Chapter 18 New

8/14/2019 Chapter 18 New

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Chapter 18: Substance Misuse

and Abuse


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AMERICAN RED CROSS FIRST AIDRESPONDING TO EMERGENCIES FOURTH EDITION

Copyright 2005 by The American National Red CrossAll rights reserved.

Introduction

Substance abuse and misuse cost the United States billionsof dollars annually in medical care, insurance and loss ofproductivity.

Even more important, however, are the lives lost orpermanently impaired each year from injuries or medicalemergencies related to substance abuse or misuse.


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Introduction(continued)

Legal substances are among those most often misused or abused.

Such legal substances include

Nicotine (found in tobacco products).

Alcohol (found in beer, wine and liquor).

Over-the-counter medications, such as aspirin, sleeping pillsand diet pills.


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According to the National Vital Statistics Reports, over 40,000Americans died as a result of drug- or alcohol-induced deathsin 2001.

Introduction(continued)


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Activity

Define and discuss the following terms:

Substance misuse

Substance abuse

Drug

Medication

Dependency

Addiction

Tolerance


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Activity(continued)

Define and discuss the following terms:

Overdose

Withdrawal

Synergistic effect


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Activity

Substance misuse

Substance abuse

Drug

Medication

Dependency

Addiction

Tolerance -


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Misused and Abused Substances

Substances are categorized according to their effects on the body.

The six major categories of commonly misused and abusedsubstances are

Stimulants.

Depressants.

Hallucinogens.

Narcotics.

Inhalants.

Cannabis products.


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Stimulants

Stimulants are drugs that affect the central nervous system byincreasing physical and mental activity.

The effects of stimulants include

Temporary feelings of alertness and prevention of fatigue.

Appetite suppression.

Many stimulants are ingested as pills, but can be absorbed orinhaled.


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Stimulants

Amphetamines, dextroamphetamines and methamphetamines arestimulants.

Slangs are: uppers, bennies, black beauties, speed, crystal, meth, andcrank

Cocaine is one of the most publicized and powerful stimulants.

A purer form of cocaine is known as crack.

Highly addictive and called rock and freebase rocks

The most common stimulants in America are legal:

Caffeine

Nicotine

Other stimulants are used for medical purposes.


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Hallucinogens

Hallucinogens, also known as psychedelics, are substances thataffect mood, sensation, thought, emotion and self-awareness.

Hallucinogens sometimes cause what is called a bad trip.

A bad trip can involve intense fear, panic, paranoiddelusions, vivid hallucinations, profound depression,tension and anxiety.

The victim may be irrational and feel threatened by anyattempt others make to help.


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Hallucinogens(continued)

Among the most widely abused hallucinogens are

Lysergic acid diethylamide (LSD), also known as acid.

Psilocybin (mushrooms).

Phencyclidine (PCP), called angel dust.

Mescaline (peyote, buttons or mesc).

Most are ingested, PCP can be inhaled


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Depressants

Depressants are substances that affect the central nervous system bydecreasing physical and mental activity.

Depressants are commonly used for medical purposes.

Relieve anxiety, promote sleep, depress respiration, relieve pain,relax muscles, impair coordination and judgment

Common depressants include

Barbiturates.

Benzodiazepines.

Narcotics.

Alcohol.


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Depressants continued

Most are ingested or injected.

Alcohol is most widely used and abused substance in the U.S.

Causes many unhealthy consequences

Affect the brain causing lack of coordination, memoryloss or apathy

Cause liver disease such as cirrhosis

Lead to psychological, family, social and work

problems Alcohol poisoning is caused when large amount is

consumed in a short period of time. Resulting in LOC andif untreated DEATH


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Narcotics

Narcotics, derived from opium, are drugs that work on thecentral nervous system to relieve pain.

Are very powerful and highly addictive and are illegalwithout a prescription.

When taken in large amounts euphoria, stupor, coma ordeath can result.

The most common natural narcotics are morphine andcodeine.

Most other narcotics, including heroin, are synthetic orsemisynthetic.


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Narcotics continued

Heroin abuse is results in serious health conditions

Fatal overdose

Spontaneous abortion

Collapsed veins

HIV and Hep. B

Long Term

Infection or heart lining and valves, abscesses and liverdiseases

Addiction


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Inhalants

Inhalants are substances inhaled to produce a mood-alteringeffect.

Inhalants also depress the central nervous system.

Inhalants include medical anesthetics, such as amyl nitriteand nitrous oxide (also known as laughing gas), as well as

hydrocarbons, known as solvents.

Solvents are similar to alcohol they include

Toluene found in glue

Butane found in lighter fluid

Acetone found in nail polish remover

Fuels such as gasoline and kerosene

Propellants found in aerosol sprays

Inhalant can damage heart, lungs, brain and liver


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Cannabis Products

Cannabis products, including marijuana, tetrahydrocannabinol,or (THC), and hashish, are all derived from the plant Cannabissativa.

Marijuana is the most widely used illicit drug in the United

States. Marijuana, although illicit, has been used for some medicinal

purposes to treat

Nausea from chemotherapy.

Glaucoma.

Muscular weakness caused by multiple sclerosis.

Weight loss from cancer and AIDS.


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Cannabis Products(continued)

The effects of marijuana include

Feelings of elation.

Distorted perceptions of time and space.

Throat irritation.

Red eyes.

Rapid pulse.

Dizziness.

Increased appetite.


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Designer Drugs

These drugs are variations of other substances, such as narcotics andamphetamines.

The molecular structures of designer drugs include substances usedfor medical purposes that are modified by chemists.

When altered, the user can experience a variety of unpredictable and

dangerous effects Most common drug is methylenedioxymethamphertamine (MDMA) or

ecstasy

Ecstasy is popular for the euphoric high

Other signals are:

Increase BP, Rapids HB, Profuse sweating, Paranoia,Sensory distortion, Erratic mood swings


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Anabolic Steroids

Anabolic steroids are sometimes used by athletes to enhanceperformance and increase muscle mass.

Their medical uses include stimulating weight gain.

Chronic use of anabolic steroids can lead to sterility, livercancer and personality changes.

Steroid abuse by young people may also disrupt normalgrowth.


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Over-the-Counter Substances

The most commonly misused and abused over-the-countersubstances are aspirin, laxatives and nasal sprays.


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Over-the-Counter Substance(continued)

Aspirin is used to relieve minor pain, reduce fever and treat heartdisease.

Aspirin misuse can

Cause inflammation of the stomach and small intestine.

Impair normal blood clotting.


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Laxatives are used to relieve constipation.

Laxative misuse can cause uncontrolled diarrhea that mayresult in dehydration.

Laxative abuse is associated with attempted weight loss andeating disorders, such as anorexia nervosa and bulimia.


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Antihistamines, such as decongestant nasal sprays, can help relievethe congestion of colds or hay fever.

If misused, they can cause physical dependency.

Used over a long period of time sprays can result in nose bleedsand changes in the lining of the nasal passages, eventually makingit difficult to breathe without the spray


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Signals of Substance Misuse and Abuse

Signals of substance misuse and abuse are similar to those ofother medical emergencies.

Signals of abuse or misuse include

Moist or flushed skin.

Sweating, chills, nausea, vomiting.

Fever.

Headache.

Dizziness..

Rapid pulse, rapid breathing.

High blood pressure.

Chest pain.


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Signals of Substance Misuse and Abuse(continued)

Respiratory distress, disruption of normal heart rhythm andeven death can result from using a stimulant.

A victim of stimulant overdose may appear to be

Very excited.

Restless.

Talkative.

Irritable.

Unconscious.


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Specific signals of hallucinogen abuse may include

Sudden mood changes.

Flushed face.

Seeing or hearing something that is not present.

Anxiousness or being frightened.

Specific signals of depressant abuse include

Drowsiness. Confusion.


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Slurred speech.

Slow heart and breathing rates.

Poor coordination.


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Care for Substance Misuse and Abuse

Follow these general principles as you would for anypoisoning:

Check the scene to make sure it is safe to help the person.

Do not approach if victim is behaving in a threateningmanner.

Call 911, the local emergency number or the PoisonControl Center.

Care for any life-threatening conditions.

Care for any other conditions you find.

Withdraw from the area if the victim becomes violent orthreatening.


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Care for Substance Misuse and Abuse(continued)

Look for clues.

Look for product or medicine containers, drug paraphernaliaand signals of other medical conditions.

If you suspect that someone has taken a designer drug, tellEMS personnel.

After a substance abuse emergency, the victim may needadditional support to overcome addiction.


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Preventing Substance Misuse and Abuse

Approaches vary, including educating people about substancesand their effects on health and attempting to instill fear ofpenalties, which have not by themselves proved to be particularlyeffective.

To be effective, prevention efforts must address the variousunderlying factors of and approaches to substance abuse.


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Preventing Substance Misuse and Abuse(continued)

The following factors may contribute to substance abuse:

A lack of parental supervision

The breakdown of traditional family structures

A wish to escape unpleasant surroundings and stressfulsituations

The widespread availability of substances

Peer pressure and the basic need to belong

Low self-esteem, including feelings of guilt and shame

Media glamorization

History of substance abuse


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Some poisonings from medicines occur when victims knowinglyincrease the dosage beyond what is directed.

The best way to prevent such misuse is to take medications only

as prescribed.

On the other hand, many poisonings from medicines are notintentional.


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The following guidelines may help prevent unintentionalmisuse or overdose:

Read the product information and use only as directed.

Ask your physician or pharmacist about the intended useand side effects of prescriptions and over-the-countermedications. If you are taking more than one medication,check for possible interaction effects.

Never use another persons prescribed medications.

Always keep medications in their appropriate, marked

containers.

Destroy all out-of-date medications.

Always keep medications out of the reach of children.


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Copyright 2005 by The American National Red Cross

Closing

There are six major categories of substances that, when abusedor misused, can produce a variety of signals.

You do not have to diagnose the condition to give care.

If you suspect that the victims condition is caused by

substance misuse or abuse

Give care for a poisoning emergency.

Call 9-1-1, the local emergency number or Poison ControlCenter personnel and follow their directions.

Call the police, if necessary.

Questions?

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