Substance Abuse and Substance Abuse and its Deadly its Deadly

ConsequencesConsequences

Nick van Terheyden, MDNick van Terheyden, MD

Latest InfoLatest Info

Binge Drinking Slows Teenage BrainsBinge Drinking Slows Teenage Brains Less Brian MatterLess Brian Matter Decreased learningDecreased learning Permanent destruction of White Brain Permanent destruction of White Brain

MatterMatter

Drug MythsDrug Myths I am stronger than the drugI am stronger than the drug

– I can control what others cannotI can control what others cannot

Drugs make me more creative/social Drugs make me more creative/social etc.etc.

Life is better stoned.Life is better stoned. Drugs do no permanent harm.Drugs do no permanent harm. What I do in my own time is my own What I do in my own time is my own

businessbusiness Doctors/counselors/authorities are liars.Doctors/counselors/authorities are liars. *** is *** is wayway safer than alcohol. safer than alcohol. I know a guy/girl who’s been doing this I know a guy/girl who’s been doing this

for years and s/he’s for years and s/he’s finefine……

Drug Stats IDrug Stats I

The illegal drug industry ranks The illegal drug industry ranks in size with Mobil Oil as the U.S. in size with Mobil Oil as the U.S. second largest business-only second largest business-only Exxon is larger.Exxon is larger.

Drugs and alcohol cost Drugs and alcohol cost taxpayers nearly $276 billion taxpayers nearly $276 billion dollars a year in preventable dollars a year in preventable health care costs, extra law health care costs, extra law enforcement, auto crashes, enforcement, auto crashes, crime, and lost productivity.crime, and lost productivity.

Drug Stats IIDrug Stats II

In 1999, an estimated 14.8 In 1999, an estimated 14.8 million Americans were current million Americans were current illicit drug users.illicit drug users.

There is an average of 1.5 There is an average of 1.5 million emergency room visits million emergency room visits per year because of drug use.per year because of drug use.

Five typical marijuana Five typical marijuana cigarettes have the same cigarettes have the same cancer-causing capability as 112 cancer-causing capability as 112 tobacco cigarettes.tobacco cigarettes.

StatisticsStatistics

America has only 5% of the world population but America has only 5% of the world population but consumes 60% of ALL illegal drugs produced in the worldconsumes 60% of ALL illegal drugs produced in the world

Each year, a typical young person in the United States is Each year, a typical young person in the United States is inundated with more than 1,000 commercials for beer inundated with more than 1,000 commercials for beer and wine coolers in addition to several thousand fictional and wine coolers in addition to several thousand fictional drinking incidents on television. drinking incidents on television.

Alcohol is involved in 50% of all driving fatalities.Alcohol is involved in 50% of all driving fatalities. Almost half of Americans ages 12 and older reported Almost half of Americans ages 12 and older reported

being current drinkers of alcohol. This translates into being current drinkers of alcohol. This translates into 105 million people.105 million people.

In the next 30 days, 17% of all 7In the next 30 days, 17% of all 7thth graders will use graders will use alcohol. 25% of all 9-12alcohol. 25% of all 9-12thth graders will use enough to be graders will use enough to be defined as heavy drinkers.defined as heavy drinkers.

Every 40 minutes, a kid is arrested for drunk drivingEvery 40 minutes, a kid is arrested for drunk driving

Narcotics (Opioids)Narcotics (Opioids)

HeroinHeroin MorphineMorphine CodeineCodeine HydrocodoneHydrocodone HydromorphHydromorph

oneone

OxycodoneOxycodone MethadoneMethadone MeperidineMeperidine FentanylFentanyl PropoxyphenPropoxyphen

ee

Roseanne – Age 29 Roseanne – Age 29 (Heroine Addict)(Heroine Addict)

EFFECTSEFFECTS

CNS effectsCNS effects– AnalgesiaAnalgesia– DrowsinessDrowsiness– Mood changesMood changes– EuphoriaEuphoria– respiratory depressionrespiratory depression

vomitingvomiting slows gastrointestinal motilityslows gastrointestinal motility No good correlation between No good correlation between

blood concentrations and blood concentrations and lethalitylethality

Aortic Valve infectedAortic Valve infected

CocaineCocaine

COCAINECOCAINE Popular recreation drugPopular recreation drug brain becomes tolerant which brain becomes tolerant which

results in the need for more and results in the need for more and moremore– HeadacheHeadache– ExhaustionExhaustion– ShakingShaking– Blurred visionBlurred vision– NauseaNausea– ImpotenceImpotence

Cocaine - Pharmacologic EffectsCocaine - Pharmacologic Effects

CNS stimulationCNS stimulation– euphoriaeuphoria

– hyperactivityhyperactivity

– restlessnessrestlessness

elevation of blood pressure and heart rateelevation of blood pressure and heart rate hyperthermiahyperthermia dilatation of pupils of eyesdilatation of pupils of eyes nausea and vomitingnausea and vomiting Cardiac arrhythmiasCardiac arrhythmias

Cocaine AdvertCocaine Advert

Cocaine affects the BrainCocaine affects the Brain

……study of K. Little et al; study of K. Little et al; Am J Psychiatry on post Am J Psychiatry on post mortem brain tissue of mortem brain tissue of chronic users – chronic users – dopamine transporter dopamine transporter proteins (VMAT2) proteins (VMAT2) reducedreduced

Ken CaminitiKen Caminiti

Recovering AlcoholicRecovering Alcoholic 4 failed drug tests since 4 failed drug tests since

2002 for cocaine possession2002 for cocaine possession Died from massive heart Died from massive heart

attack @ age 41, Oct. 2004.attack @ age 41, Oct. 2004. ““When asked how someone When asked how someone

so fit and disciplined in his so fit and disciplined in his sport could be so reckless sport could be so reckless with alcohol and drugs, with alcohol and drugs, Caminiti shook his head and Caminiti shook his head and said “I just don’t said “I just don’t understand…” understand…” sports illustrated, October 18, 2004sports illustrated, October 18, 2004

Intracerebral Hemorrhage Intracerebral Hemorrhage (Cocaine)(Cocaine)

CrackCrack

CRACK MIXTURE OF BAKING CRACK MIXTURE OF BAKING SODA AND COCAINESODA AND COCAINE

smoked in glass water pipesmoked in glass water pipe HyperactivityHyperactivity ParanoiaParanoia powerful chemical powerful chemical

dependence occurs dependence occurs

Melissa – Age 18 (Crack Melissa – Age 18 (Crack addict)addict)

Psychedelics And Psychedelics And HallucinogensHallucinogens

PeyotePeyote MescalineMescaline LSD LYSERGIC ACID LSD LYSERGIC ACID

DIETHYLAMIDE “Trips” Trigger DIETHYLAMIDE “Trips” Trigger Panic, Depression, Confusion, Panic, Depression, Confusion, Fear Of Insanity, Distorted Fear Of Insanity, Distorted Thoughts And PerceptionsThoughts And Perceptions

PCP Phencyclidine “Angel Dust” PCP Phencyclidine “Angel Dust” Behaviorally Toxic -Psychotic Behaviorally Toxic -Psychotic Attacks Temporary InsanityAttacks Temporary Insanity

Lysergic Acid Lysergic Acid Diethylamide (LSD)Diethylamide (LSD)

The “High”: The “High”: Visual Visual hallucinationshallucinations

Serious Risks: Serious Risks: Possible Possible “flashbacks”; “flashbacks”; poor judgment poor judgment leading to leading to accidents accidents (crashes, (crashes, jumping off high jumping off high places)places)

Dilated pupilsDilated pupils higher body higher body

temperaturetemperature increased heart rate increased heart rate

and blood pressureand blood pressure SweatingSweating loss of appetiteloss of appetite SleeplessnessSleeplessness dry mouthdry mouth TremorsTremors NumbnessNumbness WeaknessWeakness TremblingTrembling NauseaNausea hallucinationshallucinations

Phencyclidine - Pharmacologic EffectsPhencyclidine - Pharmacologic Effects

hallucinogenhallucinogen slurred speechslurred speech staggering gaitstaggering gait nystagmusnystagmus hyperthermiahyperthermia increased heart rate and blood increased heart rate and blood

pressurepressure hostile and bizarre behaviorhostile and bizarre behavior distorted sensory experiencedistorted sensory experience

““Crystal Crystal Meth”(Methamphetamine) Meth”(Methamphetamine) ((meth, crystal, ice, jib, crank, speed)meth, crystal, ice, jib, crank, speed)

Man made analog of amphetamine. Smokable. Made Man made analog of amphetamine. Smokable. Made in basement labs.in basement labs.

Meth contains a lot of dangerous chemicals.Meth contains a lot of dangerous chemicals. Triggers massive release of dopamine – intense Triggers massive release of dopamine – intense

“rush”“rush” Neurotoxic in animal models – destroys dopamine Neurotoxic in animal models – destroys dopamine

and serotonin neurons - Long term damageand serotonin neurons - Long term damage Predisposition to neurodegenerative diseases later Predisposition to neurodegenerative diseases later

in lifein life EffectsEffects: Anxiety, rapid heart beat, sweating, energy.: Anxiety, rapid heart beat, sweating, energy. Serious RisksSerious Risks: Violence/aggression, hallucinations, : Violence/aggression, hallucinations,

paranoia, heart attack, HIV and other transmittable paranoia, heart attack, HIV and other transmittable diseases, nerve damage, chronic depression, tooth diseases, nerve damage, chronic depression, tooth loss, gum disease.loss, gum disease.

Brain neurochemistry Brain neurochemistry alterationalteration

Eroding the MindEroding the Mind

Methamphetamine EffectsMethamphetamine Effects

EcstasyEcstasy

MDMA – “E”MDMA – “E” MethylenedioxyamphetamineMethylenedioxyamphetamine Hallucinogen, (euphoria, depression)Hallucinogen, (euphoria, depression) Effects last 4-6 hours, after effects last weeks to monthsEffects last 4-6 hours, after effects last weeks to months Works on serotonin system (mood)Works on serotonin system (mood) May damage neurons permanently after 1 useMay damage neurons permanently after 1 use Addictive potential like very weak cocaineAddictive potential like very weak cocaine Malignant hyperthermiaMalignant hyperthermia chronic paranoid psychosischronic paranoid psychosis cardiac arrestcardiac arrest coagulopathycoagulopathy

EcstasyEcstasy EffectsEffects: Increased energy, nausea, : Increased energy, nausea,

hallucinations, chills, sweating, shaking, hallucinations, chills, sweating, shaking, blurred vision, rapid heart beat, high blurred vision, rapid heart beat, high blood pressure, muscle cramping.blood pressure, muscle cramping.

Serious RisksSerious Risks: Heat stroke, severe : Heat stroke, severe dehydration, possible changes in brain dehydration, possible changes in brain functioning, memory problems, serious functioning, memory problems, serious depression.depression.

Eventually, you “run out” of Serotonin, Eventually, you “run out” of Serotonin, regardless of how much you take.regardless of how much you take.

Ectasy Affects on the BrainEctasy Affects on the Brain

Dark indicates damage

InhalantsInhalants

Chemicals that produce vapors Chemicals that produce vapors with psychoactive effectswith psychoactive effects

Solvents, aerosols, cleaning Solvents, aerosols, cleaning fluids, and petroleum productsfluids, and petroleum products

Local irritation to nose and Local irritation to nose and upper respiratory tract, upper respiratory tract, nosebleeds, loss of nosebleeds, loss of coordination, loss of appetite coordination, loss of appetite

Decreased breathing and HRDecreased breathing and HR

InhalantsInhalants EffectsEffects:: NauseaNausea SneezingSneezing FatigueFatigue CoughingCoughing nose bleedsnose bleeds rapid pulserapid pulse HeadachesHeadaches involuntary release involuntary release

urination or fecesurination or feces impaired judgmentimpaired judgment

Serious Risks:Serious Risks: Violent behaviorViolent behavior loss of consciousnessloss of consciousness loss of feeling in hands and loss of feeling in hands and

feetfeet Kidney damageKidney damage brain damagebrain damage loss of smellloss of smell Loss of hearingLoss of hearing Loss of memoryLoss of memory Loss of bone marrowLoss of bone marrow hepatitishepatitis

Drug Abuse Related Toxicity

HIV (Human Immunodeficiency Virus) HIV (Human Immunodeficiency Virus) infectioninfection

AIDS (Acquired Immunodeficiency AIDS (Acquired Immunodeficiency Syndrome)Syndrome)

In large cities perhaps 40-50% of IV In large cities perhaps 40-50% of IV drug users test positive for HIV.drug users test positive for HIV.

Sharing of needles and syringes is Sharing of needles and syringes is primarily responsible.primarily responsible.

Hepatitis B - Another blood-borne Hepatitis B - Another blood-borne disease responsible for 100s of deaths disease responsible for 100s of deaths in IV drug abusersin IV drug abusers

All DrugsAll Drugs

All drugs are dangerous!All drugs are dangerous! With many of these drugs, there’s no way for the With many of these drugs, there’s no way for the

user to know:user to know:– who made the drugwho made the drug– what the ingredients arewhat the ingredients are– how much of an ingredient the drug containshow much of an ingredient the drug contains

Because of these unknowns, the drug’s effects Because of these unknowns, the drug’s effects can be very unpredictablecan be very unpredictable

AlcoholAlcohol

BAC – Blood Alcohol BAC – Blood Alcohol Concentrations. Measured in Concentrations. Measured in grams/100 ml blood.grams/100 ml blood.

..01 – marked increase in sleepiness. Impairs sleep.01 – marked increase in sleepiness. Impairs sleep. .02 – decreased ability to understand commands, esp. .02 – decreased ability to understand commands, esp.

radio.radio. .03 risk of fatal MVA 1.5x normal.03 risk of fatal MVA 1.5x normal .05 – too impaired to operate a vehicle. 24 hour .05 – too impaired to operate a vehicle. 24 hour

suspension. Poor speed/distance perception. Poor suspension. Poor speed/distance perception. Poor problem solving skills. Fatal MVA 2 x normal.problem solving skills. Fatal MVA 2 x normal.

.08 – “legally” impaired. Fatal MVA 4 x normal..08 – “legally” impaired. Fatal MVA 4 x normal. .1-.19 – neurologic impairment, reaction time, ataxia...1-.19 – neurologic impairment, reaction time, ataxia.. .2-.3 – severe impairment.2-.3 – severe impairment .4 – hypothermia, stage 1 anesthesia, aspiration.4 – hypothermia, stage 1 anesthesia, aspiration .5-.8 – onset of coma, death.5-.8 – onset of coma, death

LimitsLimits

Ethanol (Alcohol)Ethanol (Alcohol)

CNS depressionCNS depression– impaired judgementimpaired judgement– depressed learned social and cultural depressed learned social and cultural

inhibitionsinhibitions– impaired self evaluationimpaired self evaluation– euphoriaeuphoria– memory loss memory loss – shortened attention spanshortened attention span

blurred visionblurred vision nystagmusnystagmus impaired hearingimpaired hearing reduced muscle coordinationreduced muscle coordination

Alcohol Brain DamageAlcohol Brain Damage

Alcohol Liver DamageAlcohol Liver Damage

You Don’t Need to Drink You Don’t Need to Drink AlcoholAlcohol

Drinking/Drugs and Drinking/Drugs and DrivingDriving

Jacqueline SaburidoJacqueline Saburido

December 1999December 1999

The car in which Jacqueline was in was hit by another car that was driven by a 17-year old male student on his way home after drinking a couple of hard packs with his friends

She Suffered 60% BurnsShe Suffered 60% Burns

Jacqueline was caught in the burning car and her body was heavily burnt during around 45 seconds. After the accident Jacqueline has needed over 40 operations

Three Months After the Three Months After the AccidentAccident

Lifelong TreatmentLifelong Treatment

Without a left eyelid Jacquie needs eye drops to keep her vision

4 Years On4 Years On

TobaccoTobacco

Tobacco and Lung DiseaseTobacco and Lung Disease

Tobacco and Lung DiseaseTobacco and Lung Disease

Tobacco and Heart Tobacco and Heart DiseaseDisease

Tobacco and Mouth Tobacco and Mouth DiseaseDisease

MarijuanaMarijuana

Marihuana EFFECTSMarihuana EFFECTS

euphoriaeuphoria sleepinesssleepiness impaired short-term memoryimpaired short-term memory impaired balanceimpaired balance altered time perceptionaltered time perception impaired multi-taskingimpaired multi-tasking Hashish extract of cannabis 2 to Hashish extract of cannabis 2 to

10 times more potent than 10 times more potent than marijuanamarijuana

Thank YouThank You

Questions?Questions?