Commonly Misused Substances

Transcription

1 Commonly Misused Substances

2 Substances Commonly Used in an At- Risk Manner Alcohol Ethanol, methanol, isopropyl alcohol. Seda+ve/Hypno+cs/Anesthe+cs Benzodiazepines, barbiturates, anesthe8cs (Gammahydroxybutyrate (GHB), ketamine). Primarily used orally although ketamine may be injected. Opioids Heroin, oxycodone, morphine, hydromorphone, methadone, fentanyl, codeine, propoxyphene and others. All of these substances maybe used orally, intranasally or by injec8on. Long ac8ng formula8ons and patches may be chewed. S+mulants Amphetamines, cocaine, methamphetamine, ephedrine, phencyclidine, methylphenidate. All of these substances may be used orally, intranasally or by injec8on. SAMHSA, 2005

3 Substances Commonly Used in an At- Risk Manner Hallucinogens LSD, mescaline, psilocybin (mushrooms), phenylcyclidine (PCP), ecstasy, methylenedioxymethamphetamine (MDMA). Cannabis/Tetrahydrocannabinol (THC) Marijuana. Smoked, vaporized, oral. Steroids Dianabol, nandrolone. Typically by injec8on. Vola+le Substances Toluene, acetone, butane, fluorocarbons. Inhaled ( Huffed ). cn#nue SAMHSA, 2005

4 Seda9ve/Hypno9c/Anesthe9c Benzodiazepines, barbiturates, anesthe9cs (GHB, ketamine) Altered consciousness Ataxia Sexual dysfunc8on Death Confusion Slurred speech Stupor/coma Loss of coordina8on Dizziness Apnea Memory impairment Weight gain Paradoxical/uncharacteris8c behavior Loss of mo8va8on Poor comprehension Development of tolerance Incoordina8on Emo8onal lability Memory impairment Poor task comple8on Nystagmus with accommoda8on (barbiturates) Severe anxiety Autonomic hyperac8vity Insomnia Psychosis Headache Seizure Hypersensi8vity to s8muli If injected, Ketamine use may present with Signs/SXS common to injec8on drug use. NIDA, 2008; Stark, 2009

5 Opioids Heroin, oxycodone, morphine, hydromorphone, methadone, fentanyl, codeine, propoxyphene Pinpoint pupils Respiratory depression Nausea/vomi8ng Bradycardia Cons8pa8on Coma Relaxed and/or euphoric state ("nodding ) Sexual dysfunc8on Amenorrhea Development of tolerance to euphoria/analgesia (but not to pupillary response) Yawning Diaphoresis Diarrhea Autonomic hyperac8vity Rhinorrhea Nausea/vomi8ng Tremor Malaise Lacrima8on Myalgia Insomnia Anxiety Piloerec8on Abdominal cramps Dysphoria, Signs/SXS related to route of administra8on: Injec8on: Embolis Celluli8s Endocardi8s HIV Abscesses Viral hepa88s Foreign body emboli Infec8ons consequences of unsterile injec8on Fresh needle marks and scaring (track marks) Soc 8ssue necrosis (with injec8on of pill forms) NIDA, 2008; Stark, 2009

6 S9mulants Amphetamines, Cocaine, Ephedrine, Phencyclidine Hypertension Diaphoresis Fine tremor Muscle spasms Tachycardia Agita8on Appe8te suppression Chest pain Tachypnea Paranoia Hyperthermia Sexual dysfunc8on Mydriasis Brisk reflexes Formica8on Weight loss Malnutri8on Reduced fer8lity Development of tolerance Muscle pain/tremor Depression/irritability Intense persistent drug seeking behavior Hunger No specific withdrawal syndrome but cessa8on of use may be accompanied by fa8gue/malaise Signs/SXS related to route of administra8on: Intranasal: Rhinorrhea Inhaled: Bronchi8s COPD/bronchiectasis Injec8on: Embolis Septal perfora8on Pneumonia Eczema localize to nares Dry mouth with poor den88on Burns to the lips and fingers Abscess forma8on Infec8ons consequences of unsterile injec8on Skin and soc 8ssue necrosis with chronic wound forma8on and adjacent or distant osteomyeli8s NIDA, 2008; Stark, 2009

7 Hallucinogens LSD, Ecstasy, Mushrooms Tachycardia Nystagmus Nausea Paranoia Dry mouth Ataxia Mood lability Bruxism Hyperreflexia Vomi8ng Mydriasis Autonomic hyperac8vity Visual/auditory hallucina8ons Tolerance develops rapidly to LSD, flashbacks may occur long acer heavy or prolonged use No specific withdrawal syndrome Medical Consequences: Rhabodomyolysis and acute renal failure with large doses, elevated liver enzymes NIDA, 2008: Stark, 2009

8 Cannabis Marijuana, tetrahydrocannabinol Euphoria Tachycardia Agita8on Dry mouth Poor concentra8on Anxiety Hypertension with postural hypotension Hunger Memory impairment Toxic psychosis Reddened conjunc8vae Paranoia Impaired manual dexterity Affect disorders Dental caries Cough Chronic bronchi8s No discrete withdrawal syndrome although cessa8on of use may be accompanied by disphoria or anxiety Restlessness and irritability Smoked cannabis is a respiratory irritant. No specific consequences associated with oral or vaporized consump8on. NIDA, 2008; Stark, 2009

9 Vola9le Substances Solvent smell Diarrhea Ataxia Nausea Sneezing Dysphoria Vomi8ng Coughing Disinhibi8on CNS depression Slurred speech Coma Nasal sores Fa8gue Depression Burns Memory loss Delusions Respiratory problems Weight loss Psychosis Perioral eczema (glue sniffer s rash) Poor concentra8on Primarily psychological dependence HA Inhala8on of vola8le substances is associated with sudden death from arrhythmia Drowsiness Chronic liver and renal failure Stark, 2009