WEEK THREE – GET EDUCATED – ADDICTION, DRUGS, ABUSE & HUMAN TRAFFICKING UNDERSTANDING ADDICTION Dr. Michael Krausz’s (UBC, St Paul's Hospital) The Centre for Health Evaluation and Outcome Services Survey of 500 chronically homeless people in 3 BC communities found a ‘higher-than-expected level of childhood trauma with 80% of participants suffering significant trauma, abuse, violence, or emotional neglect as children. Most of the study participants have experienced more than one type of maltreatment, experiences that have devastating lasting impact, including moderate to high risk of suicide. Many also suffered severe mental health challenges such as schizophrenia, mood disorders, and fetal alcohol syndrome.’ 1 Defining Addiction Dr. Paul Earley, an Addiction Medicine physician, defines addiction this way: “Addiction is a primary, progressive, biochemical, psychosocial, genetically transmitted disease of relapse [hallmarks of denial, loss of control, manageability; the only disease that tells you, you don't have it].”2 What Addiction is Not A behavioural issue [“Just change your behaviour!”] An ethical issue A choice A lack of will power A problem only “bad” people have Not a symptom of another psychiatric illness [it is a disease of its own; addiction has a life of its own] Two Types of Addiction 1. Substance addiction Alcohol, drug, smoking, prescription drugs, caffeine, food/over eating. 2. Non-substance addiction Anger, pornography, sexual addictions, gambling, self-preservation, fear, worry, control, money, success, entertainment 1 Connor, M. (2016). The Shift. USA: CreateSpace. (p. 158-159) 2 Earley, P. (2014). Keynote address at Conquering Addictions Together: Addiction: A disease of man. Tabott Recovery Campus, Atlanta, GA. COMMON STREET DRUGS CANNABINOIDS: Marijuana - Blunt, dope, ganja, grass, herb, joint, bud, Mary Jane, pot, reefer, green, trees, smoke, sinsemilla, skunk, weed Taken: Smoked, swallowed Hashish- Boom, gangster, hash. Taken: Smoked, swallowed Acute Effects - Euphoria; relaxation; slowed reaction time; distorted sensory perception; impaired balance and coordination; increased heart rate and appetite; impaired learning, memory; anxiety; panic attacks; psychosis OPIODS: Heroin Diacetylmorphine- smack, horse, brown sugar, dope, H, junk, skag, skunk, white horse, China white; cheese (with OTC cold medicine and antihistamine) Taken: Injected, smoked, snorted Opium Laudanum, paregoric: big O, black stuff, block, gum, hop Taken: Swallowed, smoked Acute Effects - Euphoria; drowsiness; impaired coordination; dizziness; confusion; nausea; sedation; feeling of heaviness in the body; slowed or arrested breathing STIMULANTS: Cocaine: blow, bump, C, candy, Charlie, coke, crack, flake, rock, snow, toot Taken: snorted, smoked, injected Amphetamine Biphetamine, Dexedrine: bennies, black beauties, crosses, hearts, LA turnaround, speed, truck drivers, uppers Taken: swallowed, snorted, smoked, injected Methamphetamine Desoxyn: meth, ice, crank, chalk, crystal, fire, glass, go fast, speed Taken: swallowed, snorted, smoked, injected Acute Effects - Increased heart rate, blood pressure, body temperature, metabolism; feelings of exhilaration; increased energy, mental alertness; tremors; reduced appetite; irritability; anxiety; panic; paranoia; violent behavior; psychosis CLUB DRUGS: MDMA (methylene-dioxy-methamph-etamine): Ecstasy, Adam, clarity, Eve, lover's speed, peace, uppers Taken: swallowed, snorted, injected Acute Effects for MDMA - Mild hallucinogenic effects; increased tactile sensitivity; empathic feelings; lowered inhibition; anxiety; chills; sweating; teeth clenching; muscle cramping Flunitrazepam Rohypnol: forget-me pill, Mexican Valium, R2, roach, Roche, roofies, roofinol, rope, rophies Taken: swallowed, snorted Acute Effects for Flunitrazepam - Sedation; muscle relaxation; confusion; memory loss; dizziness; impaired coordination GHB (Gamma-hydroxybutyrate): G, Georgia home boy, grievous bodily harm, liquid ecstasy, soap, scoop, goop, liquid X Taken: swallowed Acute Effects for GHB - Drowsiness; nausea; headache; disorientation; loss of coordination; memory loss DISSASOCIATIVE DRUGS Ketamine Ketalar SV: cat Valium, K, Special K, vitamin K Taken: injected, snorted, smoked Acute Effects for ketamine - Analgesia; impaired memory; delirium; respiratory depression and arrest; death PCP and analogs, Phencyclidine: angel dust, boat, hog, love boat, peace pill Taken: swallowed, smoked, injected Acute Effects for PCP and analogs - Analgesia; psychosis; aggression; violence; slurred speech; loss of coordination; hallucinations Salvia divinorum: Salvia, Shepherdess's Herb, Maria Pastora, magic mint, Sally-D. Taken: chewed, swallowed, smoked Dextrometh-orphan (DXM) Found in some cough and cold medications: Robotripping, Robo, Triple C Taken: Swallowed Acute effects for DXM - Euphoria; slurred speech; confusion; dizziness; distorted visual perceptions Acute Effects of dissociative drugs - Feelings of being separate from one’s body and environment; impaired motor function HALLUCINOGENS LSD (Lysergic acid diethylamide): acid, blotter, cubes, microdot yellow sunshine, blue heaven Taken: swallowed, absorbed through mouth tissues Acute effects - Increased body temperature, heart rate, blood pressure; loss of appetite; sweating; sleeplessness; numbness, dizziness, weakness, tremors; impulsive behavior; rapid shifts in emotion Mescaline: Buttons, cactus, mesc, peyote Taken: swallowed, smoked Acute effects of Mescaline - Increased body temperature, heart rate, blood pressure; loss of appetite; sweating; sleeplessness; numbness, dizziness, weakness, tremors; impulsive behavior; rapid shifts in emotion Psilocybin: Magic mushrooms, purple passion, shrooms, little smoke Taken: swallowed Acute effects Psilocybin - Nervousness; paranoia; panic Acute Effects of Hallucinogens - Altered states of perception and feeling; hallucinations; nausea Overdose Symptoms and Signs of Use3 Clammy Hands Trouble Walking Trouble Talking Nausea Dizziness Drowsiness Loss of Balance Difficulty Breathing Turning Blue Light Headedness Fainting 3 Suman H. (July 5, 2016). How to Talk to Your Teens about Drugs. BC Trauma Care, Workshop. Seizures Slow heartbeat Things to Know Be cautious around buying drug from a “new” dealer Is the drug cheaper than usual? Start with small doses and increase if necessary Take the drugs in social settings (not alone) Know the symptoms of the drugs you are taking. If something peculiar is happening, get to the hospital. Know what areas Fentanyl and W-18 is being sold in and be aware of the shape, look and print of laces drugs. Know the common overdose symptoms Beginning Signs of Use Secrecy No room access and very quick to take away belongings from sight, such as a backpack High smell or use of perfume or deodorant Increased access to money (new materials and items) Consistently asking for money Pills, cough syrups are disappearing from cabinets, fridge Overdose Deaths4 British Columbia Illicit Drug Overdose Deaths For additional information see “‘It Feels Like Murder’: The Devastating Impact of Fentanyl in BC” by Nick Eagland, The Vancouver Sun, May 31, 2016 4 Source: http://www.cbc.ca/news/canada/british-columbia/opioid-overdose-deaths-emergency-1.3580212 http://vancouversun.com/news/local-news/it-feels-like-murder-the-devastating-impact- of-fentanyl-in-b-c A War on Traumatized People Individuals addicted to one chemical or behaviour are likely to have multiple addictions. According to the authors of “The Genesis Process: A Relapse Prevention Workbook for Addictive/Compulsive Behaviors,” A disease model of addiction revolves around the limbic system which controls the survival responses: when it feels threatened, it automatically and subconsciously creates a warning signal [flight, fight, or freeze], creating a drive or craving for whatever it associates from the past with survival. Anything that reduces stress and increases a sense of safety raises neurochemicals in the limbic system thereby linking it to survival. The limbic system creates cravings to repeat the behaviour and when reinforced over time, the experiential memory associates these strongly focused cravings with survival, acting independently from the conscious mind. When these strongly focused cravings are linked to self-destructive behaviours rather than survival behaviours, there is indication of a diseased brain. These survival-linked behaviours can become so strong that they are very difficult and almost impossible to control, creating an addiction.5 The following is an excerpt from The Shift. Read a conversation between Ian, one of our street friends and Mac, as Ian defines homelessness. Ian paused for a moment, and with a smile, looked me squarely in the eyes and quoted Albert Einstein: “We can't solve our problems with the same thinking we used when we created them.” . The challenge of defining the word was due largely to society’s perception on how we place labels on ‘them’-- the homeless. “People are people--not homeless people or street people--just people!” Ian said. “Society inaccurately and unfairly labels ‘them’ as the homeless, poor, criminals, drug addicts, or dealers and alcoholics.” As I listened to this wise man, I was quietly reminded that in the past I was guilty of doing the same. I, too, had judged and attached labels to the people on the street and segregated 'them' and 'us'. I was part of the problem. What would the world look like if we changed our thinking our words, and the labels we put on people?