Drug Education for SA Providers Courtney Ycaza, MA, LCAS, LPC, CSI

McLeod Addictive Disease Center

4/17/2015

Objectives

• Recall basic drug groups & a refresher on each

• Descriptions of designer drugs & comparison

• Current trends

• Screening Clients & how to work with clients based on this drug education

What do you want to know?

Major Drug Categories

• Opiates • Benzos • THC • Alcohol • Amphetamines • Depressants • Steroids • Inhalants • Hallucinogens

“Uppers, Downers, All- Arounders”

• Uppers: Stimulants

• Downers: Opiates/ Opioids, Sedative-

Hypnotics, Alcohol & minor downers

• All- Arounders: Everything Else

Uppers

• Strong: Cocaine, Amphetamines

• Moderate: Diet Pills, Some Rx’s

• Mild Plant: Khat, Betel Nut, Ephedra

• Legal Stimulants: Caffeine, Nicotine

• Stimulants initially boost energy; long term they

deplete the body and can lead to depression

Downers

• Opiates/ Opioids

• Benzos

• Alcohol

• Opiates are Natural, Semi-synthetic or Synthetic

• Benzos: Sedatives are the ‘calming drugs’; Hypnotics are the ‘sleeping drugs’

• Alcohol is the worlds most widely used drug, is legal in most countries

Basic’s to remember...

• Medical need vs. abuse/ dependence

• “If my doctor prescribed it then it’s OK”

• Detox process needs to be carefully considered

Designer Drugs

• Usually labeled ‘Not for Human Consumption’

• Internet has fueled sales of designer drugs

• No research- Human Testing!

• Usually variations of things we already have; designed to get around laws

• Unknown effects, unknown treatment

Where did Designer Drugs come from?

• Dr. John W Huffman- Clemson University • 1984: Researching Cannabinoid compounds for

MS, HIV, Chemo • Developed over 450 synthetic compounds • JWH series was the first; reports that it was

found on the internet and used to start making synthetic THC

The New World of Designer Drugs

• Matt Bowden of New Zealand

• Founder of Stargate International

• Recovering Meth Addict

• Runs one of the worlds most sophisticated labs for development of new designer drugs

All- Arounders

https://m.youtube.com/watch?v=cLD3AKoyV5Q

• Stargate is a private organisation dedicated to minimising the harms associated with drug use across the community.

• Stargate’s role, both in New Zealand and internationally, covers a number of facets:

• • Advocating for more effective, evidence-based drug policy through the political process at a national level, and through governments & NGOs to influence global policy; • The development and bringing to market of progressively safer, legal alternatives to alcohol and other drugs to reduce harm by providing substitution options; • Funding the Neuronutrients project to subsidise targeted nutritional technology to support the body's natural systems of addiction interruption, abstinence maintenance and cognitive restoration for existing and recovering alcohol and other drug users; • The development of ‘on the ground’ harm minimisation strategies in the retail and consumption environments to provide physical help for people experiencing drug related difficulties; • Establishment of self-funded clinics to bundle advanced treatment services tailored to individual consumers with an unprecedented level of duty of care; • Representing the interests and issues of those communities most effected by drug use to government and the public.

- Taken from Stargateinternational.org

Krokodil (Desomorphine)

• Derivative of morphine that is 8 to 10x ore powerful

• Get the name because users develop patches of dark, scaly skin

• Been around for a while; last medical use in 1981 • 2003: Homemade version in Siberia • 2010: Increased illegal production in Russia • Multiple reports of use in the US; Nothing

confirmed by DEA of any toxicology • Life expectancy of users is 1 to 2 years

DMT: The Spirit Molecule

• Found in some plants; used with another plant in the Amazon for natives in rituals

• Users report a relatively low urge to use more (cravings)

• Extreme Hallucinatory experiences- “Machine Elves”

• Users rank it to be stronger than Ketamine, LSD and Shrooms

• Number of people in the US using DMT has gone up every year since 2006: ▫ 688,000- 2006 ▫ 1.475 M- 2012

Flakka

• http://miami.cbslocal.com/2015/03/24/exclusive-man-on-flakka-impaled-while-trying-to-climb-fence/

• Causes hallucinations, superhuman thinking, temporary insanity, violent outburst

• Increased body temps can lead to cardiac arrest, arrhythmias, kidney failure

• Multiple reports of use leading to injuries and arrest

25I- NBOMe

• Synthetic LSD • Manufactured in China as a safe, legal alternative to

LSD • Sold as powder, liquid, blotter paper, edibles • Discovered in 2003, hit the illegal drug market in

2010 when it was sold by vendors as research chemical

• 6 to 10 hour high based on dose • Lethal dose has not yet been determined • As of 9/2013, 6 OD deaths in the US (+1 in NC since

then)

Designer Drug Intoxication & Addiction

• Varies; look for normal signs of intoxication

• Clients acting erratic, violent or aggressive

• Confused or disoriented behaviors

• Changes in behavior

• Changes in weight

• May agree to drug screens thinking they are ‘getting around’ the system

• Other signs of addictive behavior

Designer Drugs: Treatment

• Medical treatment may be needed in the event of intoxication (Hydration, monitoring, benzo if needed)

• No medication interventions in treatment

• Will need to look at drug testing issues

• Can look at options for treatment related to the type of drug it is mimicking

Designer Drugs: Client Issues

• Clients may be hesitant to disclose their use of Designer Drugs

• Will need to discuss testing procedures with your lab

• Due to the notion that some of these are not addictive, clients may not see them as an issue

• Adolescent clients will report high use of these designer drugs

• Clients may look at this as a legal high

The Bottom Line

• Designers are out there and new ones are coming daily

• As professionals, we have to try and be aware of what’s going on with our clients

• When one compound is made illegal, another will replace it

• Designers have little to no actual research so, there is not much known about there long term effects

Current Drug Trends • $700 Billion in annual cost to the US from Alcohol, Tobacco & other drugs •1 in 3 fatally injured drivers tested positive for drugs (2009) •MTF Survey: Rates of teens using e-cigs is rising • Ages 18- 25: More first time Rx pill use than THC use

North Carolina Statistics

• NC statistics are similar to national stats • Meth lab seizures in NC are also similar to

national statistics • NC Controlled Substances Reporting System • Drug Take- Back Programs • Atlanta HIDTA • North Carolina counties: Alamance, Buncombe,

Durham, Gaston, Guilford, Henderson, Johnston, McDowell, Mecklenburg, Randolph, Union, Wake, Wayne, and Wilson

The Big Business of Drugs

• Marketing Heroin •Marketing THC

As treatment providers, what do we

do? • Ask Questions

• Stay Current

• Work with other professionals

• Provide Education

Recovery

• “The mentality and behavior of drug addicts and alcoholics is wholly irrational until you understand that they are completely powerless over their addiction and unless they have structured help, they have no hope.” ― Russell Brand

Questions?

References

• Uppers, Downers, All- Arounders: Physical and Mental Effects of Psychoactive Drugs. 6th Edition. Darryl S Inaba & William E Cohen. 2007

• DSM- 5. Fifth Edition. American Psychiatric Association.

• The ACA Encyclopedia of Counseling. ACA. 2009

Contact Info

• Courtney Ycaza

• Courtney.ycaza@mcleodcenter.com