Depressants

Downers are psychoactive drugs that depress or slow down the functioning of the Central Nervous System.  This results in pain relief, muscle relaxation, lowered body temperature and drowsiness.  Coma and death can result from slowed heart rate and respiration.

Benefits: can experience feelings of inhibition, reduced stress and anxiety, relaxation, pain relief, aid in sleeplessness, and inhibit formation of memories.

Psychological Effects: pain relief, drowsiness, euphoria, relaxation, sensual sensitivity.

Physical effects: nausea, vomiting, decreased motor control, slow movements, lower heart rate and pulse.

Withdrawal Symptoms: diarrhea, nausea, vomiting, insomnia, loss of appetite and weight, anxiety, intense physical craving.  Withdrawal can be life-threatening.

Alcohol

Beer, wine, liquor

Psychological Effects: exhilaration, excitement, talkativeness, slurred speech, poor judgment, loss of memory, decreased alertness, lack of inhibitions, aggressiveness, blackouts, hallucinations, destruction of brain cells, alteration of brain metabolism.

Physical effects: loss of coordination, motor control, slurred speech, double vision, low blood pressure, shallow respiration, hangovers, nausea, vomiting,  reduction of REM, blackouts, cirrhosis, dementia, destroys brain cells, coma and death.  Scours the body of vitamins.

Withdrawal Symptoms: insomnia, hangover, Nausea, fatigue, tremors, loss of appetite, nausea, sweating, high blood pressure, convulsions.  Also, confusion, disorientation, sweating, fever, dehydration, suicide.  Withdrawal is life-threatening.

Medical Treatments:

  • disulfiram (antabuse) causes sever reactions and discomfort when combined with alcohol.
  • naltrexone (ReVia), opiate management, but does not counteract the craving or the withdrawal symptoms
  • nalmafene ( Revex) as above
  • acamprosate (Campral) GABA related treatment
  • ondansetron (Zofran), serotonin related

Pharmacology:

  • solubillity in water helps distribute it to all bodily tissues.
  • solubility in fat facilitates blood-brain barrier crossing and keeps it in the body for up to two months.
  • excreted via the lungs (5%) and the urine (95%) after biotrans-formation has occurred:

1.      oxidation by alcohol dehydrogenase converts alcohol to acetaldehyde.

2.      acetaldehyde dehydrogenase converts acetaldehyde in the liver to acetic acid.

3.      further oxidation to oxygen, CO2 and calories.

Acute Physiological Effects:

toxic reactions: (over drinking), heat loss, diuretic effects (problems getting rid of water or water retention), cardiovascular diseases, elevated blood pressure, reduced REM sleep, pregnancy and retardation in fetus (teratogenic), hangovers (headaches, nausea, fatigue, thirst).

drug interactions: with acetaminophen: increased risk of liver damage, antihistamines: excessive sedation leading to fatality

Acute Behavioural Effects: blackouts (inability to remember events during intoxication, even though awake during these episodes), impaired motor skills (bad driving skills, poor coordination, vision impairment, slurred speech), violence and aggression, sex and desire impairment.

Cognitive Expectation Theory: learned beliefs or expectations of alcohol and its effects can facilitate aggressive behaviours.  Fear and aggressiveness of not being able to handle the conflict between the ‘supposed to’ and ‘what is’.

Alcoholism: a condition where the consumption of alcohol has produced major psychological, physiological, social and occupational impairments.

Symptomatic drinking: a few drinks after work (recreational licit)

Enablers: individuals who consciously or unconsciously encourage another’s alcohol consumption in abuse

Alcohol abuse: the continued use despite knowledge of psychological, physiological, social or occupational problems that alcohol may contribute to.

BAC: blood alcohol content measures number of grams of alcohol in 100ml of blood.

Binge drinking: drinking two or more days at the expense of other activities so as to drink.

Chronic Effects:

Tolerance: tolerant effects caused in part by alcohol dehydrogenase in stomach and liver leading to increased excretion and oxidization. The brain becomes less responsive to its effects, so less of an effect is felt.  This leads to major physical problems such as cancers and brain cell death.

Physical Withdrawal:

Alcohol Withdrawal Syndrome: insomnia, vivid dreaming, severe hangover, tremors (shakes), mild agitation, anxiety (jitters), nausea and vomiting, increased heart rate and blood pressure.

DTs or delirium tremens: extreme disorientation, confusion, profuse sweating, fever, disturbing nightmares, frightening hallucinations.    3 – 4  days after sue can be life-threatening heart failure, dehydration or suicide.

Cancer: increased risk of cancer in the larynx and pharynx.

Alcoholic dementia: impairments in problem solving, remembering info, organizing facts.

Wernicke’s disease: confusion, disorientation, abnormal eye movements, difficulties in body movement and coordination as a result in vitamin B (thiamine) deficiency.

Korsakov’s psychosis: chronic amnesia and apathy, cannot remember info just presented to them, patchy memory of distant events,

Confabulation: creating elaborate stories to compensate for gaps in the memory.

3 forms of liver disease:

Fatty liver: abnormal concentration of fatty deposits as aliver is used to break down alcohol at its expense.

Alcoholic hepatitis: inflammation of liver tissue causing fever, jaundice, abdominal pain.

Alcoholic cirrhosis: progressive development of scar tissue chokes off blood vessels and destroys liver cells.

Fetal Alcohol Syndrome:

  • pre or post natal growth retardation
  • mental retardation or CNS abnormaliti4es
  • Characteristic skull and facial developments: smaller head, wide set eyes, drooping eye lids, flattening of vertical rove between nose and mouth, thin upper lip, short upturned nose.
  • Physical Growth Abnormalities such as malformed digits.

Fetal Alcohol Effect: only some symptoms of FAS are present.

Codependency: having similar issues as those involved in substance misuse, without the substance misuse.

Concordance rate: the likelihood that one member of a twin or family will have a condition if the other one has it.

  1. AA: abstinence based treatment involving the belief in a higher power
  1. SMART: Self Management and Recovery Training is based on Rational Emotive Behavioural Therapy (REBT), emphasis on NHP or no higher power with professional involvement and the individual has the power to do anything.

Heroin

AKA: Opiates: heroin (junk, down, smack), morphine (Big M, morpho), codeine). Synthetic opioids (Demerol, methadone (juice), fentanyl (china white)

Psychological Effects: anxiety or depression, drug preoccupation, dependence, illegal activities, anti-social behaviour,

Physical effects:

IV: initial tingling and warmth sensation similar to a sexual orgasm., intense euphoria, drowsiness (on the nod).  Diminished sexual appetite, low testosterone. Intense itching, red eye, pinpoint pupils, decreased respiration and vomiting can result in death, nausea, long term constipation, muscle twitches, death from overdose.

Smoking: euphoria, dream like states, long term use can cause loss of muscle coordination and can lead to paralysis and death.

Withdrawal Symptoms: intense withdrawal symptoms and need for a fix or cure for sickness.  Higher blood pressure, heart rate, can be life threatening, may include nausea, sleeplessness, insomnia, physical sickness,

Medical Treatments:

  • propoxyphene: (Darvon), synthetic opiate
  • clonidine (Catapres), treating high blood pressure, reducing stress in withdrawal
  • UROD: ultra rapid opioid detoxification: administration of naltrexone and clonidine while anaesthetized to achieve complete heroin withdrawal in a matter of hours.
  • MMT: methadone maintence
  • LAAM: levo-alpha-acetylmethadol (Orlaam), longer duration than methadone so fewer treatments
  • buprenorphine: (Subutex),  with naloxone – Suboxone.

OxyContin

AKA: oxycodone (OxyContin, Percocet, Percodan), hydrocodone (Vicodin, Hycodan),

Forms: tablets, white powder, clear liquid.

Psychological Effects: similar to heroin, but can last from 10 to 12 hours.

Physical effects: seizures, dizziness, confusion, cold or clammy skin, loss of consciousness, small pupils.  Slurred speech, decreased respiration that can lead to death. High tolerance can lead to overdose, especially if mixed with other drugs.

Withdrawal Symptoms: life-threatening, tremors, nausea, sweating, high blood pressure, loss of appetite.

Barbituates

Tasteless, odourless, at sufficient dosages they reliably induce sleep. Long-acting 6 or more hours, intermediate acting 4 – 6 hours, short acting less than 4 hours, ultra-short acting sometimes seconds, but lasts only  minutes (thiopental, Pentothal).

Acute Effects: normal, relief from anxiety, disinhibition, sedation, sleep, general anesthesia, coma, death.

Withdrawal symptoms: very similar to those of alcohol.

Anxiety: complete lack of concern, mild apprehension, justified anxiety, unjustified anxiety, panic

Anxiety Disorders:

  • panic disorder: sudden unpredictable terror
  • OCD: obsessive-compulsive disorder: persistent unwelcome thoughts, images or feelings, or need to engage in ritualistic behaviours.
  • PTSD: post traumatic stress disorder: persistent terrifying thoughts based on a past experience
  • Social anxiety disorder: overwhelming anxiety and excessive self-consciousness in social situations.
  • specific phobias: intense fear of something that poses no real danger
  • generalized anxiety disorder: greater than normal anxiety levels.

Sedative hypnotics (for sleep)    GHB

AKA: Barbituates, Non-barbituates (GHB, Gamma Hydroxyl Butyrate, Grievous Bodily Harm, G) also Gammabutyrolactone (GBL)

Forms: tablets, capsules, white powder, clear liquid.

Psychological Effects: relaxation like alcohol, but with greater euphoria, disinhibition, memory loss, paranoia, sleep, suicidal ideation, antisocial tendencies.

Physical effects: slurred speech, decreased respiration that can lead to death. High tolerance can lead to overdose, especially if mixed with other drugs.

Withdrawal Symptoms: life-threatening, tremors, nausea, sweating, high blood pressure, loss of appetite.

Anti Anxiety drugs (tranquilizers)

Rohypnol:

aka meprobamate, Benzodiazepines, Rohypnol: flunitrazepam, date rape drug., rophies, ropies, ruffies, roofies.

Buspirone:

Psychological Effects: aggressiveness, high energy, increased disinhibition, increased sexual stimulation, hallucinations, disorientation, confusion and obsession.

Physical effects: drowsiness, loss of memory, consciousness and motor control, headaches, dizziness, nightmares, blood shot eyes, muscle relaxation,  slurred speech, slowing of psycho-motor performance, blackouts, potentially lethal if combined with alcohol – respiratory depression.

Withdrawal Symptoms: life-threatening seizures, insomnia, strokes and increased anxiety.

Inhalants  (Glue)

AKA: Glue, solvents, paint thinners, aerosols, plastic cements, ether, nitrous oxide (dental anesthetic), whipped cream propellants, PAM,

Psychological Effects: floating euphoria, intoxication, giddiness, sometimes loss of consciousness, hallucinations, recklessness, omnipotence,

Physical effects: headaches, dizziness, double vision, dazed expression, sneezing, sniffing, light sensitivity, reddened eyes, rash around mouth, nausea, vomiting, slurred speech, diarrhea, chest pains, ringing in the ears.

Withdrawal Symptoms: mild withdrawal symptoms including nausea, depression, insomnia and loss of appetite.

Inhalants   (Poppers)

AKA: Amyl, butyl nitrites.

Psychological Effects: floating euphoria, intoxication, giddiness, sometimes loss of consciousness, hallucinations, recklessness, omnipotence, moderate psychological dependence,

Physical effects: headaches, dizziness, double vision, dazed expression, sneezing, sniffing, light sensitivity, reddened eyes, rash around mouth, nausea, vomiting, slurred speech, diarrhea, chest pains, ringing in the ears.

Withdrawal Symptoms: mild withdrawal symptoms including nausea, depression, insomnia and loss of appetite.

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