Chapter 18 New

Chapter 18: Substance Misuse
and Abuse
Introduction
 Substance abuse and misuse cost the United States billions

of dollars annually in medical care, insurance and loss of
productivity.
 Even more important, however, are the lives lost or
permanently impaired each year from injuries or medical
emergencies related to substance abuse or misuse.
AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

2 Copyright © 2005 by The American National Red Cross
All rights reserved.
Introduction
(continued)
 Legal substances are among those most often misused or abused.

 Such legal substances include—
 Nicotine (found in tobacco products).
 Alcohol (found in beer, wine and liquor).
 Over-the-counter medications, such as aspirin, sleeping pills
and diet pills.

Introduction
(continued)
 According to the National Vital Statistics Reports, over 40,000

Americans died as a result of drug- or alcohol-induced deaths
in 2001.

Activity
 Define and discuss the following terms:

 Substance misuse
 Substance abuse
 Drug
 Medication
 Dependency
 Addiction
 Tolerance

Activity
(continued)
 Define and discuss the following terms:

 Overdose
 Withdrawal
 Synergistic effect

Activity
 Substance misuse
 Substance abuse
 Drug
 Medication
 Dependency
 Addiction
 -
 Tolerance

Activity
(continued)
 Overdose
 Withdrawal
 Synergistic effect

Misused and Abused Substances
 Substances are categorized according to their effects on the body.

 The six major categories of commonly misused and abused
substances are—
 Stimulants.
 Depressants.
 Hallucinogens.
 Narcotics.
 Inhalants.
 Cannabis products.

Stimulants
 Stimulants are drugs that affect the central nervous system by

increasing physical and mental activity.
 The effects of stimulants include—
 Temporary feelings of alertness and prevention of fatigue.
 Appetite suppression.
 Many stimulants are ingested as pills, but can be absorbed or
inhaled.

Stimulants
 Amphetamines, dextroamphetamines and methamphetamines are

stimulants.
 Slangs are: uppers, bennies, black beauties, speed, crystal, meth, and
crank
 Cocaine is one of the most publicized and powerful stimulants.
 A purer form of cocaine is known as crack.
 Highly addictive and called rock and freebase rocks
 The most common stimulants in America are legal:
 Caffeine
 Nicotine
 Other stimulants are used for medical purposes.

Hallucinogens
 Hallucinogens, also known as psychedelics, are substances that

affect mood, sensation, thought, emotion and self-awareness.
 Hallucinogens sometimes cause what is called a bad trip.
 A bad trip can involve intense fear, panic, paranoid
delusions, vivid hallucinations, profound depression,
tension and anxiety.
 The victim may be irrational and feel threatened by any
attempt others make to help.

Hallucinogens
(continued)
 Among the most widely abused hallucinogens are—

 Lysergic acid diethylamide (LSD), also known as acid.
 Psilocybin (mushrooms).
 Phencyclidine (PCP), called angel dust.
 Mescaline (peyote, buttons or mesc).
 Most are ingested, PCP can be inhaled

Depressants
 Depressants are substances that affect the central nervous system by

decreasing physical and mental activity.
 Depressants are commonly used for medical purposes.
 Relieve anxiety, promote sleep, depress respiration, relieve pain,
relax muscles, impair coordination and judgment
 Common depressants include—
 Barbiturates.
 Benzodiazepines.
 Narcotics.
 Alcohol.

Depressants continued
 Most are ingested or injected.

 Alcohol is most widely used and abused substance in the U.S.
 Causes many unhealthy consequences
• Affect the brain causing lack of coordination, memory
loss or apathy
• Cause liver disease such as cirrhosis
• Lead to psychological, family, social and work
problems
 Alcohol poisoning is caused when large amount is
consumed in a short period of time. Resulting in LOC and
if untreated DEATH
Narcotics
 Narcotics, derived from opium, are drugs that work on the

central nervous system to relieve pain.
 Are very powerful and highly addictive and are illegal
without a prescription.
 When taken in large amounts euphoria, stupor, coma or
death can result.
 The most common natural narcotics are morphine and
codeine.
 Most other narcotics, including heroin, are synthetic or
semisynthetic.

Narcotics continued
 Heroin abuse is results in serious health conditions

 Fatal overdose
 Spontaneous abortion
 Collapsed veins
 HIV and Hep. B
 Long Term
 Infection or heart lining and valves, abscesses and liver
diseases
 Addiction

Inhalants
 Inhalants are substances inhaled to produce a mood-altering
effect.
 Inhalants also depress the central nervous system.
 Inhalants include medical anesthetics, such as amyl nitrite
and nitrous oxide (also known as laughing gas), as well as
hydrocarbons, known as solvents.
 Solvents are similar to alcohol they include
• Toluene – found in glue
• Butane – found in lighter fluid
• Acetone – found in nail polish remover
• Fuels such as gasoline and kerosene
• Propellants – found in aerosol sprays
 Inhalant can damage heart, lungs, brain and liver

Cannabis Products
 Cannabis products, including marijuana, tetrahydrocannabinol,
or (THC), and hashish, are all derived from the plant Cannabis
sativa.
 Marijuana is the most widely used illicit drug in the United
States.
 Marijuana, although illicit, has been used for some medicinal
purposes to treat—
 Nausea from chemotherapy.
 Glaucoma.
 Muscular weakness caused by multiple sclerosis.
 Weight loss from cancer and AIDS.

Cannabis Products
(continued)
 The effects of marijuana include—

 Feelings of elation.
 Distorted perceptions of time and space.
 Throat irritation.
 Red eyes.
 Rapid pulse.
 Dizziness.
 Increased appetite.

Designer Drugs
 These drugs are variations of other substances, such as narcotics and
amphetamines.
 The molecular structures of designer drugs include substances used
for medical purposes that are modified by chemists.
 When altered, the user can experience a variety of unpredictable and
dangerous effects
 Most common drug is methylenedioxymethamphertamine (MDMA) or
ecstasy
 Ecstasy is popular for the euphoric high
• Other signals are:
– Increase BP, Rapids HB, Profuse sweating, Paranoia,
Sensory distortion, Erratic mood swings

Anabolic Steroids
 Anabolic steroids are sometimes used by athletes to enhance

performance and increase muscle mass.
 Their medical uses include stimulating weight gain.
 Chronic use of anabolic steroids can lead to sterility, liver
cancer and personality changes.
 Steroid abuse by young people may also disrupt normal
growth.

Over-the-Counter Substances
 The most commonly misused and abused over-the-counter

substances are aspirin, laxatives and nasal sprays.

Over-the-Counter Substance
(continued)
 Aspirin is used to relieve minor pain, reduce fever and treat heart
disease.
 Aspirin misuse can—
 Cause inflammation of the stomach and small intestine.
 Impair normal blood clotting.

(continued)
 Laxatives are used to relieve constipation.

 Laxative misuse can cause uncontrolled diarrhea that may
result in dehydration.
 Laxative abuse is associated with attempted weight loss and
eating disorders, such as anorexia nervosa and bulimia.

(continued)
 Antihistamines, such as decongestant nasal sprays, can help relieve

the congestion of colds or hay fever.
 If misused, they can cause physical dependency.
 Used over a long period of time sprays can result in nose bleeds
and changes in the lining of the nasal passages, eventually making
it difficult to breathe without the spray

Signals of Substance Misuse and Abuse
 Signals of substance misuse and abuse are similar to those of
other medical emergencies.
 Signals of abuse or misuse include—
 Moist or flushed skin.
 Sweating, chills, nausea, vomiting.
 Fever.
 Headache.
 Dizziness..
 Rapid pulse, rapid breathing.
 High blood pressure.
 Chest pain.
(continued)
 Respiratory distress, disruption of normal heart rhythm and

even death can result from using a stimulant.
 A victim of stimulant overdose may appear to be—
 Very excited.
 Restless.
 Talkative.
 Irritable.
 Unconscious.

(continued)
 Specific signals of hallucinogen abuse may include—

 Sudden mood changes.
 Flushed face.
 Seeing or hearing something that is not present.
 Anxiousness or being frightened.
 Specific signals of depressant abuse include—
 Drowsiness.
 Confusion.

(continued)
 Slurred speech.
 Slow heart and breathing rates.
 Poor coordination.

Care for Substance Misuse and Abuse
 Follow these general principles as you would for any

poisoning:
 Check the scene to make sure it is safe to help the person.
 Do not approach if victim is behaving in a threatening
manner.
 Call 9–1–1, the local emergency number or the Poison
Control Center.
 Care for any life-threatening conditions.
 Care for any other conditions you find.
 Withdraw from the area if the victim becomes violent or
threatening.

Care for Substance Misuse and Abuse
(continued)
 Look for clues.

 Look for product or medicine containers, drug paraphernalia
and signals of other medical conditions.
 If you suspect that someone has taken a designer drug, tell
EMS personnel.
 After a substance abuse emergency, the victim may need
additional support to overcome addiction.

Preventing Substance Misuse and Abuse
 Approaches vary, including educating people about substances

and their effects on health and attempting to instill fear of
penalties, which have not by themselves proved to be particularly
effective.
 To be effective, prevention efforts must address the various
underlying factors of and approaches to substance abuse.

(continued)
 The following factors may contribute to substance abuse:

 A lack of parental supervision
 The breakdown of traditional family structures
 A wish to escape unpleasant surroundings and stressful
situations
 The widespread availability of substances
 Peer pressure and the basic need to belong
 Low self-esteem, including feelings of guilt and shame
 Media glamorization
 History of substance abuse
(continued)
 Some poisonings from medicines occur when victims knowingly

increase the dosage beyond what is directed.
 The best way to prevent such misuse is to take medications only
as prescribed.
 On the other hand, many poisonings from medicines are not
intentional.

(continued)
 The following guidelines may help prevent unintentional

misuse or overdose:
 Read the product information and use only as directed.
 Ask your physician or pharmacist about the intended use
and side effects of prescriptions and over-the-counter
medications. If you are taking more than one medication,
check for possible interaction effects.
 Never use another person’s prescribed medications.
 Always keep medications in their appropriate, marked
containers.
 Destroy all out-of-date medications.
 Always keep medications out of the reach of children.

Closing
 There are six major categories of substances that, when abused
or misused, can produce a variety of signals.
 You do not have to diagnose the condition to give care.
 If you suspect that the victim’s condition is caused by
substance misuse or abuse—
 Give care for a poisoning emergency.
 Call 9-1-1, the local emergency number or Poison Control
Center personnel and follow their directions.
 Call the police, if necessary.
 Questions?


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Chapter 18: Substance Misuse

 Substance abuse and misuse cost the United States billions

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

 Legal substances are among those most often misused or abused.

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

 According to the National Vital Statistics Reports, over 40,000

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

 Define and discuss the following terms:

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

 Define and discuss the following terms:

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

 Substances are categorized according to their effects on the body.

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

 Stimulants are drugs that affect the central nervous system by

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

 Amphetamines, dextroamphetamines and methamphetamines are

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

 Hallucinogens, also known as psychedelics, are substances that

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

 Among the most widely abused hallucinogens are—

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

 Depressants are substances that affect the central nervous system by

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

 Most are ingested or injected.

 Narcotics, derived from opium, are drugs that work on the

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

 Heroin abuse is results in serious health conditions

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

 Inhalant can damage heart, lungs, brain and liver

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

 The effects of marijuana include—

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

 Anabolic steroids are sometimes used by athletes to enhance

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

 The most commonly misused and abused over-the-counter

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

 Laxatives are used to relieve constipation.

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

 Antihistamines, such as decongestant nasal sprays, can help relieve

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

 Respiratory distress, disruption of normal heart rhythm and

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

 Specific signals of hallucinogen abuse may include—

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

 Follow these general principles as you would for any

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

 Look for clues.

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

 Approaches vary, including educating people about substances

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

 The following factors may contribute to substance abuse:

 Some poisonings from medicines occur when victims knowingly

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

 The following guidelines may help prevent unintentional

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

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