Unit 14 Commonly Abused Nonprescription Drugs

Commonly Abused Nonprescription Drugs

Substance Common Signs and Symptoms of Intoxication

Common Signs and Symptoms of Intoxication

Commercial and Street Names

Acute Health Effects/Health Risks

Possible Treatment Options

Tobacco Nicotine Abdominal cramps Agitation/restlessness excitement/ confusion Seizures Depression Headache

Vomiting Palpitations Muscle Twitching/ Damage Burning sensation in the mouth/drooling

Ciggies/darts/durries/rollie s Smokes/fags/butts/cancer sticks/snuff/shag/leaf crop/plant/

Cancer/heart disease/stroke/COPD/ Diabetes/Infections Dental Problems/hearing loss/ Vision loss pregnancy risks

CBT/Mindfulness Support hotlines Motivational Interviewing Web/text/social media- based interventions Nicotine Replacement Therapy (NRT) Antidepressants: Wellbutrin Nortriptyline Varenicline (Chantix) Acupuncture Hypnotherapy

Alcohol Alcohol (Ethyl Alcohol)

Lack of coordination

(stumbling/swaying) Flushing of the face Bloodshot eyes Louder speech than Usual Slurred speech

Damp or clammy skin Mood swings or Personality changes

(aggression/depression ) Drowsiness Vomiting Stupor

Booze, Cold One, Firewater, Hard Stuff, Liquid courage, Nightcap, Sauce, Shooter, Giggle juice

HBP, Heart disease, stroke, liver disease, digestive problems, Cancer (breast, mouth, throat, esophagus, voice box, liver, colon, rectum)

Detox: in/outpatient, therapy or counseling, medications: Naltrexone (Revia) Acamprosate (Campral) Disulfiram (Antabuse)

Cannabinoids Cannabinoids Euphoria, relaxation, agitation, irritation, irritability, increased bp, disorganization, red/bloodshot eyes, appearing intoxicated, glassy eyes, tachycardia, nystagmus, ataxia, slurred speech

Impaired coordination, sleepiness, risky behaviors, decreased inhibitions, extreme hunger (munchies), paranoia, extreme anxiety, panic attacks, psychosis, injury to self or other d/t the effects on judgement, perception, coordination

Pot, grass, dope, MJ, Mary Jane, hooch, weed, hash, reefer, ganja

Heart attack, increased appetite, tachycardia, memory loss, challenges in problem solving, depression, anxiety, hallucinations, * Harmful effects on the CNS/PNS: Hyperemesis syndrome, impaired coordination and performance, anxiety, mood disorders, exacerbation of psychotic d/o, neurocognitive impairment,

Motivation enhancement therapy Cognitive Behavioral Therapy Contingency manage- ment

Commonly Abused Nonprescription Drugs

cardiovascular dz, neurological dz, respiratory dz, cerebrovascular dz, peripheral vascular dz, pneumomediastinum, pneumothorax, pneumopericardium, bullous lung dz, increased risk of COPD, desquamated interstitial dz, appearance of brown pigmented macrophages.

Hashish Lowered resistance to illnesses: cold, the flu, bronchitis Adolescents grow issues Abnormal cell structure and division insomnia, headaches, depression

Reduction of testosterone production And reduced sexual functioning Respiratory problems Emotional & psychological issues: lack of motivation, depression, increased risk of development of psychosis, anxiety, panic attacks, hallucinations irritability, cravings, trouble sleeping, decrease appetite

Mary Jane Bud Ganga Herb Chronic Grass Dope Hash Trees hemp

Chronic bronchitis, chest colds, HBP, infant’s motor development - memory and learning - distorted perception (sight, sounds, time touch) - difficulty in thinking and problem solving - loss of coordination

- Cognitive-behavioral therapy (CBT) - contingency management

Opioids Heroin Shallow breathing Blue skin or lips Confusion Small pupils Loss of consciousness

Dope, smack, H, Junk, Skag, Snow, Horse, China white, Brown, Beast, Hero

Loss of pregnancy Cardiovascular infections and problems Excessive intake Euphoria, vague speech, HIV, addiction, depression, drowsiness; impaired coordination, dizziness, confusion, nausea, sedation;

Buprenorphine, naltrexone, Methadone, behavioral therapies

Commonly Abused Nonprescription Drugs

feeling of heaviness in the body, slowed or arrested endocarditis hepatitis, fatal overdose,

Opium Altered mental status (confusion) Delirium Decreased awareness or Responsiveness Breathing problems (slow or stop) Extreme sleepiness or loss of alertness Euphoria Tiny pupils

Aunti, Aunti Emma, Big O, Black pill, Chandu, Chinese Molasses, Dopium, Dream Gun, Fi- do-nie, Gee, Guma, Midnight Oil, Zero

Brain death, Loss of pregnancy Cardiovascular infections and problems Excessive intake Euphoria, vague speech, HIV, addiction, depression, drowsiness; impaired coordination, dizziness, confusion, nausea, sedation; feeling of heaviness in the body, slowed or arrested endocarditis hepatitis, fatal overdose,

Buprenorphine, naltrexone, Methadone, behavioral therapies

Stimulants Cocaine feelings of euphoria, increased alertness, hypersensitivity to outside stimuli, increased heart rate, increased body temp, chest pain, tremors, panicky feelings, anxiety, delirium, paranoia,

Aunt Nora, Batman, Big C, Big Rush, Blow, Candy, Charlie, Coca, Coke, Colombia, Crack, Pearl, Powder, Rail, Snow, Stardust, Stash, White Girl

Higher blood pressure and heart rate, anxiety, paranoia, and panic, Shaking, Erratic and even violent behavior, Vertigo, Nausea, Muscle spasms, Heart attack, Stroke, Seizure, Irregular heart Rhythm, Coma, Cramping, nasal damage

Residential treatments for detox, Behavioral Interventions: Contingency Management CBT Therapeutic Communities: Vocational Rehab Community-based Programs (Cocaine Anonymous)

Amphetamine

Psychosis, Hallucinations, Delusions, Paranoia, Hostility, Aggression, marked increase in energy, wake for hours, decreased

Addies, Bennies, Black Beauties, Crosses, Hearts, LA Turnaround, Speed, Truck Drivers, Uppers

Addiction, Tolerance, Increased respiration rate, Cardiac arrhythmias, Headache, Nausea and vomiting, Malnutrition, Cardiovascular system

Residential program, extended residential program, medically managed detox, individual therapy, group therapy, family therapy, cognitive behavioral therapy, rational emotive

Commonly Abused Nonprescription Drugs

appetite, decreased need for sleep, reduction of normal, expected social inhibitions, alerted sexual behaviors, increased risk-taking behaviors, unrealistic goals for achievement, unrealistic beliefs about personal power and ability

abnormalities Hypertension, Angina pectoris, Skin disorders, Seizures, dilated pupils, mental and behavioral changes, amphetamine- induced psychosis, loss of physical coordination, physical collapse, vit deficiency, respiratory depression, convulsions (seizures), coma, death

behavioral therapy, motivational interviewing, acupuncture, nutrition, art therapy, spiritual counseling, recreation, A.A. and N.A.

Methamphetamine Hyperactivity Twitching, facial tics, jerky movements, Paranoia, Dilated pupils, Outbursts or mood swings

Rapid eye movement,

Reduced appetite,

Agitation, Burns

(particularly on the lips or

fingers) Erratic

sleeping patterns,

Chalk, Christina, Cookies, Crank, Cream, Crystal, Crystal Meth, Ice, Meth, No Doze, No Stop, Pookie, Rocket Fuel, Scooby Snacks, Speed, Trash, Tweek, Wash, White Cross

Respiratory issues Liver failure Blackened, rotting teeth Arrhythmia Kidney failure Malnutrition Premature aging Birth defects Reproductive issues Skin infection (abscesses) Seizures High blood pressure Sudden cardiac death Impaired cognition Memory loss Paranoia Delusions Depression Anhedonia (the inability to feel pleasure) Aggression Psychosis Insomnia Death Heart disease (MI) Rhabdomyolysis Anorexia

Contingent therapy Prozac (shott-term for cravings) Tofranil (assist with therapy adherence) Inpatient/Outpatient detox treatment May use Benzodiazepine initially for agitation Counseling and Therapy (CBT) 12 step programs

Commonly Abused Nonprescription Drugs

Hyperthermia Anxiety Confusion Motor slowing Verbal impairment Suicidal ideation

Club Drugs MDMA amplified energy, feelings of emotional closeness, and sensory alterations mood swings euphoria increased sociability

blurred vision, nausea, vomiting, muscle cramping, appetite loss, hyperactivity, and teeth grinding poor judgement impulsive behavior reduced sex drive increased aggression

Adam, Beans, Candy, Clarity, Dancing Shoes, Disco Biscuits, E, E-Bomb, Egg Rolls, Eve, Happy Pills, Lover’s Speed, Peace, Rolls, Smartees, The Vowel, Vitamin E, Vitamin X, Molly, ecstasy, XTC

teeth problems d/t Grinding liver and kidney damage depression, hopelessness, apathy anxiety decreased cognition (attention, memory, problem solving), fatigue, insomnia hyperthermia

Inpatient/outpatient rehab Cognitive behavioral Therapy Behavioral interventions

Flunitrazepam muscle relaxation confusion impaired judgment amnesia loss of motor coordination stupor weakness extreme intoxication respiratory depression death

nightmares Roofies, ruffies, Roche (la rocha) Mexican valium, forget me pills, Rope, wolfies, circles, and R2, the date rape drug

Decreases the CNS causing: Anxiety Reduce muscle tension Insomnia Decrease in brain function (impaired memory) Decreased coordination, slurred speech and dulled reflexes Decreased blood Pressure Tremors Headaches Dizziness

Inpatient rehab, counseling, group therapy, and medication-assisted treatment

GHB Euphoria, amnesia, drowsiness, decreased anxiety, confusion, nausea, blackouts, memory

Loss of inhibitions, Impulsive behavior, Incoherent or slurred speech, Unusual body

G, Gina, Liquid Ecstasy, Liquid X, Liquid G, Goop, Georgia., Home Boy, Grievous Bodily Harm, Easy Lay, Date Rape Drug,

Weight loss, insomnia, drowsiness, Memory impairment, Increased heart rated Increased blood

No medication for treatment. SSRI’s are utilized for anxiety and depression. Inpatient detox

Commonly Abused Nonprescription Drugs

loss, increase sociability, increased libido, dizziness, Vomiting Irregular or shallow breathing Involuntary muscle contractions Inability to stand Unconsciousness Incoherency Profuse sweating

language: Agitation Seizures

Geeb, Scoop Pressure Psychotic thoughts (hallucinations/delirium ) Topical irritation to skin and eyes loss of consciousness seizures, liver damage, kidney failure, respiratory depression, death, loss of motor control, tremors, restlessness

Program Individual and group therapy

Dissociative Drugs

Ketamine Nausea and/or vomiting Severe confusion Chest pain and irregular heart rate Paralysis Violence or terrors possibly related to hallucinations Seizures Extreme sedation or even loss of consciousness or coma Heightened blood Pressure

Impairment creating new memories, accessing old memories Short-term and visual Memory deficits

Blind Squid, Cat Valium, Green, Jet, K, K-Hold, Kay, Special K, Super Acid, Vitamin K

Sedation A dream-like state Colorful dreams Feelings of intense strength and power Decreased focus Agitation Anxiety, Depression Dizziness Hallucinations Difficulty thinking Out of body experiences Alterations in discernment Amnesia Confusion Reduced awareness of environment Disorientation Drowsiness Dissociation Decreased ability to feel pain Forgetfulness Decreased coordination Double vision Involuntary eye movements

Medically supervised detox, Individual therapy, group therapy, Family therapy, Behavioral therapy

Commonly Abused Nonprescription Drugs

Seizures Impaired motor function Nausea, Vomiting Flashbacks Slowed breathing Cessation of breathing Elevated blood pressure Decreased heart rate Tachycardia Irregular heartbeat Motionlessness Excessive salvia production Garbled speech Respiratory Depression Seizures, Insomnia Overdose, death Painful urination Trouble urinating Frequent urge to urinate Inability to hold urine Cloudy or bloody urine Ulcerative cystitis Brain death

PCP and analogs euphoria, omnipotence, superhuman strength, and social and sexual prowess violent behavior, nystagmus, tachycardia, hypertension, anesthesia, and analgesia drunk feeling

Hallmark: Nystagmus HTN Mental Status

Respiratory depression Irregular breathing (apnea/tachypnea) Pharyngeal and laryngeal reflexes (hyperactive) Bronchorrhea resulting In airway obstruction Self-inflicted trauma psychosis

Angel, Angel Dust, Dust, Purple Rain, Rocket Fuel, Stardust, Water, Yellow Fever, Zombie Horse tranquilizer, hog, elephant

Agitation Depression Sedation Loss of inhibition slurred speech, violent behavior and blank staring, horizontal, vertical, or rotatory nystagmus, ataxia, hyperthermia, seizures stupor, mild coma, muscle contractions, bizarre postures hyperthermia, convulsions, induce acute schizophrenia, psychosis, audiovisual

Emergent: A,B,Cs, physical restraint if needed. - benzodiazepines (w/o psychosis) - Haldol if psychosis is present; but my lengthen the QT interval. Thus, utilize Olanzapine or ziprasidone (agitation/psychosis)

- Benadryl for dystonic sx - monitor bld glucose -thiamine and dextrose 50% (low bld sugar) -naloxone to treat co- ingested opiates

*after stabilization, then

Commonly Abused Nonprescription Drugs

hallucinations, paranoid delusions, catatonia cardiopulmonary arrest intracranial hemorrhage in hypertension hyperkalemia secondary to rhabdomyolysis

address behavioral issues

Saliva Divinorum Mood swings unpredictable behaviors Hallucinations Visual distortions (Perceptions of colors and shapes) Uncontrollable laughter Intense dissociation and Disconnectedness from reality

Sleeping or being awake at odd times Increased injuries, accidents, or risky behaviors Decreased interest in physical appearance Trouble concentrating or remembering things

Maria Pastora, Sally-D, Salvia, Diviner’s sage, The Female, Sage of the Seers, Diviner’s Mint, Magic Mint, Sheperdess’ Herb

Mood swings Floating Loss of touch with reality Vivid colors and unusual patterns Perception of levitating Depersonalization (body feeling connected to the space around them) Temperature changes in the body (chills) Slurred speech Talkativeness Nausea Uneasiness Dizziness Irregular heartbeat Loss of control over motor functions

- Detox program -family counseling -fostering a good family dynamic for healthy communication and a positive system - improve stress management techniques - improve coping skills for potential triggers - group and individual sessions enhancing self- eesteem and self-image

Dextromethorpha n

Impaired motor function Numbness Dissociative episodes Audio and visual hallucinations Nausea or vomiting Increased heart rate High blood pressure

Slurred speech Confusion Euphoria Distorted visual Perceptions Risk taking. Foggy thinking Bone/muscle pain Insomnia/restlessness

Robo-tripping, skittling, dexing, DXM, skittles, red devil, Robo, cousin, triple C, cousin, Purple Drank, sizzup, red devil, Poor Man’s PCP, red hots, orange crush, lean, tussing

Breathing problems, especially irregular or shallow breathing Bluish tint under the fingernails or on the lips due to lack of oxygen Blurred vision Blacking out

Detox, long-term rehab Program (outpatient/residential) CBT Family therapy Group therapy Individual therapy to Acquire coping skills & recovery tools

Commonly Abused Nonprescription Drugs

Agitation Elevated body temperature Buildup of acid in body fluids

Diarrhea Cold flashes Insomnia fatigue

Vomiting Stomach or intestinal spasms Hallucinations Restlessness Anxiety or paranoia Convulsions Dizziness Extreme drowsiness Changes in blood pressure, either too high or too low Muscle twitches Heart palpitations Elevated body Temperature Liver damage Brain damage (hypoxia) Repsiratiory depression

Hallucinogen s

LSD Hallucinations Bad trip – “hearing Colors” Severe injury- Accidents, self- Mutilation suicide aggressive

Sweating. Nausea. Dilated pupils. Rapid heartbeat. Dry mouth. Tremors. Insomnia. Blurred vision. Raised body temperature. Weakness. A distorted sense of time. Visual hallucinations. Mixed senses (for example, “seeing” sounds). Intensified sense of smells and noises. A sense of a mystical experience.

Acid, Blotter, Dots, Sugar Cubes, Yellow Sunshine, Microdot, windowpane

Extreme anxiety. Feelings of lost identity, that they are ceasing to exist. Panic. Paranoia. Rapid mood swings. Aggression towards others, including homicide. Self-mutilation. Dying in an accident. Committing suicide. Features of psychosis

Detox (drug abus txmt) Inpatient/Outpatient Treatment CBT Motivational Interviewing Contingency management

Mescaline Euphoria Traumatizing

Visual hallucinations Altered states of

Big Chief, Blue Caps, Buttons, Cactus, Mescal,

Hallucinogen-Persisting Perception Disorder

Medical Detox Partial inpatient

Commonly Abused Nonprescription Drugs

hallucinations Synesthesia

consciousness High or feeling of euphoria A dream-like or surreal state Laughter Feeling like time is moving more slowly Synthesis or a blending of the senses Dilated pupils

Moon, San Pedro, Topi (HPDD), known in layman’s terms as flashbacks and visual disturbances. Persistent or drug- induced psychosis: changes in thinking and perception (visual disturbances, disorganized thinking and paranoia)

hospitalization after medical detox Outpatient treatment

Psilocybin euphoria peacefulness spiritual awakening derealization, or the feeling that surroundings are not real depersonalization or a dream-like sense of being disengaged from surroundings distorted thinking visual alteration and distortion, such as seeing halos of light and vivid colors dilated pupils dizziness muscle weakness Nausea/vomiting paranoia drowsiness and yawning impaired concentration lack of coordination unusual body sensations

*muscle spasms, fear, agitation, psychosis, delusions and delirium

Psychosis Synesthesia (mixing up Senses) Dry mouth Increased heartrate Chills Numbness Lowering inhibitions

Shrooms, boomers, zoomers, mushies, simple Simon, little smoke, sacred mushrooms, purple passion, mushroom soup, cubes

numbness, particularly in the face increased heart rate and blood pressure dry mouth, sometimes leading to nausea and vomiting muscle weakness and twitching, convulsions exaggerated reflexes sweating and high body temperature, often followed by chills and shivering loss of urinary control

changes in mood light-headedness anxiety and panic attacks confusion and disorientation fear or paranoia liver failure, bradycardia, chest pain, seizures, gastroenteritis, intestinal fibrosis, renal failure, erythromelalgia, and rhabdomyolysis

*most can be treated without medications

* Antidote: physostigmine

Commonly Abused Nonprescription Drugs

confusion frightening hallucinations

Other Compounds

Anabolic Steroids Altered mental status with agitation (psychosis) Burning or itching skin Seizures deafness Depression Dry skin Heart rhythm disturbances (rapid pulse, irregular pulse) High blood pressure Increased appetite

Increased appetite Increased infection risk Muscle weakness Nausea and vomiting Nervousness Sleepiness Stopping of menstrual cycle Swelling in lower legs (ankles, or feet) weakness

arnolds, gym candy, pumpers, roids, stackers, weight trainers, and juice.

Cardiovascular: HTN Hypercoagulative state Myocardial toxicity Non-ischemic - Cardiomyopathy Dyslipidemia Erythrocythemia Accelerated Coronary athro- Sclerosis Hepatic: Cholestasis Nonalcoholic Steatohepatitis (NASH) Direct liver toxicity Hepatic neoplasms Decreased SHBG Hepatomegaly Bile acid nephropathy Endocrine: Acne Gynecomastia (males) Virilization (females) Irregular menses (females) Decreased levels of HDL Premature epiphyseal Closure Neuropsych: MDD Body dysmorphic Syndrome Narcissistic personality d/o Aggression Dependence Anxiety

Supervised detox (inpatient) Comfort medication Synthetic hormones

Antidepressants/Antianxie : Prozac/Effexor Clonidine ASA/ibuprofen Behavioral therapy (CBT) Multivitamins: vitamin B1, B6, B12, nicotinamide, and linoleic acid

Commonly Abused Nonprescription Drugs

Bipolar depressive d/o Suicidal tendencies Decreased pattern recognition

Inhalants Confusion

Poor concentration Depression Irritability Hostility Paranoia Lightheadedness Agitation Headaches Excitability Loss of coordination Drowsiness Upset stomach Blurred/double Vision Mucous membrane irritation sudden death

Ulcers around nose & Mouth Tiredness Runny nose/nose- Bleeds Slurred speech Poor hygiene & Grooming Decrease in appetite & weight loss Apathy Paint-stained hands, Fingers or clothes Chemical orders on the breath or clothes

"laughing gas" (nitrous oxide), "snappers" (amyl nitrite), "poppers" (amyl nitrite and butyl nitrite), "whippets" (fluorinated hydrocarbons, found in whipped cream dispensers), "bold" (nitrites), and "rush" (nitrites).

Kick, bang, sniff, whippets, Texas shoeshine, snorting/sniffing, baffing, gladding huffing, dusting

Memory problems Personality changes Learning disabilities Hallucinations Speaking problems Complex problem solving, planning, & organization problems vision problems problems w/mvmt: walking muscle spasms tremors slow/clumsy mvmts Lung damage Liver and Kidney Damage Hearing loss Weakened immune System Seizures Limb spasms Brain damage Heart rhythm changes Coma death

CBT Motivational interventions Family counseling Activity & engagement Programs Support groups and 12- step programs