Faculty Meeting Presentation

Prescription Drug, Over the Counter Drug and Inhalant Abuse

Kelly Sullivan Ruta, SAC, LCSW Student Assistance Counselor

What Is in Your Medicine Cabinet ?

November 26, 2007 PRESCRIPTION DRUGS

Prescription drugs are on the list of most abused drugs, right behind marijuana. Even more unsettling is the fact that one-third of new non-medical prescription drug users in 2005 were 12- to 17-year-olds; girls are more likely to have abused prescription drugs than boys.

DEPRESSANTS  often prescribed by doctors to treat a variety of health conditions including anxiety and panic attacks, tension, acute stress reactions, and sleep disorders.  Examples include: o Barbiturates are a type of depressant often prescribed to promote sleep (Amytal, Nembutal, Seconal, Phenobarbital) o Benzodiazepines are a type of depressant prescribed to relieve anxiety (Ativan, Halcion, Librium, Valium, Xanax)

STIMULANTS  often prescribed to treat asthma, respiratory problems, obesity, attention deficit/hyperactivity disorder and sleep disorders like narcolepsy.  Examples include: o Amphetamines and Dextroamphetamine (Dexedrine, Adderall) are stimulant drugs whose effects are similar to cocaine. o Methylphenidate (Ritalin) is a central nervous system stimulant. It has effects similar to, but more potent than, caffeine and less potent than amphetamines.

PAIN KILLERS  Opioids, or painkillers, are drugs that contain opium or are derived and imitate opium and are commonly prescribed for pain relief  Morphine derivatives (narcotics) come from opioids and are used to therapeutically treat pain, suppress cough, alleviate diarrhea, and induce anesthesia  abusers experience a general sense of well-being by reduced tension, anxiety, and aggression  Examples include: Codeine, Fentanyl, Morphine, Vicodin, OxyContin, Percocet, and Percodan, Demerol, Dilaudid, Lorcet, Darvon, Darvocet OVER THE COUNTER DRUGS (OTC)

DXM Dextromethorphan:  DXM is a synthetic drug that is chemically similar to morphine and has been added to cough syrups and some cold medications since the 1970’s  Cold medicines such as Robitussin, Nyquil, Vicks Formula 44, and Coricidin HBP Cough and Cold tablets contain the active ingredient called DXM, which is found in more than 120 non-prescription cough and cold medications. DXM, when taken in high dosages, can give a “high” feeling and is frequently abused by teens today.  Teenagers have various nicknames for DXM including: Robo, Skittles, Triple C’s, Dex, Vitamin D, and Tussin. Coricidin HBP Cough and Cold tablets contain much more potent doses of DXM than cough syrups, so the kids don’t need to drink a whole bottle of cough syrup. Recreational users intentionally exceed suggested doses to experience a sense of heightened perceptual awareness, altered time perception, and/or visual hallucinations. P seudoephedrine  Pseudoephedrine is used to relieve nasal discomfort caused by colds, allergies, and hay fever. It is also used to relieve sinus congestion and pressure. Common cold products including, but not limited to Sudafed®, Tylenol® Cold, Advil® Cold, Drixoral®, Benadryl® Allergy & Cold Tablets, Robitussin® Cold Sinus & Congestion, as well as many generic brands.  It is the key ingredient in the clandestine manufacturing of illicit methamphetamines so is now behind the counter and limited quantities are sold to prohibit “smurfing or shelf sweeping”.

Dramamine  Users report that in fifteen minutes to an hour, the drug begins to have an effect, which includes hallucinations and a confusing "high". The psychological effects are often described as "dreaming while awake", involving visual and auditory hallucinations that are distinctly different from those experienced with other psychedelic drugs.

Sleeping pills: Tylenol PM, Advil PM, Sominex

NyQuil and Mouthwash: for alcohol content

HUFFING

 Inhalant abuse, or “huffing,” is on the rise. Huffing is a term meaning the intentional inhaling of a chemical, often some household product, to achieve an intoxication effect.  Inhalants are common household products such as shoe polish, glue, aerosol air fresheners, hair sprays, nail polish, paint solvents, degreasers, gasoline or lighter fluids, computer dusters & furniture polish.  Whippets (Nitrous oxide), commonly called laughing gas, was the first inhalant used for recreational purposes. Introduced as an anesthetic in the 1850’s, this compound of nitrogen and oxygen is still used medicinally, particularly by dentists. It doesn’t completely block pain, but it does alter the perception of pain, so that there is no distress. Nitrous oxide tends to produce a pleasant, dreamy state of consciousness, somewhere between waking and sleep.  Inhalants produce an effect that may be similar to alcohol intoxication. Initial symptoms described by abusers who were "huffing" include drowsiness, lightheadedness, and loss of inhibition. Further use can lead to dizziness, hallucinations or delusions, belligerence, apathy, and impaired judgment.  Sudden cardiac death from fatal cardiac arrhythmias has been reported even in teen inhalant abusers. Death from huffing can occur upon the first time of use, or after prolonged inhalant abuse. Other causes of death include asphyxiation, aspiration, or suffocation.  Chronic inhalant abuse may result in serious and sometimes irreversible damage to the user's heart, liver, kidneys, lungs, and brain. Brain damage may result in personality changes, diminished cognitive functioning, memory impairment, and slurred speech.  An average of 598,000 youth ages 12-17 initiated inhalant use in the past 12 months, based on data from 2002-2004, according to a new report by the Substance Abuse and Mental Health Services Administration (SAMHSA). This is 1.8 million new initiates to inhalants in three years.

American Drug Council for Education SIGNS AND SYMPTOMS OF DRUG USE

It is important to keep in mind that if a child shows any of the following symptoms, it does not necessarily mean that he or she is using drugs. The presence of some of these behaviors could be the product of adolescent stress. Others may be symptoms of depression or a host of other problems. Whatever the cause, they may warrant attention, especially if they persist or if they occur in a cluster. A mental health professional or a caring and concerned adult may help a youngster successfully overcome a crisis and develop more effective coping skills, often preventing further problems.

The key is change; it is important to watch for any significant changes in your child's physical appearance, personality, attitude or behavior.

Physical Signs

 Loss of appetite, increase in appetite, any changes in eating habits, unexplained weight loss or gain.  Slowed or staggering walk; poor physical coordination.  Inability to sleep, awake at unusual times, unusual laziness.  Red, watery eyes; pupils larger or smaller than usual; blank stare.  Cold, sweaty palms; shaking hands.  Puffy face, blushing or paleness.  Smell of substance on breath, body or clothes.  Extreme hyperactivity; excessive talkativeness.  Runny nose; hacking cough.  Needle marks on lower arm, leg or bottom of feet.  Nausea, vomiting or excessive sweating.  Tremors or shakes of hands, feet or head.  Irregular heartbeat. Behavioral Signs

 Change in overall attitude/personality with no other identifiable cause.  Changes in friends; new hang-outs; sudden avoidance of old crowd; doesn't want to talk about new friends; friends are known drug users.  Change in activities or hobbies.  Drop in grades at school or performance at work; skips school or is late for school.  Change in habits at home; loss of interest in family and family activities.  Difficulty in paying attention; forgetfulness.  General lack of motivation, energy, self-esteem, "I don't care" attitude.  Sudden oversensitivity, temper tantrums, or resentful behavior.  Moodiness, irritability, or nervousness.  Silliness or giddiness.  Paranoia  Excessive need for privacy; unreachable.  Secretive or suspicious behavior.  Car accidents.  Chronic dishonesty.  Unexplained need for money, stealing money or items.  Change in personal grooming habits.  Possession of drug paraphernalia.

Drug Specific Symptoms:

Marijuana: Glassy, red eyes; loud talking and inappropriate laughter followed by sleepiness; a sweet burnt scent; loss of interest, motivation; weight gain or loss.

Alcohol: Clumsiness; difficulty walking; slurred speech; sleepiness; poor judgment; dilated pupils; possession of a false ID card.

Depressants: (including barbiturates and tranquilizers) Seems drunk as if from alcohol but without the associated odor of alcohol; difficulty concentrating; clumsiness; poor judgment; slurred speech; sleepiness; and contracted pupils.

Stimulants: Hyperactivity; euphoria; irritability; anxiety; excessive talking followed by depression or excessive sleeping at odd times; may go long periods of time without eating or sleeping; dilated pupils; weight loss; dry mouth and nose.

Inhalants: (Glues, aerosols, and vapors ) Watery eyes; impaired vision, memory and thought; secretions from the nose or rashes around the nose and mouth; headaches and nausea; appearance of intoxication; drowsiness; poor muscle control; changes in appetite; anxiety; irritability; an unusual number of spray cans in the trash.

Hallucinogens: Dilated pupils; bizarre and irrational behavior including paranoia, aggression, hallucinations; mood swings; detachment from people; absorption with self or other objects, slurred speech; confusion.

Heroin: Needle marks; sleeping at unusual times; sweating; vomiting; coughing and sniffling; twitching; loss of appetite; contracted pupils; no response of pupils to light.

Tobacco/Nicotine: Smell of tobacco; stained fingers or teeth.