3: The Drugs Prepared by J. Mabbutt & C. Maynard NaMO September 2008 3: The Drugs Objectives 1. During the session drug, types, classifications, street names & use statistics will be overviewed 2. Participants will be involved in an activity to explore why people use different types of drugs 3. At the end of the session, nurses & midwives will have a greater understanding of the types of drugs & their use enabling an increase in knowledge & confidence in practice 3: The Drugs Drugs defined A drug is: “… any chemical substance which, when taken into the body alters its function physically and psychologically” “… any substance people consider to be a drug with the understanding that this will change from culture to culture and from time to time” – WHO (1989); Krivanek (1982) From Commonwealth Government /NCETA 2004 – GP Trainers Illicit Drug Issues CD Rom 3: The Drugs Psychoactive Drugs (1) Psychoactive drugs are generally defined as substances which alter: – mood – cognition (thoughts) – behaviour From Commonwealth Government /NCETA 2004 – GP Trainers Illicit Drug Issues CD Rom 3: The Drugs Psychoactive Drugs (2) Affect mental processes and behaviour Affect thought processes and actions Alter perceptions of reality Change level of alertness, response time and perception of the world Achieve effects by interacting with the Central Nervous System (CNS) Carmichael (2001) From Commonwealth Government /NCETA 2004 – GP Trainers Illicit Drug Issues CD Rom 3: The Drugs Psychoactive Drug Use Is a common activity Is part of a range of human behaviours Can be classified in many ways, including legal status, drug effects Alters mood or consciousness, although there are other ways to achieve this: e.g. skydiving, meditation, extreme (and non-extreme) sport, sex. Children, for example, love to alter their consciousness by ‘spinning around’ From Commonwealth Government /NCETA 2004 – GP Trainers Illicit Drug Issues CD Rom 3: The Drugs Drug Classifications Psychoactive drugs may be classified according to their: 1. status • legal • chemical • medical • social 2. action and properties • depressant • stimulant • hallucinogenic etc From Commonwealth Government /NCETA 2004 – GP Trainers Illicit Drug Issues CD Rom 3: Classifying Psychoactive Drugs Depressants Stimulants Alcohol LSD, magic Amphetamine (methamphetamines mushrooms / ‘ice’) Benzodiazepines Barbiturates Nicotine Opioids (heroin, Cocaine morphine, methadone) Solvents (glue / amyl Caffeine or butyl nitrite) GHB Ecstasy (MDMA)# Hallucinogens Ecstasy (MDMA)# PCP, Ketamine Cannabis* (in high doses) Other (e.g. nutmeg/mace, N2O, Cannabis* *Cannabis has unique properties – CNS depressant but hallucinogenic effects at high doses. #Ecstasy (MDMA) can also be hallucinogen and stimulant From Commonwealth Government /NCETA 2004 – GP Trainers Illicit Drug Issues CD Rom Cannabis Cocaine Ecstasy Powder – Amphetamine/Methamphetamine Base – Amphetamine/Methamphetamine ‘Ice/Crystal’ Methamphetamine Pills – Methamphetamine 3: The Drugs Dependence ‘Substance dependence’ is a condition characterised by a combination of physical changes, psychological states and behaviours that gives drug use greater priority over other activities. Carmichael (2001, p. 30) From Commonwealth Government /NCETA 2004 – GP Trainers Illicit Drug Issues CD Rom 3: The Drugs Dependence diagnosing criteria The two best known and used criteria come from the: – Diagnostic & Statistical Manual of the American Psychiatric Association DSM-IV TR (2000) and the – World Health Organisation (WHO) International Classification of Diseases 10th Edition (ICD-10 1993) Both have a list criteria relating to dependence If three or more of the criteria have occurred a 12 month period the person meets the criteria for dependence From Commonwealth Government /NCETA 2004 – GP Trainers Illicit Drug Issues CD Rom 3: Tolerance and withdrawal Body in balance Drug has effect CEIDA Core Traning Manual Body adjusts Increase dose needed for effect Sudden cessation of drug causes withdrawal Body in balance 3: The Drugs Tolerance, Dependence & Withdrawal Tolerance Occurs when more of the drug is needed to produce the initial effect Dependence The need to keep taking a drug to feel physically and or mentally OK – Dependence requires a high level of tolerance Withdrawal The effects on the body and mind of a person who suddenly stops taking a drug, after becoming dependent on it 3: The Drugs How people use drugs – Activity • Break into two groups • Both groups list: • All the ways drugs can get into the body • Why this method may be used for a certain drug • Each group has 5 minutes before they report back to the whole group and this is written up on the board Approved name of drug Street name Price in NSW, 2004-5 * Alcohol Grog, piss, booze, sauce Amphetamines Speed, goey, whiz, uppers, oxblood, point, crystal, crystal meth, ice, shabu Benzodiazepines benzos, rowies, moggies, downers, sleepers, tummies, series, pills Cannabis marijuana, grass, pot, shit, ganja, mull, hash, durry, green, dope, cone Leaf- Ounce (28 g) $150 Head- Ounce (28 g) $200 Hydroponic- (28 g) $250 Hash/resin- Deal (1g ) $50 Cocaine Snow, coke 1 gram $150–$300 Ecstasy E, eccies, XTC, fantasy, GBH, liquid ecstasy, good speed 1 tablet/capsule $30–$70 Heroin/opioids Hammer, H, shit, smack, horse, harry, white, skag, junk 1 taste/cap (0.1–0.3 g) $50 Full gram $200–$500 1 weight gram $90–$500 3: Appendix 6: Street names of drugs * Adapted from the Illicit Drug Data Report. 2004–05 Australian Crime Commission * Adapted from the Illicit Drug Data Report. 2004–05 Australian Crime Commission Approved name of drug Street name Price in NSW, 2004-5 * Ketamine Special K Varied across States: ACT – $65 S.A. – $200 Lysergic acid diethylamide (LSD) Acid, blotter, trips, wangers, tabs, dots $10 to $25 per tab Methylene Dioxyamphetamine (MDA) Adam 1 tablet/capsule $30-$70 Methylene Dioxymethamphetamine (MDMA) Ecstasy, Utopia, E, XTC 1 tablet/capsule $30-$70 Phencyclidine (PCP) Angel dust PMA Dr Death Psilocybin Magic mushrooms, gold tops Solvents glue, tol, toluene, bute, nitrus, amyls, petrol, super, aerosol paint-chroming 3: Appendix 6: Street names of drugs * Adapted from the Illicit Drug Data Report. 2004–05 Australian Crime Commission 3: Percentage of all deaths attributable to Tobacco, Alcohol and Illicit drugs, in Australia 2003 12 10 8 Tobacco Deaths Alcohol Deaths Illicit Drug Deaths 6 4 2 0 Tobacco Alcohol Illicits 3: Percentage of Drug related deaths attributable to Tobacco, Alcohol & Illicit drugs, Australia 2003 80 70 60 Tobacco Deaths Alcohol Deaths Illicit Drug Deaths 50 40 30 20 10 0 Tobacco Alcohol Illicits 3: Percentage of Tobacco related deaths in Australia 2003 by condition 45 40 Lung cancer 35 COPD 30 25 IHD 20 Stroke 15 Oesphag cancer Other 10 5 0 Tobacco 3: Percentage of Alcohol related deaths in Australia 2003 by condition 30 Abuse 25 Suicide / Self inflict Road accid 20 15 Oesophag cancer Breast cancer 10 5 Other 0 Alcohol 3: Percentage of Illicit drug related deaths in Australia 2003 by condition 50 45 40 Heroin poly Drug Hep C 35 30 25 Suicide self inflict Hep B 20 15 10 Other 5 0 Illicit