Uppers, Downers and All Arounders

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Uppers, Downers and All Arounders

• Chapter 7
• Other Drugs, Other Addictions

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Inhalants

• Used for their stupefying, intoxicating and
  slight psychedelic effects
• Most widely abused according to popularity are
• Nitrous oxide
• Nitrites
• Gasoline
• Glue
• Spray paint
• Aerosol spray
• Lacquer thinner
• Typewriter correction fluid

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TYPES OF INHALANTS
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Inhalants

• Readily accessible to children
• Get little attention because of low status of
  inhalant abuse as a drug problem
• Practice of inhaling substances goes back to
  ancient times
• Modern version is with abuse began in 1700s with
  the discovery of nitrous oxide, chloroform and
  ether
• After WWII abuse of glue and metallic paints rose
  dramatically and continues today
• Responsible for 700 1,200 deaths each year

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Inhalants

• Abuse is prevalent among adolescents, although
  adults abuse it too
• Internationally, abuse afflicts the young, poor,
  and children exposed to chemicals daily,
  especially children of cleaners and shoemakers
• Inhalant of choice for many countries is gasoline
• More males and females abuse inhalants
• High use among Hispanics and Native Americans

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Inhalants

• Methods of inhalation
• Sniffing breathing the substance from a
  container directly into lungs
• Huffing soaking a rag and inhaling from it
• Spraying the inhalant into the nose or mouth
• Balloons or crackers suing a tool to puncture a
  container that releases the inhaler into a
  balloon and then is inhaled
• By spraying the pressurized solvent directly into
  the mouth, a dangerous amount of pressure is put
  into the lungs and can freeze tissue

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Inhalants

• Volatile solvents
• Mostly carbon hydrocarbon based compounds that
  turn into gas at room temperature
• Includes, gasoline and its addictives, kerosene,
  paints, especially metallic, paint thinner, nail
  polish remover, spot removers, glues and plastic
  cements, lighter fluid and variety of aerosols
• Quick acting because they are absorbed almost
  immediately, then moves to heart, brain, liver
  and other tissues

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Inhalants

• Short-term Effects
• Temporary stimulation
• mood elevation
• Reduced inhibitions
• Reward/reinforcement center is affected like
  cocaine does
• Soon depressive effects takes over
• Dizziness
• Slurred speech
• Unsteady gait
• Drowsiness
• High does may cause illusions, delusions and
  hallucinations

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Inhalants

• Prolonged inhalation causes
• Delirium with confusion
• Psychomotor clumsiness
• Emotional instability
• Impaired thinking
• Coma
• Long-term Effects
• Lack of coordination
• Weakness
• Disorientation
• Loss of weight
• Impaired memory
• Can cause injury to brain, liver, kidney, bone
  marrow and particularly the lungs

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Inhalants

• Toulene (methyl benzene)
• Most abused solvent
• Found in glues
• Drying agents
• Solvents
• Thinners,
• Paints
• Inks and cleaning agents
• In one study, 65 of chronic abusers of spray
  paint had neurological damage
• m

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Inhalants

• Trichloroethylene
• Common solvent found in typewriter corrections
  fluids, paints, metal degreasers and spot
  removers
• Causes overall depressive effects and some
  hallucinations
• N-Hexane methyl butyl ketone (MBK)
• Used in glues and adhesives and diluents for
  plastics and rubber
• Recovery from brain damage can take three years

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Inhalants

• Alkanes
• Methane, ethane, butane and propane
• Gasoline sniffing is common on some Native
  American reservations
• Effects include insomnia, tremors, anorexia, and
  sometimes paralysis
• When leaded gas is inhaled, symptoms include
  hallucinations, convulsions, and chronic
  irreversible effects of lead poisoning
• Alcohol inhalants include ethanol, methanol,
  isopropanol

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Inhalants

• Warning signs of solvent abuse include
• Headaches
• Chemical order on body, clothes or room
• Red, glassy or watery eyes and dilated pupils
• Inflamed nose and/or Nosebleed
• Rashes around the nose and mouth
• Slow, thick or slurred speech
• Staggering gait, Disorientation, Lack of
  coordination
• Pains in chest and stomach
• Nausea Fatigue
• Shortness of breath
• Loss of appetite
• Intoxication
• Irritability and aggression
• Seizure Coma

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Inhalants

• Volatile Nitrites
• Amyl Nitrate (1857)
• Dilate blood vessels so heart and brain receive
  more blood
• Effects start in 7-10 seconds and last 30 seconds
  to 1 minute
• One inhalation there is
• a feeling of fullness in head,
• Rush of mild euphoria
• Dizziness
• Giddiness
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Inhalants

• Effects wear off, user experiences
• Headaches
• Vomiting
• Nausea
• Chills
• Thought to enhance sexual activity
• Sought by male homosexuals for their euphoric and
  psychological effects
• Viagra and methamphetamine combination can
  dangerously lower blood pressure
• Tolerance develops rapidly
• Variants sold as room odorizer, tape head
  cleaners and sneaker cleaners

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Inhalants

• Anesthetics
• Chloroform, Ether, Oxygen and nitrous oxide
• Found to have euphoric effects as wells as
  anesthetic effects
• Abused by young people, middle class, affluent
  groups like doctors, anesthesiologists, hospital
  workers, and healthcare professionals
• Nitrous Oxide discovered in 1776
• Immediately used as a recreational drug
• Common abused form is whipping crème bottles
• Source container is used to fill a balloon then
  inhaled
• 7-10 seconds effects begin
• Dizziness, giddiness and disorientation
• Lasts 2-3 minutes
• Long-term exposure can cause central and
  peripheral nerve damage and brain cell damage due
  to lack of oxygen since nitrous oxide replaces
  oxygen in blood

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Inhalants

• Halothane
• Prescription surgical anesthetic gas (Fluothane)
• Because of limited availability, abuse tends to
  be with anesthesiologists and hospital personnel
• Dependence
• DSM-IV-TR classifies inhalant disorders as
  inhalant dependence and abuse, intoxication,
  induced delirium, dementia, psychotic disorder,
  mood disorder and anxiety disorder
• Breaking habit or treating compulsion difficult
  due to users being young and immature, combined
  with cognitive impairment that hinders
  comprehension and recovery

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SPORTS AND DRUGS

• Three main categories of drugs
• Therapeutic used for medical problems
• Performance enhancing (ergogenic drugs) that are
  mostly banned
• Recreational or mood altering drugs
• History
• Greek Olympic athletes ate large amounts of
  mushrooms or meat to improve performance
• 1800s cyclists, swimmers and other athletes used
  morphine, opium, cocaine, caffeine,
  nitroglycerin, sugar cubes soaked in ether and
  low doses of strychnine
• Boxers drank water laced with cocaine between
  rounds

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SPORTS AND DRUGS

• During Cold War era, Soviet weightlifting team
  used steroids in the 1952 Olympics initiating a
  steroid race for medals
• 1958 steroids were widely abused by athletes
• Commercialization of sports pressured athletes to
  improve their performance
• 2001 estimates that 400,000 junior high and high
  school students had tried steroids
• High school athletes encouraged to use steroids
  to bulk up and then go clean in college
• Anabolic Steroids stunt bone development and
  disrupt hormonal function in adolescents

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SPORTS AND DRUGS

• Therapeutic Drugs
• Used for medical problems
• Four main groups Anesthetics, Muscle relaxants,
  Anti-inflammatory Asthma medications
• Anesthetics
• Used to deaden pain
• Topical anesthetics desensitize nerve endings on
  skin
• Most common are opioids, including
• Vicodin (most prescribed), Demerol, Morphine,
  Codeine, Darvon
• Danger is the drugs block pain without repairing
  damage
• Compulsive use and dependence and result

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SPORTS AND DRUGS

• Muscle relaxants
• Depresses neural activity within skeletal muscles
• Used to treat muscle and ligament damage
• Some athletes use relaxants to control anxiety
• Abused occasionally for mental effects
• Benzodiazepines are highly addictive, with
  tolerance and tissue dependence

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SPORTS AND DRUGS

• Anti-inflammatory drugs
• Controls inflammation and lessen pain
• Nonsteroid aspirin, ibuprofen, butazoliden
• Corticosteroids cortisone prednisone
• High doses cause severe psychosis
• Asthma medications
• Affects 10 of population
• Aggravated by heavy exercise
• Exercise induced asthma found in 11-23 of
  athletes
• Permission given to use certain asthma
  medications
• Ephedra is banned due it stimulant quality

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SPORTS AND DRUGS

• Anabolic-androgenic steroids (AASs)
• Very broad category of drugs
• Most are banned by Olympic Committee
• Most abused performance enhancing drugs
• Derived from male testosterone or are synthesized
• Anabolic means muscle building
• Androgenic means producing masculine
  characteristics.
• Clinically used to treat
• testosterone deficiency
• Osteoporosis,
• Certain types of anemia
• Breast cancer
• Endometriosis

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SPORTS AND DRUGS

• Anabolic-androgenic steroids (AASs)
• Athletes use to
• Increase body weight
• Lean muscle mass
• Muscular strength
• Increases aggressiveness and confidence
• Patterns of use
• Steroid users may take 20-200 times the
  clinically prescribed dose
• Stacking practice of taking 3 or more kinds of
  inject able or oral steroids and alternating
  cycles of use and non-use
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SPORTS AND DRUGS

• Anabolic-androgenic steroids (AASs)
• Cycling means taking steroids for 4-18 weeks
  during intensive training, then stopping for
  weeks or months to give body a rest
• 82 who used steroids took 3 or more different
  types of steroids
• 30 took 7 or more during training

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SPORTS AND DRUGS

• Anabolic-androgenic steroids (AASs)
• Side Effects
• Increased masculinization
• Increased muscle mass and muscle tone
• Bloated appearance
• Long-term use causes suppression of bodys own
  natural testosterone
• Long- term use in men causes feminine
  characteristics
• Swelling breasts
• Nipple changes
• Decreased size of sexual organs
• Impairment in sexual function

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SPORTS AND DRUGS

• Anabolic-androgenic steroids (AASs)
• Side Effects Women
• Gain in muscular development occur with
  masculinizing effects, including
• Increased facial hair
• Decreased breast size
• Lowered voice
• Clitoral enlargement
• Mental emotional effects
• Confidence and aggressiveness
• Emotional instability
• Rage
• Depression
• psychosis

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SPORTS AND DRUGS

• Anabolic-androgenic steroids (AASs)
• Compulsive use and addiction
• Initially feels a sense of euphoria and wellbeing
  that contributes to continued use and compulsive
  use
• Studies show that steroids increase body mass and
  muscle strength when combined with diet and
  exercise
• Athletes obtain steroid from
• Black market through gyms, mail order companies
  or friends
• From doctors, veterinarians, or pharmacists
• Serious users spend 200-400 weekly
• Some professional athletes spend 20,000-30,000
  year

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SPORTS AND DRUGS

• Other drugs used by athletes
• Stimulants like amphetamines, caffeine,
• Ephedra and ephedrine (banned by NFL, IOC, and
  NCAA, but not the NBA, NHL or major league
  baseball
• Chewing tobacco
• Human growth hormone (HGH)
• Used by athletes to increase muscle strength and
  growth
• Reduces fat
• Increases muscle mass, skin thickness and
  connective tissue
• Gigantism and abnormal bone growth reported
• Metabolic and endocrine disorders reported
• Abuse associated with cardiovascular disease
• Decreases life span by up to 20 years
• Banned by U.S. Olympic Committee, NCAA
• Difficulty to detect because it is found
  naturally in the body

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SPORTS AND DRUGS

• Recreational/mood-altering use of drugs by
  athletes
• Peer pressure
• Help to fit in social situations
• Help cope with heavy schedule
• Reduce stress
• Fill up time on long road trips
• Stimulants
• Amphetamines, caffeine and tobacco

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SPORTS AND DRUGS

• Recreational/mood-altering use of drugs by
  athletes
• Sedatives-hypnotics
• Xanax, Barbiturates, Opioids taken as
  self-rewards
• Used to unwind after competition
• Counter-act use of stimulants
• Alcohol
• Marijuana (NCAA bans use)
• Testing
• NCAA uses two drug-testing programs
• One for all championships and post season
  football games

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OTHER ADDICTIONS

• Compulsive behaviors
• Gambling, overeating, shopping, sexual behavior,
  Internet use and TV watching, compulsive lying,
  hair pulling, fire setting
• Impulsive control disorders
• Failure to resist an impulse that is harmful to
  the individual or others
• Often starts off as being pleasurable
• Increasing sense of tension or arousal before
  actually committing the act
• Often followed by gratification, pleasure, relief
• Then remorse and guilt over the consequences of
  the act

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OTHER ADDICTIONS

• Compulsive behaviors
• Obsessive compulsive disorders
• Excessive hand washing, checking things,
  ordering, and counting
• Repetitive activity whose goal is to reduce
  anxiety or distress.not pleasure or
  gratification
• Addictive behaviors change brain chemistry in
  much the same way as psychoactive drugs
• People change their behaviors much like those who
  are recovery from alcohol or other drugs
• Many 12 Step groups are formed around compulsive
  behaviors

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OTHER ADDICTIONS

• Compulsive behaviors
• Can be triggered by
• Genetic predisposition,
• Environmental stresses
• Comfort and reassurance or escape provided by
  repetitive behaviors
• Increased dopamine levels suggest biochemical
  thread
• Twin studies show a connection between compulsive
  behaviors and heredity
• Compulsive over-eating shown to be partly
  hereditary

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OTHER ADDICTIONS

• Compulsive behaviors
• Mid-1990s genetic connections between alcohol,
  drug and compulsive behaviors shown
• Genetic predisposition indicated a genetic marker
  in the reward deficiency syndrome in severe
  cases of alcohol, drug and compulsive behaviors
• Researchers propose that carriers of the A1
  allele gene have a deficiency of dopamine
  receptors in the reward/reinforcement center

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Compulsive Gambling

• Compulsive Gambling
• 125 million Americans gamble and of those, 2.2
  million are pathological gamblers, and 5.3
  million are problem gamblers
• 1.1 million are teenagers
• Male compulsive gamblers outnumber females 2 or 3
  to 1
• College students have a higher rate of gambling
• Gamblers anonymous formed in 1957

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• Slide 7-10 List of the four phases that lead to
  compulsive gambling.
• In the winning phase, gamblers are confident they
  can make a living gambling.
• In the losing phase, they start to chase their
  losses and gamble poorly.
• In the desperation phase, their debts mount, they
  gamble foolishly and will do anything to keep
  gambling.
• In the giving up phase, they feel they can never
  win and all they want to do is stay in action and
  will do anything to stay there. Mania,
  depression, and suicide thoughts are common.

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Compulsive Shopping (Oniomania)

• Compulsive Shopping (Oniomania)
• Inability to handle money in a responsible manner
  is a hall mark of almost any addict
• Shopping addicts report relief from depression
  and subsequent high when buying similar to a
  cocaine high
• Both result in a subsequent crash accompanied by
  depression and guilt than felt before buying
• More than 400 debtors Anonymous groups in U.S.
• Depression seems a major part of compulsive
  shopping

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Anorexia Nervosa

• Eating Disorders
• Anorexia Nervosa addiction to weight loss,
  fasting and control of body size
• Maintains weight by limiting food intake through
  fasting, dieting, excessive exercise, use of
  amphetamines and other diet pills
• Bulimia symptoms appear in 30-80 of all
  anorexics
• Have distorted perceptions of their bodys shape
  and size
• Often feels overweight even when emaciated
• Anorexics have a tendency to be concerned with
  following directions and people pleasing
• May be considered to be good girls, model
  students, academically talented, but lack
  self-esteem.
• Refusal to eat gives the anorexic sense of
  control over their lives

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Anorexia Nervosa

• Semi-starvation strains all the body systems,
  especially the heart, liver brain
• Death rates are 4-20
• Most severely ill anorexics have to admitted to
  the hospital due to
• Extreme weight loss
• Disturbed heart rhythms
• Extreme depression
• Often suicide ideation
• Loss of menstruation
• Takes 10-12 weeks for full nutritional recovery
• Rate for full recovery is 40
• Prozac and other antidepressants help anorexics
  improve eating behaviors

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Bulimia Nervosa

• Characterized by eating large amounts of food in
  one sitting, followed by inappropriate methods of
  ridding self of food
• Self-induced vomiting
• Use of diuretics, laxatives, fasting and
  excessive exercise
• Often are ashamed of their behavior, doing it in
  secret
• During binge episodes, there may be a feeling of
  frenzy, not feeling in control and sense of being
  disconnected from ones surroundings

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Bulimia Nervosa

• Causes include
• Social pressure to look thin
• Socialization of girls to look thin
• Biochemical changes that reward bingeing and
  purging
• Problems
• Dental complications and propensity towards
  alcohol and drug abuse
• High rate of depression
• Greater risk of suicide
• Risk of stomach acid burns to esophagus and
  throat resulting in chronic sore throat and risk
  of cancer
• Heart arrhythmias, electrolyte imbalances and
  irregular or loss of menstruation

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Binge Eating Disorder

• Marked by recurrent episodes of binge eating
  without vomiting, laxatives or other compensatory
  activities
• People eat in response to emotional states rather
  than hunger
• Used to modify emotions, especially anxiety,
  solitude, stress, and depression
• Generally overweight
• May suffer from high cholesterol, diabetes, high
  blood pressure, gall bladder disease, heart
  disease and high rates of depression
• Allows their self-esteem to suffer

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Binge Eating Disorder

• Both physiological and psychological causes
  underlie the disorder
• Treatment is addressed through counseling,
  psychiatric treatment and behavioral therapy and
  self-help groups
• Diet pills that contain amphetamines are used for
  short-term periods
• Diet pills may work initially, but lose their
  effectiveness

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SEXUAL ADDICTION

• Sexual behavior which the addict has little
  control over
• Practiced by males, females, gay, straight, young
  and old
• Includes masturbation, pornography, serial
  affairs, phone sex, visits to topless bars and
  strip shows
• Practiced as a way to cope with anxiety,
  solitude, low self-worth
• Can be the persons all-consuming activity

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INTERNET ADDICTION

• Survey of 18,000 people by ABC News found that
  almost 6 of participants met criteria for
  serious compulsive problem
• Symptoms include
• Logging in on every chance there is
• Thinking about the internet constantly
• Needing progressively more time online to get
  same satisfaction
• Losing track of time while online
• Neglecting responsibilities
• Checking email constantly

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INTERNET ADDICTION

• Cybersexual addiction
• Over 10 million internet users log onto 10
  popular sex sites in 1 month
• Computer Relationship Addiction
• Pursuit of online relationships to the neglect of
  real-life relationships