Kerry Herndon, MSW, LAC-E
Western Montana Addiction Services
Project SUCCESS- Sentinel HS
Mixing substances is NEVER a good idea
300 die in MT per yr from Rx drug use
 MT ranks #3 in the nation for Rx drug abuse
 Rx drugs are easy to obtain
 Street value is high, so those who have them are making $
 U.S. consumes 80% of the worlds opiate supply
 ER’s: alcohol & Rx drug use in combination
 50% most DUI related blood draws contain other substances
in addition to alcohol
 20% of people in the U.S. have used Rx drugs for nonmedical purposes
 Everyday (in the U.S.) about 2,000 teens use Rx drugs for
recreation for the first time
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a quick-fix
family history/lack of nurturing parents
early aggressive or impulse behavior
peer pressure
low self-esteem
Boredom
escape reality
drug availability,
and belief that drug abuse is o.k.
Taking drugs prescribed to someone else
Using old, unfinished prescriptions to treat a
condition for which the drug was not originally
prescribed.
 Taken in ways other than as directed
 Not waiting long enough between doses
 Taking more than what is prescribed
 Crushing/scrapping pills and snorting them
 Chewing them rather than swallowing them
 Injecting them
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Chloral hydrate
Clonazepam
Lorazepam
Oxazepam
Diazepam
Diphenydramine
An antihistamine
Topiramate
Anticonvulsant
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The doses of each substance alone does not cause death;
however, combining them causes respiratory depression and
death.
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What is in the bowl?
How will your body will react?
How it will interact with other drugs or
medications you are taking?
Very dangerous!
Turn and Run!
Opiate
Used for pain relief
 Lots of existing health conditions can be complicated by
taking these drugs.
 Interacts negatively with many other substances
 Abuse can cause:
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 Nausea
 Dizziness
 Loss of Appetite
 Dry Mouth
 Mood Swings
 Difficulty Breathing
 Headache
 Withdrawal
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Oxycodone
Hydrocodone
Alprazolam
Diazepam,
Temazepam
Doxylamine
Caused respiratory depression and, when
combined, can be deadly.
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Lortab and Vicodin are a combination of
acetaminophen (Tylenol) and hydrocodone.
Hydrocodone
 Opiate
 Used for pain relief & sometimes cough
 Causes:
▪ Respiratory Depression
▪ Depresses Central Nervous System
▪ Has a long list of possible side effects
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Used as a muscle relaxant, to treat anxiety,
insomnia, agitation, seizures, muscle spasms,
alcohol withdrawal, and premedication for
medical procedures.
Examples: Xanax, Valium, Diazepam, Klonopin
Many possible side effects from misuse or
combining with other substances.
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Propofol
Lorazepam
Diazepam
Midazolam
Cardiac arrest
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Sedative- Hypnotic
Mild sedation to complete anesthesia
Very dangerous in overdose
 Many celebrity accidental overdoses
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Depresses or stops central nervous system
Any drug that’s name ends in
“barbital”
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Barbiturates
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Synthetic opiate
Prescribed mostly to help with opiate
withdrawal symptoms and reduce cravings
Controversial for drug treatment
Many reactions with other drugs.
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Examples: Adderall, Ritalin, Concerta
Physical effects: hyperactivity, blood shot eyes, headache,
heart rate increases, blood pressure increases or decreases,
heart palpitations, insomnia, tremors, fever, blurred vision,
tremors, dry mouth, skin issues/acne, convulsions, seizure,
stroke, coma, heart attack or death.
Psychological effects: euphoria, anxiety, alertness,
concentration, sociability, irritability, energy, changes in selfesteem or confidence, aggression, obsessive behaviors,
paranoia.
 Primary cause of death was thought to be
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pneumonia and iron deficiency anemia
Hydrocodone (for cough and chest pain),
Acetaminphen (for fever),
Chlorpheniramine (an antihistamine for runny nose)
L-methamphetamine (possibly from the
decongestant pseudoephedrine)
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Deliberate inhalation of fumes, vapors, or gases
Over 2.6 million children, aged 12 – 17, use an Inhalant each year
1 in 4 students in America has intentionally huffed by the time they reach
the eighth grade.
Inhalants tend to be the drug that is tried first by children.
59% of children are aware of friends huffing at age 12.
Inhalants are the fourth most-abused substance after alcohol, tobacco,
and marijuana.
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The number of lives claimed by Inhalant Abuse each year is
unknown because these deaths often are attributed to other
causes.
Death can occur the first time -Sudden Sniffing Death
Syndrome, suffocation, choking, or a fatal injury.
Effects the brain, heart, kidneys and liver, and other organs
Inhalants can be addictive
Progression to illegal drugs or alcohol abuse.
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Comes from the leaves of a coca plant
Used by: Smoking, Snorting, Eating, Injecting
Rapid intense high followed by intense feelings of
depression, edginess and craving for more
Difficulty sleeping, increased heart rate, muscle spasms,
convulsions, damage to nasal cavity/tissue, loss of appetite,
heart attacks, seizures, strokes, respiratory failure and blood
shot eyes.
Makes you feel paranoid, angry, hostile, anxious even when
you are not high.
Interferes with the brain processes
Feelings of pleasure diminished (need to use more)
Combining with other drugs or alcohol can be deadly.
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Expensive!
Risk of disease from sharing needles –
hepatitis, HIV/AIDS, etc.
Increased risk of sexual assault, unplanned
pregnancy.
Increased feelings of depression
Gives the illusion of power and energy
Most often leaves users feeling emotionally,
physically and sexually unable to function.
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Opiate
Used by: Injecting, snorting, smoking
Usually a white or brown powder
Sometimes a black sticky substance
 “black tar heroin”
Converted to morphine in the brain
Withdrawal: restlessness, muscle/bone pain, insomnia,
diarrhea, vomiting, cold flashes, kicking movement
 Sometimes treated w/ other medication, such as
methadone
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Surge of euphoria, dry mouth, flush skin,
heavy extremities, clouded head
Slows breathing, sleep patterns affected,
blood pressure
Prolonged use: collapsed veins, infection of
heart lining and valves, abscesses, liver
disease, kidney disease, heart problems,
pneumonia, clogged blood vessels, brain
damage
Infectious diseases from needle use
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Psychedelic drug
MDMA active substance
Ecstasy usually a pill form
Often mixed with other things
Molly powered or crystalline form (pure)
Euphoria, sense of intimacy with others, decreased anxiety, and is usually
followed by fatigue.
Difficulty concentrating, jaw clenching, grinding of teeth, no appetitie,
dry mouth, increased anxiety/paranoia, depression, irritability, emotional
sensitivity, dizziness, vertigo, hyperactivity, hypertension, heart attack,
damage to the heart, hyperthermia, stroke, loss of consciousness, coma
or death.
Reduction of serotonin and dopamine
Some studies show positive effects for some health conditions, but so far
the risks outweigh the benefits.
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Designer drug (synthetic/man made)
Most use in the USA was discovered between 2010 and 2011, use
increased after it was reported in the news
Effects similar to amphetamine and cocaine
White crystals resemble salts made for bathing
States on package “not for human consumption”
Can be swallowed, snorted, smoked or injected
Symptoms include: headache, heart palpitations, nausea, cold fingers,
hallucinations, paranoia, panic attacks, violent behavior, heart attack,
kidney failure, liver failure and suicide.
Increases pain tolerance
Those using have dilated pupils, involuntary muscle movement, rapid
heartbeat and high blood pressure.
Most users have a history of mental health issues
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Cough suppressant
Dissociative hallucinogen
Causes visual distortion, distorted body perception, feelings of
dissociation, excitement, loss of sense of time, stimulant like-euphoria
Side effects for recreational users: vomiting, blurred vision, blood shot
eyes, dialated pupils, sweating, fever, hypotension, slowed breathing,
diarrhea, muscle spasms, passing out and blacking out.
SIZZURP/PURPLE DRANK:
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Cough syrup (usually with codeine)
Fruit flavored soda
Jolly Rancher
Mentioned in a lot of music and popular in hip-hop culture
Many deaths associated with using
Drowsiness, hallucinations, vision changes, nausea, confusion, difficulty breathing
RED SOLO CUP! Cough syrup frozen in the cup and then soda inside.
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Promethazine (Sizzurp)
Codeine syrup (Sizzurp)
Respiratory depression
Amphetamine/Stimulant
Originated in 1919 in Japan --- military use
 Taken by just about any means imaginable
 Called by many names
 Distributed in many colors
 Very addictive
 Serotonin/Dopamine receptors damaged
 Bugs in skin
 Significant withdrawal symptoms
 Long-term complications form minimal use
 Causes: Alertness, euphoria, improved concentration, mania,
anxiety, increased self-esteem, aggressiveness, obsessive
behaviors, paranoia
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Can induce: anorexia, hyperactivity, dilated pupils, flushed
skin, excessive sweating, restlessness, dry mouth, headache,
increased or slowed heart beat, irregular heart beat, rapid
breathing, high/low blood pressure, fever, diarrhea,
constipation, vision changes, dizziness, twitching, insomnia,
numbness, tremors, skin issues, convulsions, and heart
attack.
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Horse Tranquilizer/Anesthetic
Can cause loss of memory
Used mostly as a club drug/raves
Injected, consumed or smoked
Sometimes used as a date rape drug
Difficult to move or talk
Floating sensation
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Usually taken orally, but can also be injected
Altered thinking, different visual experiences, altered sense of time,
spiritual experiences, increased appetite, wakefulness, numbness,
weakness, nausea, hypo/hyperthermia, elevated blood sugar, chills,
heart rate increases, sweating, increased saliva production, tremors, and
metallic taste.
Can cause anxiety, paranoia, and delusions. May result in personality
changes, see colors differently, seeing patterns or movement in solid
things, los of identity, ability to process emotion, panic attacks,
psychosis, and “flashbacks”.
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Angel dust or wet
Used by: ingesting, smoking or inhaling
Powder and liquid forms often sprayed onto a leafy material
such as cannabis, mind, oregano, parsley, etc. then smoked.
Causes numbness, staggering, slurred speech, bloodshot
eyes, loss of balance, convulsions, changes in body image,
paranoia, hallucinations, aggressive behavior, euphoria,
suicidal impulses, animated, detached, feelings of strength
or power, dilated pupils, amnesia, delusions, and skin
dryness.
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Usually eaten
Cause hallucinations, perception disorder,
perceptual disturbances (especially when
mixed with marijuana).
Audio, visual, tactile changes
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Benzodiazepine
Similar to valium
“Date Rape Drug”
Suppresses CNS
Causes blackouts and unconsciousness
Memory loss
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Stimulant
Found in many drinks & chocolate
Can be taken as a pill
Energy drinks associated with deaths
5 hr energy – In the news!
Ligament formation
Sports injury
Hip and joint issues
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BAD NEWS!
Energy Drink: Stimulant
 Increases heart beat
 Increase blood pressure
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Alcohol: Depressant
 Slows your heart beat
 Increases blood pressure
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Alcohol Poisoning
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Secobarbital
Brallobarbital
Antihistamine
Hydroxyzine
Alcohol
Asphyxiated on vomit
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A psychoactive mint, used in traditional spiritual practices by the
Mazatec people of Mexico
Contains a naturally occurring hallucinogen
Most potent when smoked and is comparable in potency to LSD
(powder form)
Can be ingested in a liquid extract form.
Green plant leaves or liquid extract
Causes dramatic and scary states of mind
Can be subtle to a full-psychedelic experience
Can cause intense hallucinatory experience (particularly when smoked)
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Pills or injected
Build muscle
Aggression, Anger, Violence
Changes our hormone balance
Causes problems with our
sex hormones and organs
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A lot out there
New stuff all the time
Being mixed with other drugs
Too new to know the long-term effects
Be Smart!
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Fourteen different medications in his system
Including several barbiturates