ADA PRESENTATION CATHERINE AMULUNDU CLINICAL PSYCHOLOGIST. University of Nairobi ISO 9001: Certified

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1 ADA PRESENTATION CATHERINE AMULUNDU CLINICAL PSYCHOLOGIST University of Nairobi ISO 9001: Certified

2 Drugs & Substance Abuse

3 OBJECTIVES Help the participants understand the basic concepts in drugs and drug abuse Identify the causes of ADA Differentiate the different classes of the drugs and their effects

4 What are psychoactive drugs? Psychoactive drugs interact with the central nervous system (CNS) affecting: mental processes and behaviour perceptions of reality level of alertness, response time, and perception of the world 4

5 ADA SITUATION IN THE COUNTRY AND WORKPLACE 33.3% of employees in the public sector are currently using alcohol, 8.5% tobacco, 3.8% miraa, 1.1% bhang and 0.4% narcotics (mandrax, heroin, cocaine). In comparison to the national prevalence, current usage of alcohol in the public sector (33.3%) is markedly higher compared to the rest of the country (13.6%); current usage of tobacco in the public sector (8.5%) is slightly lower compared to the rest of the country (9.1%); current usage of miraa in the public sector (3.8%) is slightly lower compared to the rest of the country (4.2%); And current usage of bhang in the public sector (1.1%) is slightly higher compared to the rest of the country (1.0%) 1 NACADA Public Sector Survey NACADA Research Survey 2012

6 Cont d. Results also show that 7.2% of current alcohol users drink on a daily basis, 8.8% have failed to go to work in the last one year due to a hangover and 9.2% take alcohol in the morning to enable them to start working.

7 Science has generated much evidence showing that prolonged drug use changes the brain in fundamental and long-lasting ways

8 Implication: Brain changes resulting from prolonged use of drugs may compromise mental and motor functions

9

10 POINT TONOTE When a person first tries drugs, it is usually a voluntary decision, but After repeated drug use, deciding to use drugs is no longer voluntary because DRUGS CHANGE THE BRAIN! 10

11 ADDICTION PROCESS Early detection of drug use can prevent against drug addiction. Addiction can be divided into five stages: 1. Experimental 2. Social 3. Instrumental 4. Habitual 5. Compulsive

12 MODES Orally Nasally Intravenously Intramuscular Subcutaneously Per rectal topically

13 Modes of administration

14 Modes of administration

15 Modes of administration 15

16 Modes of administration

17 Modes of administration 17

18 Modes of administration

19 Downloading, Flushing, Sambaza

20 Why Do People Take Drugs in The First Place? To feel good To have novel: feelings sensations experiences AND to share them To feel better To lessen: anxiety worries fears depression hopelessness

21 Why do people initiate drug use? Much, if not most, drug use is motivated by the pursuit of pleasure.

22 MODELING

23 CIGARETTE PACKET WARNINGS Parental model influences the children most 23

24 CULTURAL INFLUENCES

25 SOCIAL ACCEPTANCE

26 POPULAR CULTURE Music

27 MUSIC and DRUGS

28 Work pressure e.g. Heavy workload Unrealistic Deadlines Low achievement Low self esteem Poor/lack of conducive environment Lack of proper working tools/ frustration Work related hazards e.g. Pub workers, medical staff.. 28

29 We Know There s a Big Genetic Contribution to Drug Abuse and Addiction.Overlapping with Environmental Influences that Help Make Addiction a Complex Disease.

30 Biology/genes Biology/ Environment Interactions Environment

31 Classification of drugs Stimulants Depressants Hallucinogens Inhalants Prescription drugs Steroids

32 32 Stimulants

33 Catha Edulis

34 Crystalmeth

35 Cocaine & ECSTASY

36 36 Chang aa Production

37 Depressants Decrease the activity of the central nervous system.

38

39 A standard drink MTC HD

40 Standard Drink

41 Alcohol MTC HD

42 Risky drinking levels (for chronic harm) MTC HD

43 Heavy drinking More than 14 drinks per week for men (or >4 drinks per occasion); more than 7 drinks per week for women (or >3 drinks per occasion); and more than 7 drinks per week for all adults 65 years and above Most Kenyans do binge drinking- wild, excessive drinking

44 44

45 Hallucinogens Cause pronounced alteration of perception, a state of fantasy or illusion, a feeling of being lost in the world of dreams.

46

47 LSD

48 Can inhalants be found at home?

49 Prescription drugs Are legally available over the counter at chemists and hospitals. 1.Psychotropic medications 2.Sleep medication 3.Pain medication 4.Ant allergies/ anti histamines 5.Cough syrups and expectorants

50 Effects of Drugs Effects of Drugs

51 Neurotoxicity NEUROTOXICITY AIDS, Cancer AIDS Mental illness CANCER MENTAL ILLNESS Homelessness Crime Violence Health care Productivity Accidents

52

53 Drama & shame behind Alcohol

54

55 Long-term effects of stimulants Strokes, seizures, headaches Depression, anxiety, irritability, anger Memory loss, confusion, attention problems Insomnia, hypersomnia, fatigue Paranoia, hallucinations, panic reactions Suicidal ideation Nosebleeds, chronic runny nose, hoarseness, sinus infection Dry mouth, burned lips, worn teeth Chest pain, cough, respiratory failure Disturbances in heart rhythm and heart attack Loss of libido Weight loss, anorexia, malnourishment, Skin problems

56 Effects of Tobacco Aneurysm- cardiovascular disease Cataracts Cancer (lung and other types) Chronic bronchitis Emphysema Asthma symptoms Obstructive pulmonary diseases Heart disease (stroke, heart attack) Vascular disease FASD/SIDS Death

57 Healthy Lungs Smokers Lungs

58 Gum damage hence tooth decay

59 Increased tooth decay 59

60 Tobacco can cause oral cancer. 60

61 61

62 Buerger s Disease. Blood vessels get blocked and this starves the body parts which may lead to amputation of arms. 62

63 your company name. All rights reserved. Title of your presentation

64 64

65 Impotence

66 Secondary smoke

67 Men in Diapers What grown men are forced to do when they have Spermatorrhea 67

68 BEFORE

69

70 Long-term effects of alcohol use Decrease in blood cells leading to anemia, slow-healing wounds and other diseases Brain damage, loss of memory, blackouts, poor vision, slurred speech, and decreased motor control Increased risk of high blood pressure, hardening of arteries, and heart disease Liver cirrhosis, jaundice, and diabetes Immune system dysfunction Stomach ulcers, hemorrhaging, and gastritis Thiamine (and other) deficiencies Testicular and ovarian atrophy Harm to a fetus during pregnancy 70

71 Normal Liver Liver damaged by alcohol 71

72

73 FETAL ALCOHOL SYNDROME Brain of baby with Brain of baby with heavy no exposure to alcohol prenatal exposure to alcohol 73 Photo courtesy of Sterling Clarren, MD 73

74 Birth defects

75

76 76 Septic needle marks

77 Cancer of the tongue

78 Suicide Leading causes of death in people below 30 years. Alcohol is a factor in more than 60% of all suicide attempts. 78

79 INTRODUCTION HIV: Human Immunodeficiency Virus. H Human This particular virus can only infect human beings. I Immunodeficiency HIV weakens the human immune system by destroying important cells that fight disease and infection. V Virus A virus can only reproduce by incorporating itself into the cell of the human body (host). AIDS: Acquired Immuno-Deficiency Syndrome; An advanced stage of HIV infection.

80 MAGNITUDE OF HIV/AIDS Globally: By 2013 Approx. 78million people had become infected since the beginning of epidemic. Approx. 39million people had died since the beginning of the pandemic. Sub-Saharan Africa: Approx million people had HIV infection. Women accounted for 58% of all HIV infections.

81 KENYA 2013 HIV prevalence in Kenya is 5.6%. Population of approx. 40million. This is 2.24m individuals!! 101,560 New infections in Kenya. 21% of the new infections occurred in young women aged years. 191,840 children were living with HIV infection. 63% of men and 80% of women knew their HIV status (ANC)

82 HIV TRANSMISSION: The human body is the reservoir of the infectious virus. The virus is present in; Human blood, Semen, Vaginal secretions, Breast milk and other body fluids and secretions.

83 TRANSMISSION The Virus can be transmitted through: 1.Unprotected (vaginal, oral, anal)sex with someone who is HIV infected. 2.Injection or Transfusion of contaminated blood or blood products. 3. Donation of Semen (AI) 4.Skin Graft or organ transplants taken from infected individual

84 ACUTE INFECTION Acute retroviral syndrome. (ARS) Within 2-4 weeks after HIV infection, most people develop flu-like symptoms. Symptoms can include fever, swollen glands, sore throat, rash, muscle and joint aches and pains, fatigue, and headache. At this stage, the body has not produced Antibodies against HIV, so the individual is Antibody tests-negative!!

85 LATENCY STAGE (3 6 months) After the acute stage of HIV infection, the disease moves into a stage called the clinical latency stage Latency means a period where a virus is living or developing in a person without producing symptoms. During the clinical latency stage, viral replication slows down, the body`s immune system is forming the antibodies and the screening tests are POSITIVE. This stage can last for several years.

86 Management of HIV positive Currently, No individual should die due to HIV infection! Combination of: Non-Discrimination!! Love and support from all the people connected. Healthy lifestyle. Good and balanced Nutrition. Prevention of Opportunistic infections (TB, Bacterial infections, HIV related malignancies, Herpes Zooster, Wasting syndrome). Maintenance on ART if indicated.

87 ARVs- Anti-Retro-Virals ART (Antiretroviral Therapy) PMTCT (Prevention of Mother To Child Transmission) PEP (Post Exposure Prophylaxis) Pr-EP (Pre Exposure Prophylaxis)

88 LEVELS OF PREVENTION Primary: Before the infection occurs Stay negative. Secondary: The infection is present Get managed and avoid further infections Tertiary: The infection has reached the level of disability, improve the quality of life. Home Based Care

89 PRIMARY PREVENTION STRATEGIES ABC A: ABSTINANCE B: BE FAITHFUL TO ONLY ONE PRTNER!! C: CONDOM USE.

90 BE FAITHFUL TO ONE PARTNER!!

91 SERVICES AT THE UHS (some) VCT PEP PMTCT VMMC Cervical cancer screening STI screening and treatment Psycho-social support Bring your concerns to us and we shall take it up.

92 WHAT IS YOU ROLE?? Do you have the right and effective decision-making SKILLS. Must you give in to peer pressure? The fight of HIV infection must be won!! Should have been won yesterday!! Other epidemics are catching up!!

93 IS THERE HOPE! WHAT CAN WE DO! WHAT S OUR ROLE.!???? University of Nairobi ISO 9001: Certified

94 And if you were Thank you for listening! University of Nairobi ISO 9001: Certified

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