Center for Development of Human Services Examining the Effects of Parental Alcohol and Drug Abuse on Children Stephen Webster, PharmD Student University at Buffalo School of Pharmacy and Pharmaceutical Sciences © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Center for Development of Human Services Credits • William A. Prescott Jr., Pharm. D. Clinical Assistant Professor University at Buffalo School of Pharmacy and Pharmaceutical Sciences, Department of Pharmacy Practice © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Center for Development of Human Services Credits • James Brustman, CDHS Child Welfare Trainer • Phyllis Harris, CDHS Administrator • William Rea, CDHS Child Welfare Trainer • David Peters, Senior CDHS Child Welfare Trainer © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Introduction • Substance abuse has a major impact on the child welfare system. * It is estimated that 9 % of children in the U.S. (6 million) live with at least one parent who abuses alcohol or other drugs. * Between 1/3rd and 2/3rds of child maltreatment cases involve substance abuse * 85 % of states reported substance abuse was one of the two major problems exhibited by families in which maltreatment was suspected. © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Project Goals 1. Training Manual for CDHS Trainers 2. Handbook for Child Welfare Caseworkers Overall: Educate trainers and caseworkers on the effects of parental drug/alcohol abuse on children. © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Today’s Agenda 1. Overview of Substance Abuse and Addiction 2. Summary of each Commonly Abused Substance 3. Family-related Consequences of Parental Substance Abuse 4. Conclusion © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Overview of Substance Abuse and Addiction • What is physical addiction ? • What is psychological addiction ? • What is tolerance, withdrawal, and potentiation ? • How quickly can someone become addicted to a drug ? © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Overview of Substance Abuse and Addiction • Why do some individuals become dependent/addicted and others not ? • Are substance dependent parents more likely to abuse/neglect their children ? • What does a family history of substance abuse mean for its members ? • Is it possible to be an effective parent if you are abusing drugs ? © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Drug Sections • - Each drug section will discuss: * Common street names * Mechanism of action * Route of administration * Indicators of intoxication * Long-term effects * Withdrawal © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Alcohol • The most commonly abused substance in the United States • Alcohol dependence has both genetic and environmental factors. © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Alcohol • Mechanism of Action - Alcohol is a depressant that slows central nervous system functioning. - Alcohol is immediately absorbed into the blood stream from the stomach and small intestine resulting in a rapid onset of effect. © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Alcohol • Immediate Physiological Effects - Decreased blood pressure, heart rate, breathing, body temperature, and coordination - Feeling of well-being Slowed cognition Drowsiness © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Alcohol • Signs and Symptoms of Intoxication - Severe drowsiness Confusion Aggression Hypotension Emotional blunting Memory impairment Poor coordination Slurred speech Decreased heart rate Increased irritability Decreased body temperature Severe respiratory depression © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Alcohol • Consequences of Long-term Use - Addiction, Tolerance, Withdrawal - Long-term Physiological Effects Liver cirrhosis, kidney damage, immune system impairment, gastric ulceration and cancer, heart disease, and high blood pressure. © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Alcohol • Withdrawal - Severity: The potential to be life-threatening. - Approximately 25% will have seizures. - Approximately 10% will have hallucinations. - Delirium tremens, the most serious alcohol withdrawal syndrome, occurs in 5% of cases. It is characterized by hyperagitation, tremor, disorientation, persistent hallucinations, and marked increases in heart and respiratory rates and blood pressure. - Roughly 5% of those experiencing Delirium tremens will die © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Alcohol • Withdrawal - Symptoms: * Increased heart rate, blood pressure, body temperature, respiration, sensitivity to light and sound * Pupil dilation, hallucinations, paranoid delusions, DT’s, alcohol craving, tremors, agitation, anxiety, disorientation, nausea, diarrhea, vomiting, headache © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Alcohol • Withdrawal - Timeline: . Major withdrawal symptoms peak between 24 and 72 hours after the last drink and last between 5 and 7 days. © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Cannabinoids (Marijuana and Hashish) • Two drugs derived from different parts of the plant Cannabis sativa • Approx. 40% of Americans over the age of 12 have tried marijuana at least once © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Cannabinoids • Common Street Names blunt, dope, ganja, grass, herb, joint, mary jane, pot, reefer, weed, chronic, boom • Administration smoke, swallowed • Mechanism of Action The major active chemical in cannabis is THC. THC binds to areas in the brain that influence pleasure sensation, memory, thought, concentration, sensory and time perception, and coordination. © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Cannabinoids • Immediate Physiological Effects Euphoric feeling Increased heart rate Increased anxiety Drowsiness Altered sensation Loss of time perception Increased hunger Eye redness © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Cannabinoids • Signs and Symptoms of Intoxication Altered sensation Loss of time perception Intense hunger Eye redness Hallucinations Poor coordination Poor judgment Poor reaction time Rapid heart beat Anxiety/Confusion Euphoric feeling Short-term memory impairment © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Cannabinoids • Consequences of Long-term Use - Craving and withdrawal symptoms including irritability, difficulty sleeping, anxiety, and aggression - Depression, memory impairment, lack of motivation - increased risk of lung infections, chronic cough, bronchitis, emphysema, lung cancer © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Cannabinoids • Withdrawal - Severity: mild to moderate when longterm user abruptly stops using the drug. - Symptoms: irritability, increased aggression, difficulty sleeping, decreased appetite, drug craving, and anxiety. - Timeline: Peak severity is approximately one week following the last use of the drug. © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Cocaine/Crack • Cocaine is the second most commonly used illicit drug in the United States • Approx. 10% of Americans over the age of 12 years have tried cocaine at least once. © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Cocaine/Crack • Common Street Names blow, bump, C, candy, Charlie, coke, flake, rock, snow, toot • Administration smoked, snorted, injected • Mechanism of Action Cocaine is a powerfully addictive stimulant. Cocaine’s euphoric effect is attributed to its inhibition of dopamine removal and subsequent accumulation in the central nervous system. © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Cocaine/Crack • Immediate Physiological Effects - Increased blood pressure, heart rate, body temperature, energy, and alertness - Dilated pupils Decreased appetite © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Cocaine/Crack • Signs and Symptoms of Intoxication Intense euphoria Paranoia Muscle twitches Increased alertness Tremors Increased energy Heavy sweating Increased Irritability Erratic and violent behavior © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Cocaine/Crack • Consequences of Long-term Use - Addiction, Tolerance, Withdrawal - Long-term psychological effects paranoid psychosis, mood disturbances, auditory hallucinations, and personality changes -Long-term physiological effects heart attacks, ventricular fibrillation, chest pain, respiratory failure, strokes, seizures, abdominal pain, weight loss, loss of the sense of smell, and nosebleeds © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Cocaine/Crack • Withdrawal - Severity: Cocaine-withdrawal syndrome is similar to severe depression. Symptoms are not life-threatening, but may require hospitalization due to precipitating psychiatric disturbances - Symptoms: Severe depression, slowed motor response, emotional blunting, hypersomnia, excessive eating, social withdrawal, paranoid delusions, suicidal thoughts and behavior, drug craving - Timeline: Peak severity is 1 to 3 days after the last use, mild symptoms may persist for 2 weeks © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Hallucinogens LSD, Mescaline, Psilocybin • LSD is a semi-synthetic compound • Mescaline is found in peyote cactus • Psilocybin is found in psilocybe mushrooms © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Hallucinogens • Common Street Names Mescaline: buttons, cactus, mesc, peyote Peyote: magic mushroom, purple passion, LSD: acid, blotter, boomers, cubes, microdot • Administration smoked, swallowed, absorbed through mouth tissues • Mechanism of Action Act on specific serotonin receptors in areas of the brain that control mood, cognition, and sensory perception © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Hallucinogens • Immediate Physiological Effects - Increased blood pressure, heart rate, and body temperature - Dizziness Loss of appetite Dry mouth Sweating Nausea Tremors Pupil dilation Altered senses Altered emotions © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Hallucinogens • Signs and Symptoms of Intoxication - Increased heart rate, blood pressure, body temperature - Violent outbursts Dizziness Euphoria Hallucinations Sweating Nausea Dizziness Anxiety Tremors Pupil dilation Emotional instability Altered sensory perception © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Hallucinogens • Consequences of Long-term Use - Tolerance - Long-term psychological effects 1) Drug-related psychosis characterized by frequent mood swings and visual disturbances which can potentially persist for years 2) Hallucinogen persisting perception disorder (HPPD), better known as “flashbacks”, in which the user experiences spontaneous recurrent episodes of sensory distortion - No Withdrawal Syndrome © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Methamphetamine/Amphetamine • Methamphetamine use is rapidly increasing across the country and devastating entire communities • Amphetamines are frequently prescribed for children and adults with ADHD © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Methamphetamine use in the United States © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Methamphetamine/Amphetamine • Common Street Names Meth: chalk, crank, crystal, fire, glass, ice, meth, speed Amph: bennies,crosses, hearts, LA turnaround, speed, truck drivers, uppers • Administration injected, swallowed, smoked, snorted • Mechanism of Action Causes a release of excess dopamine, a chemical which plays an important role in pleasure regulation in the brain © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Methamphetamine/Amphetamine • Immediate Physiological Effects - Increased blood pressure, heart rate, breathing rate, body temperature, energy, and attention - Decreased appetite Dry mouth Dilated pupils © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Methamphetamine/Amphetamine • Signs and Symptoms of Intoxication Heavy sweating Intense irritability Chills Euphoria Hyper-sexuality Heavy breathing Paranoia Fever Increased self-esteem and confidence © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Methamphetamine/Amphetamine • Consequences of Long-Term Use - Addiction, Tolerance, Withdrawal - Long-term Pyschological Effects Chronic methamphetamine use has been associated with psychosis, most resembling paranoid schizophrenia. Visual and auditory hallucinations, intense paranoia, mood disturbances, repetitive motor activity, and outof-control rages that can be coupled with extremely violent behavior are all symptoms of methamphetamine addiction psychosis. © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Methamphetamine/Amphetamine • Consequences of Long-Term Use - Long-term Physiological Effects irreversible heart damage, stroke, weight loss, dental damage, violent behavior, anxiety, confusion, and insomnia © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Methamphetamine/Amphetamine • Withdrawal - Severity: Meth.-withdrawal syndrome is similar to severe depression. Symptoms are not lifethreatening, but may require hospitalization due to precipitating psychiatric disturbances - Symptoms: Severe depression, slowed motor response, emotional blunting, hypersomnia, excessive eating, social withdrawal, paranoid delusions, suicidal thoughts and behavior, drug craving - Timeline: Major withdrawal symptoms peak between 48 and 72 hours after the last dose and subside after 5 to 7 days. © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Ecstasy/MDMA • MDMA is the main ingredient in Ecstasy • MDMA contains chemical variations of the stimulant methamphetamine and mescaline, a hallucinogen. • Ecstasy is considered a “club drug” © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Ecstasy/MDMA • Common Street Names Adam, clarity, Eve, E, lover's speed, peace, STP, X, XTC • Administration swallowed • Mechanism of Action MDMA is a psychoactive drug containing both stimulant and hallucinogenic properties. MDMA affects the brain by increasing the activity of at least three chemicals; serotonin, dopamine, and norepinephrine. © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Ecstasy/MDMA • Immediate Physiological Effects - Increased heart rate, blood pressure, body temperature, and energy - Mental stimulation Decreased anxiety Blurred vision Chills Muscle cramping Sweating Nausea © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Ecstasy/MDMA • Signs and Symptoms of Intoxication - Increased blood pressure, heart rate - Sense of well-being Decreased anxiety Hypersexuality Fever Enhanced sensory perception Intense thirst Altered time perception Empathy towards others Heavy sweating © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Ecstasy/MDMA • Consequences of Long-term Use - Tolerance, Addiction ?, Withdrawal ? - Long-term Psychological Effects increased incidences of confusion, depression, changes in cognition, memory, attention, and motor function - Long-term Physiological Effects weight loss, and heart, kidney, and liver toxicity. - Withdrawal Impossible to discern withdrawal symptoms from those attributed to neurologic damage caused by ecstasy use © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Heroin • Heroin is a semi-synthetic opioid derived from morphine • The U.S. heroin market is supplied entirely from foreign sources of opium. © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Heroin • Common Street Names brown sugar, dope, H, horse, junk, skag, skunk, smack, white horse • Administration injected, smoked, snorted • Mechanism of Action Heroin activates receptors in the brain, spinal cord, and gastrointestinal tract. When heroin enters the brain, it is converted to morphine, causing increased feelings of pleasure and blockage of pain messages from the spinal cord. © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Heroin • Immediate Physiological Effects Pain relief Intense euphoria Decreased respiration, cardiac function Alternating wakeful and drowsy states © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Heroin • Signs and Symptoms of Intoxication Intense euphoric state Alternating wakeful and drowsy states Impaired mental function Heavy-feeling extremities Staggering gait Pupil constriction Nausea Vomiting Severe Itching Dry mouth Warm flushing of the skin © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Heroin • Consequences of Long-term Use - Addiction, Tolerance, Withdrawal - Long-term Physiological Effects collapsed veins, bacterial infections of blood vessels and cardiac tissue, liver and kidney disease, lung complications including pneumonia and tuberculosis, arthritis, and constipation. © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Heroin • Withdrawal - Severity: Heroin withdrawal resembles a severe case of influenza and is not considered life-threatening. Heroin withdrawal symptoms are regarded as the most severe of all opioidrelated substances - Symptoms: Drug craving, pupil dilation, nausea, vomiting, restlessness, bone and muscle pain, diarrhea, malaise, cold flashes, and insomnia - Timeline: Peak severity is 1 to 3 days after the last use, symptoms subside after 7-10 days. © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Prescription Opioids Codeine, Morphine,Hydrocodone, Oxycodone, Fentanyl, Methadone,etc. • Opium is an analgesic derived from the seeds of the unripe poppy plant. • The term opiate refers only to the natural opium alkaloids (codeine, morphine) and the semisynthetics derived from them (hydrocodone, hydromorphone, and oxycodone). © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Prescription Opioids Codeine - Robitussin A-C, Tylenol w/ Codeine, Tylenol #2,#3 & #4 - Common Street Names Captain Cody, Cody, schoolboy; doors & fours, loads, pancakes and syrup - Administered injected, swallowed © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Prescription Opioids Fentanyl - Actiq, Duragesic, Sublimaze - Common Street Names Apache, China girl, dance fever, friend, goodfella, jackpot, murder 8, TNT, Tango and Cash - Administered buccal, injected, smoked, snorted, transdermal © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Prescription Opioids Morphine - Avinza, Kadian, MS Contin, Roxanol - Common Street Names M, Miss Emma, monkey, white stuff - Administered injected, swallowed, smoked © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Prescription Opioids Oxycodone - Endocet, Oxycontin, Percocet, Roxicet, Roxicodone - Common Street Names Hillbilly heroin, Kickers, Blue, Oxy, O.C., Killer, Percs, Percodoms - Administered injected, swallowed, snorted © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Prescription Opioids Hydrocodone - Lorcet, Lortab, Norco Vicodin - Common Street Names Vike, Watson-387 - Administered swallowed © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Prescription Opioids Propoxyphene - Darvocet, Darvon - Administered swallowed © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Prescription Opioids • Mechanism of Action - An opioid is any agent that acts on the brain and body by binding to opioid receptors located in the brain, spinal cord, and gastrointestinal tract. - Opioid drugs block the perception of pain to varying degrees. Some opioids can also produce a euphoric effect by affecting the pleasure centers of the brain © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Prescription Opioids • Immediate Physiological Effects Pain relief Drowsiness Pupil Constriction Flushing Vomiting Nausea Euphoric feeling Decreased body temp. Confusion Decreased respiration © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Prescription Opioids • Signs and Symptoms of Intoxication Decreased respiration Hypothermia Warm flushing of the skin Euphoria Pupil constriction Drowsiness Vomiting Dry mouth Confusion Itching © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Prescription Opioids • Consequences of Long-term Use - Addiction, Tolerance, Withdrawal - Long-term Physiological Effects confusion, constipation, and immune system impairment © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Prescription Opioids • Withdrawal - Severity: Opioid withdrawal resembles a severe case of influenza and is not considered life-threatening. Symptoms are less severe than those related to heroin withdrawal, but the duration is longer. - Symptoms: Drug craving, pupil dilation, nausea, vomiting, restlessness, bone and muscle pain, diarrhea, malaise, cold flashes, and insomnia - Timeline: Peak severity is 2 to 4 days after the last use, symptoms may endure for more than 14 days. © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Prescription Depressants Barbiturates, Benzodiazepines, Sleep aids • During the 1950’s, it was noted that barbiturates were related to high incidences of side effects and abuse. • During the 1960’s, benzodiazepines appeared on the market and rapidly replaced barbiturates as the class of choice for sedative-hypnotics. © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Prescription Depressants Barbiturates - Amytal, Nembutal, Seconal, Phenobarb - Common Street Names barbs, reds, red birds, phennies, tooies, yellows, yellow jackets - Administered injected, swallowed © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Prescription Depressants Benzodiazepines - Ativan-lorazepam, Halcion- temazepam, Librium-chlordiazepoxide, Valiumdiazepam, Xanax-alprazolam - Common Street Names candy, downers, sleeping pills, tranks - Administered injected, swallowed © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Prescription Depressants Sleep Aids - Eszopiclone (Lunesta) Zaleplon (Sonata) Zolpidem (Ambien) - Administered swallowed © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Prescription Depressants • Mechanism of Action Most depressants cause CNS depression by either increasing the activity or production of gamma-aminobutyric acid (GABA). GABA is the most important inhibitory neurotransmitter in the CNS. © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Prescription Depressants • Immediate Physiological Effects Slowed respiration Drowsiness Decreased heart rate Pupil constriction Feeling of well-being Dizziness Slowed muscle response Decreased blood pressure © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Prescription Depressants • Signs and Symptoms of Intoxication Severe drowsiness Severe respiratory Confusion Aggression Emotional blunting Hypotension Memory impairment Poor coordination Slurred speech Decreased heart rate Fever Increased irritability © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Prescription Depressants • Consequences of Long-term Use - Addiction, Tolerance, Withdrawal - Long-term Psychological Effects Depression, visual disturbances, vertigo, impaired memory, judgment, anxiety - Long-term Physiological Effects Impaired fine motor skills, slurred speech, chronic fatigue, loss of coordination © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Prescription Depressants • Withdrawal - Severity: Depressant-withdrawal syndrome resembles stimulant intoxication. Barbiturate withdrawal is more severe than benzodiazepine withdrawal, but both are potentially lifethreatening. Seizures, hallucinations, and delirium tremens are possible serious symptoms of both barbiturate and benzodiazepine withdrawal © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Prescription Depressants • Withdrawal - Symptoms: * Increased heart rate, blood pressure, body temperature, respiration, light and sound sensitivity * Auditory and visual hallucinations, seizures, delerium tremens, muscular weakness, depression, paranoid delusions, tremors, pupil dilation, agitation, anxiety, disorientation, convulsions, sleep disturbances, headache, nausea © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Prescription Depressants • Withdrawal - Timeline: Long-term benzodiazepine or barbiturate use is associated with acute withdrawal symptoms that precipitate within 24 hours following the last administered dose. * For short-acting depressants, major withdrawal symptoms peak between 2 and 4 days following the last administered dose and last for about 7 days. * For long-acting depressants, major withdrawal symptoms peak between 4 and 7 days following the last dose and last for about 2 weeks. © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Dissociative Drugs Phencyclidine, Ketamine, Dextromethorphan • Phencyclidine (PCP) and ketamine were originally developed as anesthetics for surgery. • The most common source of abused dextromethorphan is extra-strength cough syrup. © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Dissociative Drugs • Common Street Names Ketamine: cat Valiums, K, Special K, vitamin K PCP: angel dust, boat, hog, love boat, peace pill • Administered injected, snorted, smoke, swallowed • Mechanism of Action - Disrupts the activity of the chemical glutamate, which plays a large role in learning, memory, emotion, and pain perception. - PCP also affects dopamine activity © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Dissociative Drugs • Immediate Physiological Effects Increased blood pressure Rapid/Shallow breathing Random muscle contractions Increased body temperature Decreased sense of pain Increased heart rate Blurred vision Dizziness © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Dissociative Drugs • Signs and Symptoms of Intoxication Uncoordinated movements Euphoria Sensory detachment Hallucinations Feeling of Vulnerabiltiy Panic Hyperthermia Dizziness Suicidal thoughts Disorientation Feeling of increased strength Aggression © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Dissociative Drugs • Consequences of Long-term Use - Addiction, Tolerance, Withdrawal - Long-term Physiological Effects memory loss, numbness, and depression which can persist for up to a year after drug use stops. © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Dissociative Drugs • Withdrawal - Severity: While dissociative drug-related withdrawal is not considered life-threatening, medical attention may be necessary because of precipitating psychiatric disturbances. - Symptoms: Hyperactivity Agitation Increased pain threshold Hyperflexia Increased heart rate Delusions Violent behavior Depression Increased blood pressure Memory loss Visual/Auditory hallucinations © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Dissociative Drugs • Withdrawal - Timeline The peak severity of dissociative drugrelated withdrawal can occur from days to weeks following the last administered dose. Withdrawal symptoms can persist for months. © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Family-related Consequences of Parental Substance Abuse • Parental Effects - Decreased parental monitoring - Poor problem-solving ability - Increased incidence of aggression - Less emotional sensitivity - Lower positive engagement with the child - Antisocial behavior including child avoidance - Poor intellectual stimulation of the child © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Family-related Consequences of Parental Substance Abuse • Parental Effects - Negative parent/child relationship - Increased parental stress - Poor and inconsistent family management - Increased incidence of child neglect than abuse - Ineffective socialization and discipline - Negative parent/child relationship - Increased incidence of child abandonment © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Family-related Consequences of Parental Substance Abuse • Effect on the Family - Poor family functioning - Increased levels of conflict - Poor communication - Increased incidence of domestic violence - Unpredictable home life - Poor organization, including cleaning, timeliness, planning © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Family-related Consequences of Parental Substance Abuse • Effect on the Child - Increased incidence of physical, sexual, and verbal abuse - Increased risk of neglect - Increased risk of early drug and alcohol abuse - Increased incidence of disruptive behavior problems © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Family-related Consequences of Parental Substance Abuse • Effect on the Child - Increased incidence of emotional disorders including chemical dependence, eating disorders, anxiety, depression, aggression, suicidal behavior, phobias, low self-esteem - Increased incidence of physical problems including asthma, hypertension, headaches, and allergies © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Family-related Consequences of Parental Substance Abuse • Effect on the Child - Increased incidence of impaired cognitive and verbal skills - Increased incidence of learning disabilities © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group Conclusion Thank you all for coming! © 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group