Substance use starting with opioid use disorder

Opium, heroin, demoral, morphine, codeine, methadone, dilaudid, fentanyl, OxyContin, Vicodin, Darvon, Heroin: Smack, H, skag, junk, brown sugar, boy, white lady/nurse, China white, chiva, snow, Mexican brown, black pearl, skunk, Desensitizes the user to pain to induce a sense of well-being and euphoria, Develops rapid tolerance- eventually user cannot achieve pleasurable effects but must continue use to avoid withdrawal symptoms, Can be swallowed, smoked, snorted, injected, mainlined, rectally

Schedule 1, CNS- both depressant & analgesic, Poppy plant produces Opium-Morphine-Heroine, Suppliers:Asia, Mexico, Columbia, Isolated from morphine in 1874, Originally thought to be a cure for morphine addiction

Banned in 1914 due to Harrison Narcotic Act, Duration 3-6 hours, Detection in urine: 1-4 days, Signs of heroin abuse: ⬇️ energy level, nodding out, pinpointed pupils, long sleeve shirts worn during hot weather, blood stains on shirts, dry skin, watery eyes, cigarette burns

Hypodermic needles, Lighters, Tin foil, Straws, Aluminum bottle caps (cooking), Razors, Mirrors, Plastic baggies, Tourneiquets, Spoons

Tropical evergreen tree in the coffee family native to Southeast Asia, Opiod properties and some stimulant like effects, “Kratom Use Disorder”, Linked to more U.S. Deaths, Dependence develops quickly with tolerance and a high relapse risk

“Oxys, oxycotton, OCs”, “Killer, blue, valerie, rush”, Analgesic,equally potent as morphine, Effects: Euphoria, Signs: euphoria, pinpoint pupils, dizziness, confusion, decreased breathing and HR, OD: respiratory depression, pinpoint pupils, coma, seizures, Onset/duration: depends on route/ 8-12 hours, Route: snorted, ingestet, injected, Narcan will reverse effects!

Contricted pupils, ⬇️RR&BP, Drowsiness, slurred speech, Euphoria followed by dysphoria, Poor judgement, Impaired attention, Psychomotor retardation or agitation, Head nodding, Hypothermia

Sedation, Respiratory depression or arrest, Coma, Shock, Convulsions, Death, Also the constricted pupils here!, Tx: Narcan! (narcotic antagonist) ruickly reverses CNS depression, ⬆️HR&BP,& ⬆️LOC must be given every few hours may take days

4-12 hrs for heroin, Yawning, irritability, muscle aches, Runny nose, lacrimation, diaphoresis, Cramps, diarrhea, N/V, ⬆️BP&temp, chills, fever, hyperthermia, Restlessnes, anxiety, muscle spasms, insomnia, Dilated pupils, HTN, hyperthermia, tachycardia, Goose flesh, craving

Methadone (dolophine, methadose), LAAM (l-a-acetylmethadol), naltrexone (ReVia & Vivitrol- injectable form), clonidine (Catapres), buprenorphine (Suboxone) & naloxone (Trexan)

Dolophine & Methadose, Synthetic opiate blocks craving for and effects of heroin, Safe during pregnancy, Sedation, Decrease painful symptoms of opiate withdrawal, “harm reduction”

L-a- acetylmethadol, Alternative to methadone, Contraindicated if pregnant or liver damage

ReVia & Vivitrol- injectable form, Relapse prevention- reduce cravings, Antagonist that blocks euphoric effects of opioids, May cause: N/V, headache, sedation, pain at injection site

Catapres, Effective somatic treatment when combined with naltrexone, Used for HTN

Detoxifcation & maintenance, ⬇️of impulsive and compulsive behaviors, May be used with gambling addiction, May experience drowsiness, dizziness, blurred vision, N/V, Contraindicated if pregnant or breast feeding

Contricted

Naloxone

Since 1950s used by athletes to boost performance (anabolic androgenic), Oral, applied to skin or injection done in cycles of weeks, stacking or pyramiding, Males: shrunken testicles & breast enlargement, prostate cancer, ⬇️sperm production, Females: Development of beard, masculine charcterisitics, menstrual irregularities, High risk for MI, liver damage, severe mood swings, violent behaviorm, depression, paranoia, delusions, impaired judgment, acne, High risk for suicide

Indian hemp plant usually smokes, Tetrahydrocannabinol (THC) is active ingredient, Depressant hallucinogenic properties, Desired effects-euphoria, detachment, relaxation, Talkativeness, slowed perception of times, inappropriate hilarity, heightened sensitivity to stimuli, anxiety, paranoia, dizziness; red bloodshot eyes, Long-term effects-lethargy, anhedonia, difficulty concentrating, loss of memory

Endocannabinoids Brain-derived Regulates apetite, pain, pleasure, immune system, memory and mood Foods: omega 3s and omega 6s, Phtytocannabinoids-plants -THC, CBD, CBN, Synthetic cannabinoids - labs THC only (Marisol), K2, SPICE

Oneset/duration: 10-30 mins/2-3 hrs, Detection in urine 30 days, Withdrawal symptoms: insomnia, decreased appetite, nausea, irritability, anxiety, Paraphernalia: bongs, rolling papers, roach clips, scales, aluminum cans

More potent- from different part of the plant, Boom, gangster, hash, hemp, Smoked, swallowed, Frequent respiratory infections. mental, health decline, addiction

⬇️Testosterone & sperm count, ⬇️viability of sperm, ⬇️FSH & luteinizing hormone menstrual cycles affected anovulatory cycles, ⬇️Immunity, Age of use matters Use <17y.o.: smaller brain volumes & grey matter

⬆️BP, Tachycardia, ⬆️Sympathetic stimulation, ⬇️time to angina, ⬆️risk for MI for 1 hr after marijuana use

Designer drugs- sprayed onto plant matter and are usually smokes, Fentanyl of the marijuan world, Marketed as herbal incense or smoking blends, SE: N/V, tachycardia, HTN, suicidal thoughts, violence, paranoia

Hallucinogenic plant from Mexico, Saliva, shepherdess’s herb, Maria pastora, magic mint, Sally-D, diviner’s sage, Chewed, swallowed, smokes, Intoxication: Feelings of being separate from one’s body & environment, impaired motor function, Health risks: anxiety, tremors, numbness, memory loss, nausea

Lysergic acid diethylamide (LSD or acid), Mescaline (peyote), Psilocybin (magic mushroom), Phencyclidine piperidine (PCP, angel dust, horse tranquilizers peace pill), MXE, Bufotenine

Synthesized in 1938 in Switzerland, Developed as a circulartory & respiratory stimulant, Schedule 1 drug since 1970, Manufactured in clandestine labs, Appearance: crystalline material, microdot tablets, gelatin, sheets of perforated layer (blotter paper soaked in LSD-covered with colorful designs

Alter perception, cognition and moon, Acid, blotter acid, “candy flipping”, Onset/duration: 30-90 mins/12 hours, Most powerful hallucinogen known, Put in gel wraps, “Smartee” candies, blotters, sugar cubes

Signs: hallucinations, tachycardia, HTN, dilated pupils, hyperthermia, N/V, long lasting psychoses, diaphoresis, tremors, increased temp, No physical dependence - psychological dependence in unknown

Embalming fluid, angel dust, love boat, zombie, rocket fuel, elephant, hog, sherm, Dissociative anesthetic - human, Signs: retrograde amnesia, nystagmusm violent & erratic behavior, HTN, tachycardia, hyperthermia, sweating, flushed skin, drooling, ataxia, muscle rigidit or jerking, blank stare, ataxia, seizures, assualtiveness, impulsiveness

Sleepiness, Dizziness, Irregular HR, Loss of bladder control, Jerky eye movements, Heavy sweating, Speech impediments, Loss of reflexes, Kidney failure, Brain hemorrhaging, Coma, Death

Dissociative hallucinogen, Sold as designer drug, Feel relaxed, euphoric, agitated, “floating away”, Involuntary eye movements, loss of balance, poor coordination, slurred speech, paranoia, problems w/ communication, catatonia

Related to serotonin, Found in some species of toads, Secrete bufotoxins from parotid glands, Found in the Colorado River Toad and is now causing the species to be endangered, Only toad species with large quantities for psychoactive effect & aphrodisiac, Can be poisonous

Paranoid & grandiose, Depersonalization, Hallucincations**, Synthesia (colors are heard & sounds seen)**, Panic attacks, Bizarre and violent behavior, High suicide risk**

Psychosis, Brain damage, Death, PCP can cause hypertensive crisis, CVA, respiratory arrest, hyperthermia, seizures

Gastric lavage may lead to spasms or aspiration, Low stimuli*- minimal light, sound, activity, Stay with client, speak slowly & provide safety **, Give diazepam or Haldol, Acidify urine for PCP with cranberry juice- helps excrete drug from body- may take 10-14 days

Volatile solvents & other types of inhalants, Spray paint, glue, cigarette lighter fluid, Propellent gases used in aerosols, Gases (whipping cream, sprays, nitrous oxide, whippets, butane, propane, fabric protectors, dust spray for electronics, Produces anesthesia & slow body functions, Depresses CNS and causes euphoria

Children are at high risk, Effects: mouth ulcers*, GI probs, confusion, headaches*, anorexia, Causes hearing loss, brain damage, CNS and PNS damage, liver disease, kidney impariment, Death from asphyxiation, cardiac arrest, aspiration of vomitus, suffocation, bronchospasm, “sudden sniffing death syndrome”

Inhalants, Nausea & vomiting, Headache, Appetite decrease, Light sensitivity, Aches (Muscle), Neurons decreased, Tachycardia (arrhythmias) & tinnitus, Skin rash, sneezing, sniffing, slurred speech

Ecstasy- also called MDMA, Adam, XTC, MDA- “love”, MDE- “EVE, Also: E, XTC, X, rolling, beans, disco biscuits, Malcom X, vitamin X, smartees, skittles, Produce subjective effects resembling stimulants hallucinogens, Increases oxtocin & all neurotransmitters

Club drugs or designer drugs are neurotoxic, Causes neurons to release serotonin to produce euphoria =, damages 5-HT pathways in forebrain, Lasts 4-6 hrs- confusion. depression, sleep problems, and paranoia can last weeks, Methods of ingestion: orally, snorted, smoked, injected, Onset: 10 seconds to 40 minutes

Detected in urine for 2-5 days, Manufactured up ubregulated labs- frequently mixed with other drugs, Effects: increased stimuli & sensations, While using: engage in exhausting physical activities, ignore physical injuries, dehydration-suffer heat strokes

⬆️HR, BP, Temp, Rapid eye movement *, Nausea, sweating, chills,, Involuntary teeth grinding*, paranoia*, Dizziness, euphoria, dehydration

Memory loss, brain damage, Inability to sleep, depression, Anxiety, psychosis, cardiovascular issues

Hyperthermia, Jaw and teeth clenching, Seizures, Uncosciousness, Heart failure, Heat stroke

Mouth- bites side of mouth (trismus/bruxism), Death- “Suicide Tuesday”, Memory- deficits last 40 days, Aqua- Hypotonic water intoxication

Blow pops & pacifiers- prevents grinding of teeth & biting mouth, Nasal inhalers & decongestant rubs-enjoy sensation of menthol vapors, Surgical mask-menthol rub spread inseide the mask, Caffeine pills-mimic the MDMA high