What Are They Up To Now

Linda Alberino, MSN, ARNP-BC, ANP, CPE

DISCLOSURES

There are no disclosures for this presentation

OBJECTIVES

Recognize the toxins and drugs used on the streets and street names

Understand how and why illegal and legal drugs are used

Discuss use of drugs and harm to the body Identify options and benefits of treatment

SUBSTANCE ABUSEFACT OR FICTION

Misperception: Fact:

Substance Abuse is a criminal behavior

Substance abuse is a disease

Substance abuse is a result of moral weakness

Substance abuse is genetic

Substance abuse is a personal choice

Substance abuse is a result of the hijacked brain

Addiction is an acute conditionAddiction is a chronic, relapsing disease

EPIDEMIOLOGY OF DRUG USE IN USA 23.9 Million Americans aged 12 or older – 9.2% of

the entire population are current users. More than doubled the rate from 1969

Ages 12-17 appears to dropping 21.3% of ages 18-25, basically no increase 7.2% of ages 50-54 are using 6.6% of ages 55-59 are using 3% of 60-64 are still using

Typical Drug User

The National Survey on Drug Use and Health describes the typical drug users as: 18-25 yrs old Lives in the urban south 7.5 million users

Durden, T. (2013). Top 10 Facts About the U.S. Illegal Drug Market. www.zerohedge.com

Who are they?

New England and the Pacific West are the highest rates of usage at 11.4% and 12.3% per population.

New England has the biggest experimenting population at 55.4%

57.5% of users live in the metro areas with more than 1 million people.

Less than 1% of users live in the rural areasMales are 2X as likely to use than females ( 11.2% vs 6.8%)

Durden, T. (2013). Top 10 Facts About the U.S. Illegal Drug Market. www.zerohedge.com

Users Ethnic Background

9.1% of whites report current users 10.7% of blacks report use 3.5% of Asians report use 12.1% of American Indians

Durden, T. (2013). Top 10 Facts About the U.S. Illegal Drug Market. www.zerohedge.com

Regional Preference Marijuana seems the most popular at least 5% of population

uses in every region New England uses 10% which is the highest Northeast specifically New England are the top users of

powdered cocaine. South Atlantic is the hub for crack cocaine and hallucinogen

usage Pacific West is inhalant use, most popular in rural areas.

Also unprescribed psychotherapeutics (tranquilizers, sedatives, etc)

Midwest uses highest level of illicit pain relievers with the Eastern South Central region of the south following

Durden, T. (2013). Top 10 Facts About the U.S. Illegal Drug Market. www.zerohedge.com

What Does the Addict look like today

https://www.youtube.com/watch?v=cskq_zGVSZs&feature=youtu.be

Category & Name

Examples of Commercial &

Street Names

DEA Schedule

How Administer

ed*Marijuana Blunt, dope, ganja, grass,

herb, joint, bud, Mary Jane, pot, reefer, green, trees, smoke, sinsemilla, skunk, weed

I ? Smoked, swallowed

Hashish Boom, gangster, hash, hash oil, hemp

I ? Smoked, swallowed

Cannabinoids

EFFECTS AND RISKS

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

Health Risks - Cough, frequent respiratory infections; possible mental health decline; addiction

Category &

Name

Examples of Commercial & Street Names

DEA Schedule

How Administered*

       

Heroin Diacetylmorphine: smack, horse, brown sugar, dope, H, junk, skag, skunk, white horse, China white; cheese (with OTC cold medicine and antihistamine)

I ? Injected, smoked, snorted

Opium Laudanum, paregoric: big O, black stuff, block, gum, hop

II, III, V ? Swallowed, smoked

Opioids

EFFECTS AND RISKS

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

Health Risks - Cough, frequent respiratory infections; possible mental health decline; addiction

Category & Name

Examples of Commercial

& Street Names

DEA Schedule

How Administered*

Cocaine Cocaine hydrochloride: blow, bump, C, candy, Charlie, coke, crack, flake, rock, snow, toot

II ? snorted, smoked, injected

Amphetamine

Biphetamine, Dexedrine: bennies, black beauties, crosses, hearts, LA turnaround, speed, truck drivers, uppers

II ? swallowed, snorted, smoked, injected

Methamph-etamine

Desoxyn: meth, ice, crank, chalk, crystal, fire, glass, go fast, speed

II ? swallowed, snorted, smoked, injected

FACES OF METH

https://www.youtube.com/watch?v=5iW_fsb3Dqw

EFFECTS AND RISKS 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

Health Risks - Weight loss, insomnia; cardiac or cardiovascular complications; stroke; seizures; addiction

Also, for cocaine – Nasal damage from snorting Also, for methamphetamine – Severe dental

problem

Category & Name

Examples of Commercial & Street Names

DEA ScheduleHow

Administered*

MDMA (methylene-dioxy-methamph-etamine)

Ecstasy, Adam, clarity, Eve, lover's speed, peace, uppers

I ? swallowed, snorted, injected

F

lunitrazepam **

Rohypnol: forget-me pill, Mexican Valium, R2, roach, Roche, roofies, roofinol, rope, rophies

IV ? swallowed, snorted

GHB ** Gamma-hydroxybutyrate: G, Georgia home boy, grievous bodily harm, liquid ecstasy, soap, scoop, goop, liquid X

I ? swallowed

Club Drugs

EFFECTS AND RISKS Acute Effects, for MDMA - Mild hallucinogenic

effects; increased tactile sensitivity; empathic feelings; lowered inhibition; anxiety; chills; sweating; teeth clenching; muscle cramping

Also, for Flunitrazepam - Sedation; muscle relaxation; confusion; memory loss; dizziness; impaired coordination

Also, for GHB - Drowsiness; nausea; headache; disorientation; loss of coordination; memory loss

Health Risks, for MDMA - Sleep disturbances; depression; impaired memory; hyperthermia; addiction

Also, for Flunitrazepam - Addiction Also, for GHB - Unconsciousness; seizures; coma

Category & Name

Examples of Commercial & Street Names

DEA ScheduleHow

Administered*

Ketamine Ketalar SV: cat Valium, K, Special K, vitamin K

III ? injected, snorted, smoked

PCP and analogs

Phencyclidine: angel dust, boat, hog, love boat, peace pill

I, II ? swallowed, smoked, injected

Salvia divinorum

Salvia, Shepherdess's Herb, Maria Pastora, magic mint, Sally-D

Not Scheduled chewed, swallowed, smoked

Dextrometh-orphan (DXM)

Found in some cough and cold medications: Robotripping, Robo, Triple C

Not Scheduled swallowed

Dissociative Drugs

EFFECTS AND RISKS

Acute Effects - Feelings of being separate from one’s body and environment; impaired motor function

Also, for ketamine - Analgesia; impaired memory; delirium; respiratory depression and arrest; death

Also, for PCP and analogs - Analgesia; psychosis; aggression; violence; slurred speech; loss of coordination; hallucinations

Also, for DXM - Euphoria; slurred speech; confusion; dizziness; distorted visual perceptions

Health Risks - Anxiety; tremors; numbness; memory loss; nausea

Category & Name

Examples of Commercial & Street

Names

DEA Schedule

How Administer

ed*

Lysergic acid diethylamide:acid, blotter, cubes, microdot yellow sunshine, blue heaven  

I ? swallowed, absorbed through mouth tissues

LSD Buttons, cactus, mesc, peyote

I ? swallowed, smoked

Mescaline Magic mushrooms, purple passion, shrooms, little smoke

I ? swallowed

Psilocybin

Hallucinogens

EFFECT AND RISKS Acute Effects - Altered states of perception and

feeling; hallucinations; nausea Also, for LSD - Increased body temperature, heart

rate, blood pressure; loss of appetite; sweating; sleeplessness; numbness, dizziness, weakness, tremors; impulsive behavior; rapid shifts in emotion

Also, for Mescaline - Increased body temperature, heart rate, blood pressure; loss of appetite; sweating; sleeplessness; numbness, dizziness, weakness, tremors; impulsive behavior; rapid shifts in emotion

Also, for Psilocybin - Nervousness; paranoia; panic Health Risks, for LSD - Flashbacks, Hallucinogen

Persisting Perception Disorder

Category & Name

Examples of Commercial & Street Names

DEA Schedule

How Administere

d*Anabolic steroids

Anadrol, Oxandrin, Durabolin, Depo-Testosterone, Equipoise: roids, juice, gym candy, pumpers

III ? Injected, swallowed, applied to skin

Inhalants Solvents (paint thinners, gasoline, glues); gases (butane, propane, aerosol propellants, nitrous oxide); nitrites (isoamyl, isobutyl, cyclohexyl): laughing gas, poppers, snappers, whippets

Not scheduled Inhaled through nose or mouth

Other Compounds

EFFECTS AND RISKS

Acute Effects, for Anabolic steroids - No intoxication effects

Also, for Inhalants (varies by chemical) - Stimulation; loss of inhibition; headache; nausea or vomiting; slurred speech; loss of motor coordination; wheezing

Health Risks, for Anabolic steroids - Hypertension; blood clotting and cholesterol changes; liver cysts; hostility and aggression; acne; in adolescents—premature stoppage of growth; in males—prostate cancer, reduced sperm production, shrunken testicles, breast enlargement; in females—menstrual irregularities, development of beard and other masculine characteristics

Also, for Inhalants - Cramps; muscle weakness; depression; memory impairment; damage to cardiovascular and nervous systems; unconsciousness; sudden death

MOST ABUSED PRESCRIPTION DRUGS

NameExamples of

Commercial & Street Names

DEA ScheduleHow

Administered*

Barbiturates Amytal, Nembutal, Seconal, Phenobarbital; barbs, reds, red birds, phennies, tooies, yellows, yellow jackets

II, III, V ? injected, swallowed

Benzodiazepines

Ativan, Halcion, Librium, Valium, Xanax; candy, downers, sleeping pills, tranks

IV ? swallowed

Sleep Medications

Ambien (zolpidem), Sonata (zaleplon), Lunesta (eszopiclone); forget-me pill, Mexican Valium, R2, Roche, roofies, roofinol, rope, rophies

IV ? swallowed, snorted

Depressants

SIDE EFFECTS AND RISKS

Intoxication Effects - Sedation/drowsiness, reduced anxiety, feelings of well-being, lowered inhibitions, slurred speech, poor concentration, confusion, dizziness, impaired coordination and memory

Potential Health Consequences - lowered blood pressure, slowed breathing, tolerance, withdrawal, addiction; increased risk of respiratory distress and death when combined with alcohol

Also, for barbiturates - euphoria, unusual excitement, fever, irritability/life-threatening withdrawal in chronic users

NameExamples of

Commercial & Street Names

DEA Schedule

How Administer

ed*

Codeine

Empirin with Codeine, Fiorinal with Codeine, Robitussin A-C, Tylenol with Codeine; Captain Cody, Cody, schoolboy; (with glutethimide: doors & fours, loads, pancakes and syrup)

II, III, V ? Injected,swallowed

NAME Examples of Commercial & Street

Names

DEA Schedule

HOWADMINISTERED

Fentanyl & analogs

Actiq, Duragesic, Sublimaze; Apache, China girl, China white, dance fever, friend, goodfella, jackpot, murder 8, TNT, Tango and Cash

II ? injected, smoked, snorted

Methadone Methadone, Dolophine; Frizzies, amidone(MDMA); chocolate chip cookies

II ? Swallowed, injected

NameExamples

ofCommercial & Street Nmes

DEA Schedule

How Administered*

Other opioid pain relievers: Oxycodone HCL, Hydrocodone Bitartrate Hydromorphone, Oxymorphone, Meperidine, Propoxyphene

, Oxycontin, Percodan, Percocet: Oxy, O.C., oxycotton, oxycet, hillbillyheTyloxroin, percsVicodin, Lortab, Lorcet; Vike, Watson-387Dilaudid; juice, smack, D, footballs, dilliesOpana, Numporphan, Numorphone; biscuits, blue heaven, blues, Mrs. O, octagons, stop signs, O bombDemerol, meperidine hydrochloride; demmies, pain killerDarvon, Darvocet

II, III, V ? Morphine

Opioids and Morphine Derivatives**

Side Effects and Consequences Intoxication Effects - Pain relief, euphoria, drowsiness,

sedation, weakness, dizziness, nausea, impaired coordination, confusion, dry mouth, itching, sweating, clammy skin, constipation

Potential Health Consequences - slowed or arrested breathing, lowered pulse and blood pressure, tolerance, addiction, unconsciousness, coma, death; risk of death increased when combined with alcohol or other CNS depressants

Also for fentanyl - 80-100 times more potent analgesic than morphine

Also for oxycodone - muscle relaxation/twice as potent analgesic as morphine; high abuse potential

Also for codeine - less analgesia, sedation, and respiratory depression than morphine

Also for methadone - used to treat opioid addiction and pain; significant overdose risk when used improperly

Name

Examples ofCommercial 

& Street Names

DEA ScheduleHow

Administered*

Amphetamines

Biphetamine, Dexedrine, Adderall; bennies, black beauties, crosses, hearts, LA turnaround, speed, truck drivers, uppers

II ? injected, swallowed, smoked, snorted

Methylphenidate

Concerta, Ritalin; JIF, MPH, R-ball, Skippy, the smart drug, vitamin R

II ? injected, swallowed, snorted

Stimulants

Side Effects and Consequences Intoxication Effects - Feelings of exhilaration,

increased energy, mental alertness Potential Health Consequences - increased

heart rate, blood pressure, and metabolism, reduced appetite, weight loss, nervousness, insomnia, seizures, heart attack, stroke

Also, for amphetamines - rapid breathing, tremor, loss of coordination, irritability, anxiousness, restlessness/delirium, panic, paranoia, hallucinations, impulsive behavior, aggressiveness, tolerance, addiction

Also, for methylphenidate - increase or decrease in blood pressure, digestive problems, loss of appetite, weight loss

Name

Examples ofCommercial

 & Street Names

DEA Schedule

How Administer

ed*

Dextromethorphan (DXM)

Found in some cough and cold medicines; Robotripping, Robo, Triple C

Not scheduled swallowed

Other Compounds

Side Effects and Consequences

Intoxication Effects - Euphoria, slurred speech

Potential Health Consequences - increased heart rate and blood pressure, dizziness, nausea, vomiting, confusion, paranoia, distorted visual perceptions, impaired motor function

Current Trends in Ohio

Treatment Options

Outpatient rehabilitation Inpatient rehabilitationFaith based rehabilitation

References Drug abuse in Ohio retrieved from

www.healthy.ohio.gov/vipp/drug/dpoison.aspx on February 6, 2015

National Institute on Drug Abuse. Bath Salts (Synthetic Cathinones) Retrieved from http://www.drugabuse.gov/drugs-abuse/bath-salts-synthetic-cathinones on March 10, 2015

National Institute on Drug Abuse. Heroin Retrieved from http://www.drugabuse.gov/drugs-abuse/heroin on March 10, 2015

National Institute on Drug Abuse. Trends & Statistics Retrieved from http://www.drugabuse.gov/related-topics/trends-statistics on March 10, 2015

Rural Ohio ravaged by drug deaths. Norwalk Reflector, March 31, 2014. Retrieved Feb 8, 2015.

www.cdc.gov

www.deadiversion.usdoj.gov

www.healthyamericans.org/reports/drugabuse2013

www.justice.gov/archive/ndic/dmas/Ohio_DMA-2011(U).pdf

www.zerohedge.com