CLUB DRUGS. Neva Chauppette, Psy.D.

Transcription

1 CLUB DRUGS presented by: Neva Chauppette, Psy.D. P.O. Box 6234, Woodland Hills, CA CA Psychologist License # PSY14524 (818) (cell) - (818) (fax) NCHAUPPETT@aol.com ( )

2 COMMONLY ABUSED CLASSES OF PSYCHOACTIVE DRUGS UPPERS: (STIMULANTS) COCAINE, AMPHETAMINES, NICOTINE, CAFFEINE Physical Effect: overstimulation - increased heart rate, blood pressure; decreased appetite Mental Effect: overconfidence, excitability, anxiety, paranoia

3 COMMONLY ABUSED CLASSES OF PSYCHOACTIVE DRUGS DOWNERS: (DEPRESSANTS) OPIATES, SEDATIVE-HYPNOTICS, ALCOHOL Physical Effect: understimulation - slowed heart rate & respiration, decreased muscle coordination and energy, dulls the senses Mental Effect: initial small doses act as stimulants because inhibitions are lowered; longer and larger dose use causes slowing of mind and body overconfidence, excitability, anxiety, paranoia

4 COMMONLY ABUSED CLASSES OF PSYCHOACTIVE DRUGS ALL AROUNDERS: (PSYCHEDELICS) LSD, PCP, MDMA, MARIJUANA, PEYOTE Physical Effect: (plants) = nausea, dizziness (LSD, MDMA) = raises blood pressure, sweating Mental Effect: intensifies visual stimuli, creates hallucinations

5 COMMONLY ABUSED CLASSES OF PSYCHOACTIVE DRUGS INHALANTS: GLUE, GAS, PAINTS, AMYL/BUTYL NITRITE, NITROUS OXIDE Physical Effect: central nervous system depressants, lower blood pressure, fainting, dizziness, slurred speech, unsteady gait, drowsiness Mental Effect: impulsiveness, excitement, irritability, delirium, hallucinations

6 ROUTES OF ADMINISTRATION FIVE ROUTES LISTED IN DESCENDING ORDER: 1) Inhaling -- (7 to 10 seconds) 2) Injecting -- (15-30 secs.) intravenously (IV or slamming) (3-5 mins.) intramuscular (IM or muscling) (3-5 mins.) subcutaneously (skin popping) 3) Snorting -- (3-5 minutes) mucosal exposure 4) Contact -- (3-5 minutes) "dropping acid" (10-15 minutes) morphine suppositories 5) Oral -- (20-30 minutes)

7 DETECTION PERIOD RANGE Alcohol Amphetamines (Crank, Speed, Ice) Barbiturates (Phenobarbital) Benzodiazepines (Valium, Librium, Tranxene) Cocaine (Coke, Crack) Doriden ½ to 1 days 2-4 days 2-4 days Up to 30 days Up to 30 days hours 2-4 days

8 DETECTION PERIOD RANGE Marijuana (Casual Use (4 joints wk) (Daily Use) (Chronic, Heavy Use) Opiates/Opioids (Dilaudid) (Darvon) (Heroin) (Methadone) PCP (Casual Use) (Chronic, Heavy Use) 5-7 days days 1-2 months 2-4 days 6-48 hours 2-4 days 2-3 days 2-7 days Several Months

9 WITHDRAWAL EFFECTS Generally, the withdrawal effects are usually the opposite of the direct effects of the drug: Heroin Effects Withdrawal Symptoms (BECOMES) numbness pain euphoria anxiety dryness of mouth sweating & running nose constipation diarrhea slow pulse rapid pulse low blood pressure high blood pressure shallow breathing coughing pinpoint pupils dilated pupils sluggish muscle severe hyperreflexing & muscle cramping

10 METHAMPHETAMINE Crank, Crystal, Meth, Speed, Chrissy Most associated with HIV transmission in Los Angeles County The hypersexuality associated with the use of methamphetamine expands harm reduction considerations to include safer sex

11 METHAMPHETAMINE Be screened and treated for any sexually transmitted diseases Be screened for and vaccinated against Hepatitis A and B

12 SIGNS AND SYMPTOMS OF USE AND WITHDRAWAL OF METHAMPHETAMINE Drug Signs of Use Signs of Withdrawal Methamphetamine increased heart rate, increased body temp., respiration, and CNS stimulation,higher blood pressure, extra energy, appetite suppression, mild to intense euphoric states, with prolonged use: irritability, paranoia, anxiety, mental confusion, poor judgment, possible hallucinations 1) Dehydration 2) appetite and weight loss 3) loss of sleep 4) be cautious of aggression potential

13 METHAMPHETAMINE Avoid douching or enemas Use of safer sex strategies includes: Barrier use Lubrication use (Meth sex is often rougher)

14 METHAMPHETAMINE Use of safer sex strategies includes: Types of sex and position options Timing of sex (i.e., menses, illness, etc.) Ejaculation outside the body

15 METHAMPHETAMINE Use of safer sex strategies includes: Avoid felching/rimming w/o barriers Maintain good oral hygiene Don't floss/brush before sex Get cavities filled and gum disease treated

16 METHAMPHETAMINE Use of safer sex strategies includes: Not using ejaculation as lubrication Additional methamphetamine will not resolve erection difficulties, neither will Viagra

17 METHAMPHETAMINE Use of safer sex strategies includes: Avoid mixing amyl/butyl nitrate "poppers" with Viagra Uncircumcised males are more susceptible to STDs Reduce risk by preventing foreskin from entrapping body fluids

18 METHAMPHETAMINE The side effects of methamphetamine are: Dehydration - so hydrate, before, during and after, even if not thirsty Appetite and weight loss - pace the use of the methamphetamine, increase food consumption even if not hungry, preferably not induced by marijuana use

19 METHAMPHETAMINE Side effects: Loss of sleep - reduce use of methamphetamine, hydrate and eat, avoid alcohol Psychosis - don't use alone, seek admission preferably into a detox unit, be cautious of aggression potential

20 METHAMPHETAMINE Avoid mixing methamphetamine and the protease inhibitors This interaction could magnify the potency of the methamphetamine by 2-3 fold and will take much longer to clear

21 ECSTASY Classified as a hallucinogen or psychedelic, greater likelihood of psychological than physical dependence

22 ECSTASY aka MDMA, E, X, STC, Adam, Essence Usually in pill form The consumption of XTC is called X-ing Cost of a single pill approx. $25.00

23 SIGNS AND SYMPTOMS OF ECSTASY USE AND WITHDRAWAL Ecstasy Drug Signs of Use Signs of Withdrawal The user may experience a feeling of euphoria, an increased confidence, feelings of trust in others, increased heartbeat, rise of body temp., sweating, dehydration, or loss of appetite. Euphoric state achieved within minutes of pill consumption and lasts about 3-4 hours. The user may experience flashbacks, depression, anxiety, fatigue, dehydration, loss of appetite, a constant ringing in the ears, or feeling sick. Other responses include headaches, difficulty sleeping, or increased sexual drive.

24 ECSTASY Risk of heatstroke is real Warning signs of heatstroke: failure to sweat heat cramps in legs, arms, and back

25 ECSTASY Warning signs of heatstroke: Dizziness, headache, fatigue Vomiting, little urinary output with sparse output highly discolored

26 ECSTASY Warning signs of heatstroke: Fainting or loss of consciousness Sudden feeling of exhaustion Irritability and/or confusion

27 ECSTASY To reduce the risk of a heatstroke: Hydrate Drink a pint of water every hour Sipping water at intervals is better than drinking large amount at a time

28 ECSTASY Avoid over hydrating as that can lead to water toxicity, rare but potentially deadly Alcohol will dehydrate Try to eat something salty, drink fruit juice, sports drink

29 ECSTASY Avoid caffeinated beverages Avoid wearing a hat, which will further entrap body heat Take a period of time to cool down Stop dancing for a while

30 ECSTASY If someone collapses: 1) call an ambulance 2) get the person to a cool place 3) drench them with water as cold as possible

31 ECSTASY 4) increase the cooling down process by fanning the person, 5) when the ambulance arrives, tell them what you think the person has taken,

32 ECSTASY 6) once the body temperature is down to 102ºF wrap the person in a dry blanket or give him/her dry clothes 7) the body temperature shouldn't be permitted to fall much below 102ºF or other serious consequences might develop

33 ECSTASY XTC may cause teeth grinding and lockjaw Many ravers will suck on pacifiers while on XTC to reduce the risk of both XTC may dilate the pupils

34 ECSTASY Many ravers will wear sun visors to reduce the stimuli flood due to the pupil dilation Coming down off of XTC may trigger flashbacks, depression, anxiety, fatigue, dehydration, loss of appetite, a constant ringing in the ears, difficulty sleeping and headaches

35 ECSTASY Some XTC users purchase from local health food stores an amino acid, 5-HTP (hydroxytryptophan, Griffonia Seed-50 mg tablets, a bottle of 30 tablets $11.00) This amino acid is a building block of serotonin and promotes balanced serotonin levels in the brain

36 ECSTASY Because serotonin levels appear to be reduced by XTC use, resulting in "post-e-blues" (depression), XTC users often use this amino acid to minimize the depression associated with the comedown

37 ECSTASY In an attempt to verify the authenticity of the XTC purchased, some users have $25.00 an "Ecstasy Adulterant Screening Kit" manufactured and sold by the non-profit agency, Dancesafe

38 ECSTASY Proper use of this kit will identify the presence of a real ecstasy-like substance in the pill/powder (MDMA, MDA, MDE) It will not tell how pure the pill is, how much ecstasy is in the pill, or which form of XTC is present

39 ECSTASY Each kit can test approximately 200 pills A small scraping of the pill is tested by a Marquis reagent, which changes color in the presence of certain drugs

40 ECSTASY If XTC, in any of its forms, is present, the reagent will turn black quickly If it turns bright orange, this indicates the presence of an amphetamine, not XTC

41 SEXTASY Sextasy combination of Viagra (a drug used to treat erectile dysfunction) and Ecstasy. Growing in use and availability by club goers and others around the country and the world. Viagra is used in combination with Ecstasy to compensate for decreased sexual function (caused by Ecstasy).

42 SEXTASY Consequences of this combination include potential heart failure, erections that do not subside for hours, and anatomical damage. Can lead to unprotected, risky sexual encounters that can lead to HIV and other STDs.

43 GHB (gamma hydroxybutyrate) Classified as a sedative-hypnotic Very sedating If mixed with alcohol may lead to unconsciousness

44 GHB (gamma hydroxybutyrate) Date-Rape Drug It is colorless, odorless, slightly salty tasting liquid, but is also available in powder and capsule form It is most often swallowed and can easily be slipped into a drink

45 GHB (gamma hydroxybutyrate) At lower doses, GHB has a euphoric effect similar to alcohol (relaxed, sociable, happy) At higher doses, it may cause sedation, nausea and vomiting, muscle stiffness, confusion, unconsciousness, and in some cases coma and respiratory collapse

46 GHB (gamma hydroxybutyrate) The synergistic effect with alcohol and/or other depressants increases the risk for overdose, unconsciousness, and death

47 GHB (gamma hydroxybutyrate) GHB has a very narrow "therapeutic width," which means that the dose difference between the desired effect and falling into a coma is small A teaspoon or capful by mouth is usually considered a normal dose

48 GHB (gamma hydroxybutyrate) A safe dose that gave the desired effect today, may not do the same tomorrow The effects can generally be felt within 5 to 25 minutes after ingestion

49 SIGNS AND SYMPTOMS OF GHB USE AND WITHDRAWAL Drug Signs of Use Signs of Withdrawal GHB gammahydoxybutyrate At lower doses, can be similar to alcohol. Inhibitions are lowered, leading to a quirky calm feeling or sometimes darker mood. At higher doses, it causes sedation, nausea, muscle stiffness, confusion, and in some cases, coma and respiratory collapse. The greater amount taken, the more pronounced the effects such as nausea, a feeling of calmness, perhaps interference with mobility and verbal coherence, and seizures. Plenty of rest may be required as high doses usually induce sleep.

50 GHB (gamma hydroxybutyrate) Body builders have been known to use GHB, as it promotes slow wave sleep, which is when the body secretes muscle-building hormones

51 GHB (gamma hydroxybutyrate) Don't consume GHB and drive One dose of GHB can impair motor coordination as much as 6 drinks of alcohol Effects come on fast, and, unlike alcohol, the effects cannot be controlled or paced

52 GHB (gamma hydroxybutyrate) Daily use of GHB can cause physical dependence with harsh withdrawal symptoms, including seizures

53 GHB (gamma hydroxybutyrate) If a user becomes unconscious or begins to seizure, call an ambulance The user should be positioned on his/her side so if vomiting occurs choking can be avoided

54 KETAMINE Classified as a "dissociative anesthetic" Also known as: K, Vitamin K, Kit-Kat, Ketalar, Special K, Techno Smack, or CK1

55 KETAMINE "K" was originally created for use as a human anesthetic Still used as a general anesthetic for children and in veterinary medicine

56 KETAMINE Dissociative anesthetics are drugs that separate perception from sensation Ketamine usually comes as a liquid in small pharmaceutical bottles, and is most often cooked into a white powder for snorting

57 KETAMINE Most people snort small lines or bumps" At lower doses, "K" produces a mild dreamy feeling that the user often describes as floaty and as though they feel outside their bodies

58 KETAMINE Numbness in the extremities is also common It has the ability to cause physical tissue dependence Higher doses can produce hallucination (usually visual) and is often experienced as a separation of mind from body

59 KETAMINE This experience is referred as a "Khole" and is often compared to an out-of-body or near-death experience with the sensation of rising out of one's body

60 KETAMINE While in a K-hole, it is very difficult to move as "K" can induce a state of virtual helplessness and a pronounced lack of coordination The user is detached from reality and often fully engaged in another reality

61 SIGNS AND SYMPTOMS OF KETAMINE USE AND WITHDRAWAL Drug Signs of Use Signs of Withdrawal Ketamine (Special K) Can cause hallucinations (usually visual). The user may feel as if they have entered another reality or K-Hole. As an anesthetic, it stops the user from feeling pain and interferes with simple tasks such as walking. Can induce a state of virtual helplessness and a pronounced lack of coordination. Lowers the heart rate, larger doses can lead to oxygen starvation and acute respiratory failure.

62 KETAMINE To avoid injury or death, ketamine should never be used alone, get a "Ground Controller" to stay with the user the entire time Use the drug in a safe, secure, familiar environment

63 KETAMINE "K-dens" are user-supported environments where the drug can be used under the watchful experienced eye of a sober user

64 KETAMINE If snorted, the effect comes on within 5 to 10 minutes and usually last 20 minutes to an hour If swallowed, the effects come on in minutes and last several hours

65 KETAMINE One hundred milligrams is usually enough to enter a "K-hole" However, if liquid ketamine is injected into the muscle, less is need to enter a "K-hole"

66 KETAMINE Ketamine is never injected into a vein Many people experience nausea and vomiting after consuming ketamine. It is therefore wise to avoid eating at least 3 hours before you consume ketamine

67 KETAMINE It is particularly important that if the user loses consciousness that he/she be positioned on their side to avoid choking on vomit Death is rare and typically is associated with injecting ketamine

68 KETAMINE Ketamine psychosis generally subsides after a few weeks Individuals with psychiatric histories (personal or family of origin) should avoid this drug

69 KETAMINE Short-term memory loss is common Both physical and psychological tolerance can develop rapidly The development of psychological dependence is much more likely than the development of physical dependence

70 KETAMINE Because Ketamine is a dissociative anesthetic, the user often feels no pain while under the influence of the drug There are anecdotal reports of using Ketamine during fisting, because of the disconnection from pain sensation Possession of Ketamine is illegal with prosecution possible

71 POPPERS (volatile nitrates) aka Amyl, Rush, Ram, (and other brand names), poppers, amyl nitrites, isobutyl nitrites Mostly used as an aphrodisiac. Used in recreational activities, poppers can enhance music, rhythm, movement, and lighting effects

72 POPPERS (volatile nitrates) It is packaged in small glass ampules. Volatile nitrates are consumed by inhaling fumes through nose or through the mouth. If spilled, these drugs can burn the skin and are highly toxic if swallowed or injected.

73 POPPERS (volatile nitrates) Effects: Nitrates alter the dilation of blood vessels and lower the body s pressure. May cause increase in heart rate; may cause sense of warmth, cosmic bliss and giddiness. Headaches may also occur after extended use.

74 POPPERS (volatile nitrates) Sexual Response: Disinhibiting effects can occur; such as increase in skinsurface sensuality and relaxation of smooth muscles (i.e., rectum). Anal and vaginal penetration can be facilitated while having a decreased pain sensation. Do not mix poppers with Viagra both are vasodilators. There is a potential for sharp decrease in blood pressure, fainting, loss of consciousness, or death.

75 POPPERS (volatile nitrates) Coming down: If inhaled before sexual orgasm, there is often a sense of exhilaration, disinhibited movement and vocalization and prolonged intense orgasm. If inhaled too soon prior to orgasm or for long periods of time, a loss of erection may occur. Safe sex intentions can be compromised, especially if used with other drugs.

76 POPPERS (volatile nitrates) Special HIV considerations: While it has been suggested that poppers are associated with Kaposi s sarcoma (KS); this has not been substantiated. There is little information on any possible damage caused to the immune system. Little is generally known about the interaction with HIV medications.

77 TEN SIGNS OF SEXUAL ADDICTION 1. Out of control behavior escalating frequency escalating dangerousness

78 TEN SIGNS OF SEXUAL ADDICTION 2. Consequences - escalating and compounding consequences a) impaired or decreased job performance due to preoccupation, absenteeism b) STD, unwanted pregnancies

79 TEN SIGNS OF SEXUAL ADDICTION c) possible arrests - lewd/lascivious conduct d) marital/monogamous relationships are jeopardized/lost

80 TEN SIGNS OF SEXUAL ADDICTION 3. Inability to stop - self perpetuation of behavior once guilt and shame are fused 4. Self-destructive or high risk - as frequency of "using" goes up, so too does the need for drama; danger to add to the "rush"

81 TEN SIGNS OF SEXUAL ADDICTION 5. Effort/desire to limit the sexual behavior - limit sexual behavior to only certain types, with certain partners, etc.

82 TEN SIGNS OF SEXUAL ADDICTION 6. Sexual obsession/fantasy - when things are uncomfortable or problematic, this is the mental place sex addicts go to

83 TEN SIGNS OF SEXUAL ADDICTION 7. Increased amounts - it is equivalent to physiological need (tolerance) and the desire to achieve the same effect can only be reached with increasing frequency, intensity, etc. of acts

84 TEN SIGNS OF SEXUAL ADDICTION 8. Mood swings - sex is used as a fix to alter "bad" mood states but ultimately is bad itself due to the guilt/shame

85 TEN SIGNS OF SEXUAL ADDICTION 9. Increased time - preoccupation with obtaining, using and recovering from sexual fix

86 TEN SIGNS OF SEXUAL ADDICTION 10. Neglect - as disease progresses, so does the pervasiveness of the neglect

87 SEXUAL ADDICTION Important points to remember: The individual is in possession of the drug When providing treatment to an individual with a sexual addiction, abstinence cannot be the goal