Prison staff and harm reductionCore module session 1

Training Criminal Justice Professionalsin Harm Reduction Services for Vulnerable Groups

funded by the

European Commissions Directorate General for Health and Consumers

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Activity:True and false statements on drugsOverview on drugs

Session 1

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Activity:True and false statements on drugsTrue and false statements on drugs

Activity

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Lecture on drugs

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What is a drug?

WHO definition:

"..any substance that, when taken into a living organism, may modify its perception, mood, cognition behaviour or motor function.“

(WHO,1993)

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Why do people take drugs?

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How are drugs taken?

Swallowed (e.g. in the form of pills or liquids like alcohol)

Inhaled (e.g. smoking tobacco or marihuana)

Snorted (e.g. cocaine)

Injected (e.g. heroin)

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Effects of drugs

What kind of drug is used

The amount used

The way the drug is used (e.g. taken orally, smoked etc.)

Personal characteristics like sex, weight, age and psychological state

The social setting in which the drugs are used

Previous experience with the drug

The effect a particular drug has depends on various factors like:

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Drug dependence

Strong desire and sense of compulsion to take the drug(s)

Difficulties in controlling substance-taking behaviour Withdrawal symptoms upon cessation Development of a “tolerance” Highest priority of drug use Persistent use despite other harmful consequences

Symptoms of drug dependence

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Drug withdrawal

Withdrawal symptoms include:

Chills Nausea Diarrhoea Muscle cramps Mood swings Psychoses

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Underlying factors of drug use

Drug dependence is a complex behavioural disorder that is influenced by biological, psychological and sociological factors

Drug dependence is a chronic relapsing disease

Psychiatric diseases often underlie drug use Over 50% of those with a substance use disorder are found to

have a co-occurring mental health disorder

(Regier et al., 1990)

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Alcohol I.

Most commonly used drug in the world

Effects: talkativeness, reduced inhibition, amnesia, semi- and unconsciousness, fatal overdoses

Chronic heavy consumption can lead to negative and fatal health consequences (e.g. liver cirrhosis)

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Alcohol II.

Critical is a regular consumption of more than 40 grams of pure alcohol per day for men

(=1 litre of beer)

more than 20 grams of pure alcohol per day for women (=half a litre of beer)

(WHO, 2000)

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Tobacco

Belongs to the most widely used drugs in the world

Desired effects: increased arousal and attentiveness, suppressed appetite

Associated with a wide range of health problems (diseases of the breathing system, heart diseases and cancer)

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Cannabis

Third most popular drug in developed countries

Usually smoked or taken orally

Consumed in the form of marihuana or hashish

Possible effects: euphoria, relaxation, perceptual distortion, increased appetite, cognitive and psychomotor impairment, anxiety and paranoia

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Amphetamines and Methamphetamines

Belong to the central nervous system stimulants

Street names: “speed”, “crystal”, “ice”

Either orally ingested, snorted, smoked or injected

Symptoms include: increased breathing and heart rate, raised blood pressure, dilated pupils

Adverse effects: irregular heartbeat, loss of coordination, collapse

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Ecstasy

Belongs to the central nervous stimulants

Usually orally ingested (rarely snorted, smoked or injected)

Desired effects: euphoria, increased sensory awareness

Adverse effects: irregular heartbeat, loss of coordination, collapse, body overheating

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Cocaine

Belongs to the central nervous system stimulants

Cocaine is usually snorted; crack (a highly potent derivative of cocaine) is smoked

Effects: severe mood swings including euphoria, dysphoria and in extreme cases cocaine psychosis and heart problems

Cocaine is highly addictive

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LSD and other hallucinogens

“Magic mushrooms”, LSD

Mind altering, psychedelic drug

Desired effects: perceptual distortion of time and place, visual hallucinations and synaesthesia (sounds are seen, colours are heard)

Adverse effects: dizziness, disorientation, anxiety, depression and flashbacks

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Benzodiazepines

Belong to the sedative-hypnotics

In low doses help against anxiety; in high doses effect sedation and sleep

Legal prescription drug (Valium) appearing on the illegal market

Benzodiazepines are swallowed or injected

Alcohol increases their effect

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Opioids

Opioids are central nervous system depressants

Therapeutically used as pain killer

Heroin is a relatively potent opioid, quickly passing the blood-brain barrier

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Heroin I.

Either injected, snorted or smoked

Desired effects: drowsiness, euphoria, reduced anxiety and/ or pain

Adverse effects: lowered breathing, sedation, dependence and overdoses

Associated to far more accidental overdoses and fatal poisonings than any other scheduled substance

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Heroin II.

Heroin dependence is a chronic, relapsing disease

Causes strong psychic and physical withdrawal symptoms

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Poly-drug use

“The use of more than one drug or type of drug at the same time or sequentially”

Health risks of poly-drug use differ depending on the combination of drugs