Substance Abuse and YouEssential Skills to Success

Authors: Jonathan Mong & Marianne Schwarz; VFMP UBC Medicine 2015 Presenters:

Outline

•Who we are•Topics:

▫1. Commonly used drugs + what they do to the body

▫2. Reasons for use and risk factors for abuse

▫3. Consequences of abuse▫4. Recovery: mental tapes, coping

strategies, stages of recovery, etc.

Addiction – physiological and mental

•Different from “dependence”

•Physical and psychological need for something

•Accompanied by self-destructive behaviours

Withdrawal

•Physical and psychological symptoms that appear when off of a substance

•Can have common symptoms for many substances

Sleeping pills

•Some people use these to stay or fall asleep

•Common drug:Ativan, Imovane

•Work by blocking electrical signals from going to your brain

Sleeping Pills•The Good

▫Helps to sleep▫Relaxant

•The Bad▫Addiction▫Nausea, headaches▫Memory impairment

•The Ugly▫Comatose▫Death

Acetaminophen

•The Good• Reduce pain (e.g.

headache, muscle aches)•The Bad

▫Overdose causing vomiting, which can lead to…

•The ugly▫Overdose (causing liver

failure, kidney failure, death)

Anabolic Steroids

•Similar actions to testosterone

•Often taken to try to build muscle mass

•Can affect cells everywhere and not just in your muscles

Anabolic Steroids• The Good

▫ Bulk up▫ Appear “manly”

• The Bad▫ Acne▫ Bruising▫ Cancer▫ Depression▫ Aggression▫ Testicular shrinking▫ Stunted growth

• The Ugly▫ ...

…

Marijuana

•Taken for a variety of reasons: to relax, reduce pain, etc.

•Increases amount of substance in your brain that makes you feel good

•“Opening a door”

Marijuana•The ‘Good’

▫Pain control▫Relaxant

•The Bad▫Loss of motivation▫Decreased

awareness•The Ugly

▫Increased risk of schizophrenia

▫Legal complications

Cocaine

•Prevents substance in brain from being broken down normally

•“Can’t clean up the mess”

Cocaine• The Good

▫Gives you energy▫Gives you a “high”

• The Bad▫Heart troubles

Infections, enlarged heart, irregular rhythm

▫Seizures• The Ugly

▫Sudden heart attack▫Stroke

Case•Jack is 28 year-old•Confused wandering

Downtown Eastside•“Jerky” movements•Fever and chills•“Muscles hurt all over.” •Feels ants crawling

under his skin•Agitated

Questions/Ideas

•What did you notice is happening to Jack?•Any ideas to explain this?

Patterns of Use• Non User

▫ People who do not use the substance• Initial User

▫ People who try the substance for the first few times• Irregular User

▫ People who use the substance in social settings• Regular User

▫ People who use the substance in many settings▫ This is non-harmful regular or planned use

• Problem User▫ People who show addictive behaviour towards the substance

• Dependent User▫ People who are fully addicted to the substance▫ Physical and mental withdrawal symptoms can present▫ People driven to acquire and use substance

Motivations

•Mental or physical pain•To fit in socially•To treat the symptoms

of an illness•To prevent withdrawal•Escape from reality

Risk Factors

•Genetics•Personal

characteristics•Health or mental

illness•Gender•Early drug use•Lack of healthy

relationships

Risk Factors

•Family•Physical abuse•Culture•Stress•Trauma•Availability of

substances•Peer group

Case, part 2

•Calms down •Car accident 1 year ago•No major trauma, but had trouble sleeping

after •Prescribed a sleeping pill by his doctor•Jack says he became “dependent on it”•After prescription, he ran out and he

started drinking heavily

Ideas/Questions• Any new ideas about what is happening with

Jack?• What substances could he potentially be

abusing?

Social Consequences

Can have minimal impact or affect:•Family•Relationships•Job and finances•Housing•Physical health•Mental health

Case

•Jack remembers his father using alcohol extensively when work was hard

•Father was abusive towards Jack and his mother

•Left the house, has not seen his father since

•Felt more popular when drinking

Ideas/questions

•What do you think are Jack’s motivations for using alcohol and sleeping pills?

•What are his risk factors for substance abuse?

Recovery – Stages of Change

•Precontemplation•Contemplation•Preparation•Action•Maintenance•Relapse

Recovery – Assessing your thoughts• Mental tapes are old recordings of voices that play

in our head from time to time• These tapes can be distracting to the process of

recovery, e.g.▫ “I’m worthless because I’m not able to kick my drug

habit.”▫ “I’ll never be able to live a real life because I drink too

much alcohol and there’s nothing I can do about it.”▫ “If I don’t use alcohol then nobody will like me.”▫ “When I got high last time I had the best time of my

life. The same thing will happen when I get high again tonight.”

Recovery – HALT Principles

•Relapse is more likely to happen if you are:▫Hungry▫Angry▫Lonely▫Tired

•If you feel like you’re being overwhelmed by any of these, it’s important to “check in with yourself.”

Case

•1 year later•Sees same doctor•Has tried to stop drinking several times

but has always started up again •Wants to “kick the habit”•Staying in a friend’s basement •Currently unemployed but optimistic

Back to Jack…

•Jack sounds like he wants to stop his substance abuse. Do you think he is prepared to start the process of recovery?

Resources

•Your doctor•Community clinics•Needle exchange programs•Dial 211 - Alcohol and Drug Line - Refers

to a full range of counselling and treatment services across BC. BC

•Dial 811 - HealthLink BC•Online resources

▫Mood gym

Thank you!

•Questions?