ž They like what the do to their ž They want to change something about their lives ž CNS ž CNS ž ž Mind Altering Drugs ž ž ž ž Oxycontin ž ž GHB (gamma hydroxylbuteric ) ž (rohypnol, xanax,…) ž Alcohol is the MOST ABUSED ž Alcohol is a Central (CNS) ž Alcohol is considered to be a gateway drug to other drug use.

ž Barbiturates are prescription or tranquilizers ž Barbiturates are multi-colored pills and tablets and are depressants (CNS) ž Barbiturates cause drowsiness

Nembutal () ž Sleepers Mebaral (mephobarbital) Amytal Sodium ž Barbs ( sodium) ž Red Devils Butisol ( sodium) ž Rainbows Seconal Sodium Pulvules ž Downers ( sodium

ž Probably one of the most abused prescription drugs •

Opiates are drugs that are derived from the and are The most common opiates are: Central Nervous System (CNS) depressants.

• Smack • Chiva • Poppy • Flower • Hazel • Morf

Opiates are known by several different names: ž Snorted – Because of the high potency of heroin today, more and more users are snorting the drug. ž Smoked – The method of choice for opium is the tar like substance. Other opiates are often smoked on top of marijuana. This is known as “snow capping”. ž Injected – Injecting opiates, specifically heroin, is still the choice ingestion method. Many addicts choose to inject the drug because of the quick and powerful onset of the effects. Users can inject the drug directly into the stream or the muscle tissue. ž Eaten – All opiates can be consumed orally. Many prescription killers on the market today are opiates. Snorted – Because of the high potency of heroin today, more and more users are snorting the drug. Smoked – The method of choice for opium is smoking the tar like substance. Other opiates are often smoked on top of marijuana. This is known as “snow capping”. Injected – Injecting opiates, specifically heroin, is still the choice ingestion method. Many addicts choose to inject the drug because of the quick and powerful onset of the effects. Users can inject the drug directly into the blood stream or the muscle tissue Eaten – All opiates can be consumed orally. Many prescription pain killers on the market today are opiates.

¹ Oxycontin is a synthetic opium derivative that is available by prescription.

¹ Oxycontin is an extremely potent pain killer that comes in release tablets that last for up to twelve hours.

¹ Oxycontin is prescribed to cancer patients and suffers to help in managing pain.

± Ketamine, or ketamine hydrochloride, is a Central Nervous System (CNS) Depressant and a , or a drug that separates perception from sensation.

± Ketamine is used primarily as an anesthetic in veterinary medicine, but is also sometimes used with small children and elderly.

± Ketamine can be found as a clear white liquid or as a white powder Ketamine can be ingested several different ways: Injected Snorted Smoked Orally-In a pill or liquid form

Ketamine is also called: K Kit Kat Special K Super Acid

© GHB, or Gamma Hydroxylbuteric acid, is a central nervous system (CNS) depressant that sometimes causes .

© GHB is usually found as a clear liquid with a slightly salty taste, but can also be found as a small tablet or capsule, all of which dissolve quickly in liquid.

© GHB usually is sold by capful or teaspoon, also known as a “dose”. Date Drug ² Rohypnol (chemical name – fluritzrazepam) is a CNS Depressant that is more than ten as strong as Valium.

² Rohypnol belongs to the benzodiazepines family, which also includes drugs such as Valium, Librium, and Xanax.

² Rohypnol is known as a “ Drug” due to its association with sexual assaults.

² Rohypnol is almost always ingested orally in either the pill form or dissolved in a beverage, but is sometimes ground up and snorted.

ž ž ž ž , , energy drinks CNS STIMULANTS – Drugs that increase the chemical and electrical activity of the Central Nervous System (CNS) and make the user more alert, active, anxious, restless and, in general, more stimulated than normal. – Amphetamines are generally a white or off- white powder that can be ingested orally, snorted, or injected.

– Amphetamines are powerful stimulants that increase activity in the Central Nervous System (CNS), or speed up the way the body works.

– Amphetamines are drugs that induce false feelings of power, strength, self-assertion and enhanced i is a powerful, synthetic Central Nervous System (CNS) . i Methamphetamine is generally a white or off- white powder that can be ingested several different ways: ë Orally – In a pill form ë Snorted – This can cause severe damage to the interior and exterior of the nose. ë Intravenously - The methamphetamine can be injected into either the blood stream or the muscle tissue ë Smoked – Methamphetamine is sometimes smoked by itself or on top of marijuana

ž Cocaine is a powerfully addictive stimulant drug made from the leaves of the plant native to South America ž It produces short-term , energy, and talkativeness in addition to potentially dangerous physical effects like raising rate and . ž High is quick but doesn’t last long, so people use over and over in short periods of time ž Crack is a form of cocaine that has been processed to make a rock crystal (also called “freebase cocaine”) that can be smoked. The crystal is heated to produce vapors that are absorbed into the blood-stream through the lungs. (The term “crack” refers to the crackling sound produced by the rock as it is heated.) ž LSD ž ž PCP i LSD is hallucinogenic chemical that is derived from a parasitic fungus that grows on rye. i LSD is produced as a crystal, then dissolved in alcohol prior to sale and consumption. i LSD users describe their experience with the drug as a “trip”. i LSD has become known as:

Acid Trips Hits Blotter ž LSD is generally taken orally, either as a pill, a piece of blotter paper, or via liquid dripped onto a sugar cube. LSD can also be absorbed through the users skin. i Mushrooms that contain are known as ‘magic mushrooms’ as they contain hallucinogenic properties. i Magic mushrooms have been used by several cultures to induce altered states of consciousness during their religious rituals. i Mushrooms can be consumed in a variety of manners: i Eaten – Either raw or cooked, much like non- hallucinogenic mushrooms. i Drank – Heated with water to make a or soup. i Smoked – The is ground into a fine powder and often smoked on top of marijuana ¤ PCP is classified as a and a dissociative anesthetic, or drug that separates perception from sensation. ¤ PCP comes in several forms:

Ø Crystalline Powder

Ø Colored Powder

Ø Diluted in Water

Ø Pills

Ø Capsules

¤ PCP is also known as: v Angel Dust Sherm v Boat Dust ž THC (Marihuana, hash, …) so called weed, grass, dope, …. ž (ether, glue…) MIND ALTERING DRUGS – Drugs that cannot be classified into any single category. Mind altering drugs can contain CNS depressant, CNS stimulant, and/or hallucinogenic properties*. ¥ Inhalants are ingested into the body by breathing in the vapors of the product. Several methods of inhalation are used by abusers: Ø Use of a Bag – The bag is filled with the fumes and the user breathes air from the bag. Sometimes users will put their entire head into the bag. Ø Use of a Rag – The rag is soaked in the product and the user presses the rag over his/her mouth and nose. Ø Pressurized Containers – Some abusers will inhale the product directly from the container Well not really, they are still heavily abused…… But Here’s whats NEW ž Few street drugs have as wretched a reputation as , a cheap derivative of codeine that's mixed with , oil, alcohol or paint thinner ž Addicts shoot the concoction directly into their bodies with a hypodermic needle; the drug causes dark, scaly patches of dead and decaying skin.

ž Most refined crystalline form of MDMA ž MDMA is active ingredient in Ecstasy ž Potent hallucinogenic

ž , marketed as Suboxone, is an painkiller that's often used to wean addicts off of more powerful opiates like heroin and . ž About 3 million Americans have used it for treating addicitions ž In 2015 the number of ER visits for misuse of suboxone increased 10 fold from 2010

ž Highly concentrated form of the active ingredient in marijuana ( or THC). ž Also known as amber, honey, wax, ear wax and by its initials BHO ž Use of BHO is known as "dabbing," because of the way the drug is ingested Users place a small dab of the substance on a hot, metal surface, then inhale the resulting puff of smoke,

ž Synthetic ž Synthetic Spice

Robotriping Skittling

Triple C C-C-C ž Cough suppressant and expectorant found in many over the counter cough and cold meds ž May produce euphoria, dissociative effects or even hallucinations in high doses ž Works on same cell receptors as illegal and increases in pathways • Guiafenesin at high doses causes • Coricidin HBP Cough and Cold capsules contain DXM but lack

ž A 27-year-old man without a known psychiatric history was brought to a local (ED) for evaluation after exhibiting bizarre behavior. Earlier on the day of the evaluation, he disembarked from a ship by climbing down a mooring line while clasping a knife in his teeth. Witnesses said he ran down the pier without incident. His whereabouts for the next several hours were unknown. However, just prior to his arrest he was found naked in a local yacht club brandishing the knife and yelling almost incoherently about “the end of the world.” After several days of inpatient psychiatric hospitalization, he outlined a somewhat coherent story of the events that led to his hospitalization. ž 54 year old female comes to walk in clinic with complaints of low back pain. Patient states that she has a history of “bulging disc” but has not had any radiologic studies in “several years”. Patient states pain was worse this morning when she got out of bed. Denies any tingling sensation, radiation of pain, loss of bowel or bladder control. ž Patient states she is new to your area and has not established with a doctor yet. ž Patient is allergic to Toradol, Motrin, Ultram and Robaxin. ž Sadly for this patient…you have electronic EMR and can see that in past year she has been to clinic 13 times with complaints such as headache, toothache, back pain. ž 22 year old female brought into ER by EMS agitated and combative. Patient moving and thrashing about on stretcher, talking loudly and cursing. Patient’s clothing are partially removed, which EMS states she was found in that condition. Approximatley 10 minutes after arrival to ED patient becomes lethargic, and then unresponsive followed by activity.