse>uences associate! /it& ause1

For a!o(escents o, ot& gen!ers- ause can resu(t intermination o, t&e gro/t& spurt t&us permanent('stunting gro/t&

Ot&er se.ere &ea(t&- socia(- an! ps'c&o(ogica(conse>uences occur ,or ausers o, ot& gen!ers at a((ages- inc(u!e1

C(otting

Li.er c'sts an! cancer

C&o(estero( c&anges Heig&tene! aggression

Depresse! moo!

Insomnia

Loss o, appetite

Musc(e an! =oint pains


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Su!!ar# of 8all!ar&sAmp&etamines5inc(u!ingmet&amp&etamines6

Aggressi.e or o.eracti.e

e&a.ior- gigg(ing- si((iness-eup&oria- rapi! speec&-con,use! t&in0ing- no appetite-e$treme ,atigue- !r' mout&-s&a0iness

@ars o, pi((s o,

.ar'ing co(ors-c&ain smo0ing

H'pertension- !eat&

,rom o.er!ose-&a((ucinations-met&amp&etaminescause temporar'ps'c&osis

9arbiturates Dro%siness$ stuor$ dullness$slurred seec"$ drun&

aearance$ vo!iting

Pills of various

colors

Deat" fro! overdose or as

a result fro! %it"dra%al

addictions$ convulsions

6annabis(:arijuan

a

Initial eu"oria$ floating feeling$

sleeiness$ let"arg#$ %andering!ind$ enlarged uils$ lac& of

coordination$ craving for s%eets$

c"anges of aetite$ !e!or#

difficult#

Strong odor of burnt

leaves$ s!all seedsin oc&et lining$

cigarette aer$

discolored fingers

Induce!ent to ta&e

stronger narcotics$ recent!edical findings reveal

t"at rolonged usage

causes cognitive defects

Ecstac#?!et"#lenedio/#-

!et"a!"eta!ine@

3n/iet#$ anic$ s%eating$ loving

feelings$ ja% clenc"ing$ teet"

grinding$ bi=arre overactive

be"avior$ "allucinations$

increased "eart rate$ 9P and

bod# te!erature$ feelings of

confidence$ "ainess and love

S!all tablets of

various colors$

s"aes$ si=es and

designs$ also co!es

in casule or

o%der

6onvulsions$ ris& of deat"

fro! "eart attac&$

cerebral "e!orr"age$

"#ert"er!ia$ fluid

i!balance %it"

"#onatre!ia$ acute

&idne# failure$ DI6$ liver

to/icit#


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Fantas' 5gamma

&'!ro$'ut'rate6

Re(a$ation an!

!ro/siness- !i33iness-re(a$e!in&iitioneup&oria-increase! se$ua(arousa(- impaire!

moi(itu' an! speec&

Co(or(ess

(i>ui!A(so po/!eran! capsu(es

+remors an!

s&a0ing- amnesia-coma- con.u(sions-!ea& ,rom &ig&!oses

Glue sniffing 3ggression and

violence$ drun&

aearance$ slurred

seec"$ drea!# or

blan& e/ression

Tubes of glue$

glue s!ears$

large aer or

lastic bags or

"and&erc"iefs

uid

Suicidal tendencies$

unredictable

be"avior$ c"ronic

e/osure causesbrain da!age$


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Narcotics

a6 Opioi!s5&eroin6

Stupor!ro/siness-mar0s on o!'-/ater' e'es- (oss o,appetite- runningnose- narro/e!

pupi(s- (oss o, se$!ri.e

4ee!(e or&'po!ermics'ringe- cotton-tourni>uet# string-rope- e(t- urnt

ott(e- caps orspoons- (oo!stainon s&irt s(ee.es-g(ass in en.e(opes

Deat& ,rom o.er!ose-menta( !eterioration-!estruction o, rainan! (i.er- &epatitis-emo(isms

9@ 6ocaine Si!ilar effects to

a!"eta!ines

?!uscle ains$

irritabilit#$ aranoia$

"#eractivit#$ jer!ove!ents

eu"oria$ dilated

uils

Po%der2 in

!icro%ave ovensA

in"aled or injected

8allucinations$ deat"

fro! overdose

Bsudden deat" fro!

arr"#t"!ias$ sei=ures$

!ental disorders$severe resirator#

roble!s

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STREET DRUG DICTIONARY

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AMPHETAMINES (uppers)

Ben3e!rineDe$e!rineMet&e!rineDrinam'(

Roses- eanies- peac&esDe$ies- spee!- &earts- pep pi((s- ,ast- go2ee- uppersMet&- cr'sta(s- /&ite (ig&t- ice- /&i3Purp(e &earts- goo, a((s

AMPHETAMINEDERIVATIVES

Ecstac#

6rac&

6ran&

E$ eggs$ ec&ies$ CT6$ t"e love drug$ !itsubis"is$ :D:3$ vita!in E$

C$ 3da!$ deat"

6rac&$ slit$ base(sace base ?%it" "enc#clidine@

6r#stal :$ cran&

HALLUCINOGENS


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NARCOTICSMorp&ine

Heroin

Cocaine

H C

Mor&- Miss- Emma

H- ig H- Harr'- GOM 5Go!s o/n me!icine6- crap- =un0-&orse !'namite5&ig&2gra!e &eroine6- (emona!e5(o/2gra!e

&eroine6- In=ection o, !isso(.e! po/!er1 mainlining$blast$ smack$In&a(ation o, po/!er1 sniffing

Co0e- sno/- (a!' o, t&e streets- nose can!'- ICE- snort

Spee! a((s

MISCELLANEO

US

0antas#

9arbiturates9en=odia=eines

Feta!ine

Solvents

G98 ?grievous bodil# "ar!@$ li>uid G$ li>uid ecstac#$ li>uid C

Devils barbies$ goof balls

Ro%ies$ !oggiesF. Vita!in F$ secial F$ F "ole

6"ro!ing

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EPIDEMIOLOGY OFDRUG USE

Understanding t"e nature$ e/tent and atterns of

use and abuse of s#c"oactive drugs andco!ounds is a necessar# rere>uisite to t"e

develo!ent of efficacious and effective

revention interventions.

Understanding t"e causal factors t"at lead to

e/osure$ initiation$ rogression$ and !aintenance

of drug abuse is funda!ental to t"e advance!entof revention strategies.


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ETIO


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ETIO


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MACROSYSTEM

ATTITUDES AND IDEOLOGIES OF THE CULTURE

EXOSYSTEM EXTENDED

FAMILY

NEIGHBORS

FRIENDS

OF FAMILY

LEGAL

SERVICES

MASS

MEDIA

SOCIAL WELFARE

SERVICES

MESOSYSTEM

FAMILY

MICROSYSTEM

SCHOOL

PEERSHEALTH

SERVICES

NEIGHBORHOOD

PLAY AREA

DAYCARE CENTER

CHURCH

GROUP

CHILDCHILDCHILDCHILD

BRONFENBRENNERBRONFENBRENNERBRONFENBRENNERBRONFENBRENNERS FOUR ECOLOGICALS FOUR ECOLOGICALS FOUR ECOLOGICALS FOUR ECOLOGICAL

SETTINGS FOR DEVELOPMENTAL CHANGESSETTINGS FOR DEVELOPMENTAL CHANGESSETTINGS FOR DEVELOPMENTAL CHANGESSETTINGS FOR DEVELOPMENTAL CHANGES


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T8EORETI63

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