1. Psychoactive substances - drugs or chemicals that alter 1 or several of the ff. a. b. c. d. e. f. g. h. i.

Perception Awareness Consciousness Thinking Judgment Decision making Insight Mood Behavior

diminished effect with continued use of the same amount of the substance b. Withdrawal - behavioral, physiologic and cognitive symptoms that occur when blood or tissue concentrations of a substance abruptly decline c. Compulsive drug taking behavior d. Inability to reduce substance abuse e. Excess time spent obtaining drugs f. Impairment in social/ occupational functioning/ recreational activities g. Continued substance use despite negative consequences 4. Polysubstance Abuse -use of more than 1 abusive substance 5. Substance Intoxication - Development of a reversible substance specific syndrome induced by ingestion or exposure to substance, which produces physiologic effects on the CNS 6. Dual Diagnosis - Presence of another psychiatric diagnosis in an individual with a substance specific disorder. SUBSTABCE ABUSE - 2 to 3 times more common in MEN than women - Unemployed* - 18 to 25 years old * - Members of medical profession* - Increased risk for suicide * high risk groups WOMEN AND SUBSTANCE ABUSE Risk Factors: a. Growing up in a chaotic family b. Suffering from victimization in childhood c. Having decreased level of self esteem DEFENSE MECHANISMS

Commonly abused substances a. Alcohol b. Amphetamines c. Caffeine d. Cannabis e. Cocaine f. Hallucinogens g. Inhalants h. Nicotine i. Opioids j. Phencyclidine k. Barbiturates l. Nonbarbiturate sedative- hypnotics m. Anxiolytics 2. Substance Abuse - Misuse of a substance with significant and recurrent adverse consequences related to repeated use. 3. Substance dependence - Cluster of cognitive, behavioral and physiologic symptoms indicating continued use of substance despite significant life problems related to that use. - diagnosis requires at least 3 symptoms occurring over 12 months Symptoms of substance dependence a. Tolerance - Need for greatly increased amounts of a substance to obtain the desired effect; or

1. Denial - Individual is unable to acknowledge how destructive substance use has become and the effect of use on the individuals problems 2. Rationalization 3. Projection COMMON PERSONALITY TRAITS 1. Dominant and critical behavior toward others which masks self doubt and passivity 2. Personal insecurity and decreased self esteem 3. Rebellious attitude toward authority 4. Difficulty with intimate relationships and tendency toward narcissism A. TYPES OF SUBSTANCES ALCOHOL - Most commonly abused substance in U.S. - Ranked as the 3rd major health problem in U.S. Immediate effects 1. acute intoxication - Slurred speech - Lack of coordination - Unsteady gait - Impaired attention & memory HIGH DOSE: stupor & coma 2. Chronic use -multisystem dysfunction a. Gastrointestinal effects - Gastritis - Pancreatitis - Cirrhosis of the liver b. CNS effects - Related to the effect of thiamin (vitamin B1) deficiency (1) Wernickes syndrome - Acute confusional state characterized by: - Ataxia - Delirium - Peripheral neuropathy

TREATMENT: thiamin (2) Korsakoffs syndrome - Chronic cognitive impairment (dementia) characrterized by: - cerebral atrophy - memory loss TREATMENT: supportive manner c. Cardiovascular problems - Anemia - Cardiomyopathy - Clotting disorders d. Blackouts (anterograde amnesia) - Loss of short term memory e. Reproductive problems - Fetal alcohol syndrome (FAS) - low birth weight -abnormal facial features - microcephaly -mental retardation - cardiac & genital abnormalities -vision & hearing problems Alcoholism -defined as a chronic disease manifested by repeated drinking that produces injury to the drinkers health or to his social or economic functioning. - is the most common psychiatric disorder Filipinos were found to be the second highest consumers of alcohol Causes of alcohol abuse: Availability- alcohol is easily available and drinking is accepted as a norm in function and social gathering. Genetic factors- some excessive drinkers have a family history of excessive drinking. There is a genetic relation between alcoholism, depression and antisocial personality disorder. Biochemical factors- several biochemical factors have been suggested including

abnormalities in alcohol dehydrogenase or in the neurotransmitter mechanism. Learned behavior- it has been suggested that learning process may contribute in more specific way to the developmental of alcohol dependence through the repeated experience of withdrawal symptoms. Alcohol may act as reinforce for further drinking. Children, especially boys, tend to follow their parents drinking pattern drink to get away from pain. Personality factors- alcoholism is more common in anxiety, prone or cyclothymic personalities. Drinking alcohol is also more common among antisocial personalities. Poor coping strategies- the person cannot face the stress often resort to alcoholism. The defense mechanism involved in alcoholism includes denial, rationalization, and projection. Psychiatric disorders- some patients with depressive disorder take to alcohol in the mistaken hope that it will alleviate low mod. Persons suffering from anxiety disorders and phobic disorders are prone to take alcohol as an escape. Social causes- isolation, unemployment, loss, injustice and other social causes may lead to alcohol abuse. High risk groups- person suffering from chronic physical illness, business executives, travelling sales person, industrial workers, urban slum dwellers, student in hostels, military personnel etc. are more prone to develop alcohol abuse. The process of development of alcohol alcoholism Experimental- to begin with, persons start drinking alcohol due to peer pressure and curiosity. Recreational- gradually, whenever they meet in functions like marriages, hostel day or college

day, parties, conferences, they drink occasionally. Relaxational- whenever they want relaxation, on holidays and weekends, they start enjoying their drinks. Hence the frequency gradually increases. Compulsive- some people started drinking occasionally, start drinking almost daily or drinking heavily for period of time for pleasure or to avoid the discomfort of withdrawal symptoms. Stages of Alcoholism Early stage Increased tolerance- needing more and more of alcohol to experience the same pleasure as experience earlier. Blackouts- inability to recollect incidents which happened under the influence of alcohol. Pre occupation- always thinking about how, when and where to drink. Middle stage Loss control over the amount, time and occasion of drinking. Keeping away for alcohol sometimes, but going back to obsessive drinking after each such abstinent period. Chronic stage Getting drunk even in small amounts of alcohol. Willing to lie, beg, borrow or steal to maintain supply of alcohol. Living to drink alcohol takes priority over family or job. Physical complications of alcohol abuse Liver disorders Drinking heavily can cause alcoholic hepatitis, an inflammation of the liver. After years of drinking, hepatitis may lead to the irreversible and progressive destruction and scarring of liver tissue (cirrhosis).

Heart problems Excessive drinking can lead to high blood pressure and increases your risk of heart failure or stroke. Eye problems Over time, excessive alcohol use can cause weakness and paralysis of your eye muscles. Digestive problems Alcohol can result in inflammation of the lining of the stomach (gastritis) and can interfere with absorption of B vitamins and other nutrients. Heavy drinking can also damage your pancreas, which produces the hormones that regulate your metabolism and the enzymes that help digest fats, proteins and carbohydrates. Sexual function and menstruation Alcohol abuse can cause erectile dysfunction in men. In women, it can interrupt menstruation. Neurological complications Excessive drinking can affect your nervous system, causing numbness of your hands and feet, disordered thinking, dementia, and short-term memory loss. Diabetes complications Alcohol interferes with the release of glucose from your liver and can increase the risk of low blood sugar (hypoglycemia). This is dangerous if you have diabetes and are already taking insulin to lower your blood sugar level. Birth defects Alcohol use during pregnancy may cause fetal alcohol syndrome, resulting in giving birth to a child who has physical and developmental problems. Bone loss Alcohol may interfere with the production of new bone. This can lead to thinning bones (osteoporosis) and an increased risk of fractures.

Increased risk of cancer Chronic alcohol abuse has been linked to a higher risk of numerous cancers, including mouth, throat, liver, colon and breast cancer. Psychiatric complication of alcohol abuse Alcohol withdrawal syndrome (AWS) -responsible for a significant increase in the mortality and morbidity associated with alcohol consumption and is one of the diagnostic criteria of alcohol dependence syndrome. most common signs and symptoms restlessness Anxiety mood alterations (dysphoria) Trembling nausea & vomiting tachycardia arterial hypertension. Seizures Convulsive pictures secondary to alcohol abuse/dependence not rare not uncommon the worsening of the control of seizures on patients with previous history of convulsions (idiopathic or not) Seizures secondary to alcohol withdrawal tonic-clonic (or grand mal) isolated and occur in the first 48 hours after the suspension or reduction of alcohol consumption peak between 13 and 24 hours most patients who are not adequately treated evolve to delirium tremens. Delirium Treatment - a specific picture of delirium, related to alcohol withdrawal. Delirium conditions usually have:

 floating symptoms significant worsening in the evening Cognitive, memory and attention alterations temporo-spacial disorientation Decreased attention and thought disturbances result in incoherent speech. Wernicke Korsakoff Syndrome (WKS) -a potentially fatal complication associated with deficiency of B1 or thiamine. 2 distinct entities 1. Wernickes encephalopaty 2. Korsakoffs psychosis A triad of clinical abnormalities : cornerstones of the syndrome's diagnosis 1. Wernicke oftalmoplegy 2. ataxia 3. mental confusion Marchiava Bignami syndrome -also called "corpus callosum body primary degeneration it is a disease most commonly defined by its pathological than its clinical aspects. The main alteration is found in the medial portion of the corpus callosum decrease in the tissue density mild reddish or yellowish depression clearly demielinizating zones with abundant macrophages. Social complication of alcohol abuse FAMILY Increased family tension Increased levels of quarrelling and violence; Destabilized relationships.

Partners may become anxious, depressed, socially withdrawn and may drink excessively themselves; Detrimental effects on the children leading to behavioural problems and underperformance at school; Increased rates of divorce. WORK deterioration in performance conflict with colleagues increase in workplace accidents worsening attendance record This is likely to result in repeated dismissals ultimately leading to long-term unemployment. CRIME Excessive drinking is associated with crimes petty theft driving offences Fraud sexual offences crimes of violence

1-2

.05

-Release of inhibition -feeling of well being -judgement impaired -limited night and side vision -loss of self control -reaction time significantly slowed. -increased reaction time -Loss of equilibrium -sensory motor capabilities depressed Unfit to to drive up to 10 hours -not aware of surroundings -lethal dosage -alcoholpoisoning / overdose

3-5

.10

6-7 8-10

.15 .20

10-14 14-20

.35 .40

1can of beer = 12 oz. 4-5 percent of alcohol

1 glass of wine= 4 oz. 12 percent of alcohol 1 shot of liquor= 1 oz. 40-50 percent of alcohol Anxiolytic ( Benzodiazepines / Minor Tranquilizer/ antipanic or antianxiety agent ) -drugs having relatively mild depressant effect -is a drug used for the treatment of anxiety, and its related psychological and physical symptoms. -Consider safer than Barbituates -Drug of choice to treat sleep problem, nervousness and anxiety Anxiolytics Drugs 1. Diazepam ( Valium ) Drug Class: Anxiolytics/ Benzodiazepine Actions: 1. Act in Spinal cord and at supra spinal sites to produce skeletal muscle relaxation 2 .Inhibitory neurotransmitter Indication: 1. Short term relief of Anxiety 2. For acute alcohol withdrawal Contra indication: Hyper Sensitivity Side effects: Mild drowsiness Depression Lethargy Apathy Fatigue light headedness Restless Headache

Monitor blood pressure, pulse rate, respiratory rate during IV Administration because it can cause arteriespasm 2. Alprazolam ( Xanax), Oxazepam ( Serax ) , Lorazepam ( Ativan ) Drug Class: Anxiolytics/ Benzodiazepine Actions: Same as above Indication: Short term relief of Anxiety associated with depression Contra indication: Hyper Sensitivity Side effects: Central Nervous System: same with Diazepam GI: GI disturbance Cardiovascular: Bradycardia Tachycardia Hypertension/Hypotension Palpitations Nursing Consideration: 1. Dont Drink grape fruit while taking this drug 2. If long term therapy, dont stop taking the drug without consulting 3. Drug shouldnt stop suddenly 4. Avoid Alcohol, sleep inducing agents Barbiturates A CNS depressants are a group of drugs in the class of drugs known as sedativehypnotics, which generally describes their sleepinducing and anxiety-decreasing effects. It is highly addictive and users can quickly develop a tolerance.

Nursing Consideration:

Barbiturates can be injected into the veins or muscles, but they are usually taken in pill form.

Amobarbital Pentobarbital Phenobarbital Secobarbital

Withdrawal symptoms of barbiturates are similar to those of alcohol withdrawal. occurs 24-72 hours after the last dose Anxiety Tremors insomnia Downers, blue heavens, blue velvet, blue devils Anorexia nausea and vomiting
Nembies, yellow jackets, abbots, Mexican yellows

More Severe symptoms Hypertension Purple hearts, goof balls Tachycardia Delirium Reds, red birds, red devils, lilly, F-40s, pinks, pink ladies, seggy Hallucinations Pregnant women taking barbiturates can cause their gorilla pills, F-66s Rainbows, reds and blues, tooies, double trouble, baby to become addicted, and the newborn may have withdrawal symptoms. Opioids (Narcotic Analgesics) Narcotics - for pain relief associated with operations or sickness - for calming purposes - lack of information or misinformation about narcotics can lead to narcotics drug addiction Opium morphine Morphine comes from a group of drugs known as opiates It derived from the opium found in the poppy plant Painkiller produces a sensation of euphoria and well being Both effects are due to binding of morphine to specific opiate receptors in the brain Morphine resembles endorphins, and by binding to some opiate receptors further endorphine released is stimulated drug of choice for relieving the pain of myocardial infarction and for its

Tuinal

In small doses, the person who abuses barbiturates feels: Drowsy Disinhibited Intoxicated In higher doses user staggers as if drunk develops slurred speech Confused At even higher doses the person is unable to be aroused (coma) may stop breathing Death is possible Other Effects: Europhia Impaired attention and memory Sedation Psychomotor retardation Facial flushing Bradycardia Hypertension

cardiovascular effects in the treatment of acute pulmonary edema This drug can be very addicting if not taken as prescribed Overdose can cause asphyxia and death by respiratory depression if the person does not receive medical attention immediately.

To minimize withdrawal symptoms, long-term users should gradually reduce their codeine medication under the supervision of a healthcare professional.

Withdrawal symptoms include: -drug craving -runny nose -yawning - Sweating -insomnia -weakness -pain stomach cramps Nausea/ vomiting Diarrhea muscle spasms chills irritability

Overdose treatment: Naloxone. Withdrawal Early symptoms watery eyes headache Insomnia Restlessness Diarrhea runny nose appetite Yawning aches Dysphoria sweating and vomiting in some cases a strong abdominal pain Codeine -an opiate -analgesic -Antitussive -antidiarrheal Codeine is less effective as a painkiller than morphine Less effective at inducing euphoria. It has the benefit of being much less addictive (and legal) Withdrawal chronic use of codeine can cause physical dependence. -Severe -Irritability -loss of -body -Tremors -nausea -severe

Oxycodone - effective for managing moderate to moderately severe acute or chronic pain - can also be used as a alternative to other opiates to treat severe diarrhea and diarrhea - predominant irritable bowel syndrome when drugs such as loperamide and diphenoxylate are ineffective. The symptoms are the same as for other opiate based painkillers and may include : Anxiety panic attack Nausea insomnia muscle pain muscle weakness Fever other flu like symptoms

Adverse Effects of morphine, codeine and oxycodone Memoryloss Constipation Fatigue Dizziness Nausea Lightheadedness Headache

dry mouth Anxiety Pruritus diaphoresis

Controlled Substance C-II Indications: Relief of pain Preoperative medication Support of anesthesia Obstetric analgesia Adverse Effects: GI: nausea and vomiting, constipation CV: bradycardia Major Hazards: respiratory depression, apnea, circulatory depression, respiratory arrest, shock, cardiac arrest

Heroin Is a highly addictive drug derived from morphine, which is obtained from the opium poppy. It is a downer or depressant that affects the brains pleasure systems and interferes with the brains ability to perceive pain. White to dark brown powder or tar-like substance.

injected into a vein (mainlining) injected into a muscle inhaled as smoke through a straw (chasing the dragon) snorted as powder via the nose. Withdrawal In Regular abusers - drug craving - restlessness - muscle and bone pain - insomnia - diarrhea - vomiting - kicking movements (kicking the habit) Major withdrawal symptoms - peak between 48 and 72 hours after the last does and subside after about a week. - Sudden withdrawal by heavily dependent users who are in poor health can be fatal. Synthetics Meperidine (Demerol) Methadone (Dolophine) Propoxyphene (Darvon) Pentazocine (Talwin) Pregnancy Category C

CNS: -light-headedness -dizziness -sedation -euphoria -dysphoria -delirium -insomnia -agitation -anxiety -fear -hallucination -disorientation -drowsiness, -lethargy -impaired mental and physical performance -coma -mood changes -weakness -headache -tremor -seizures -miosis -visual disturbances -suppression of cough reflex Local: tissue irritation Opioid dependence: A strong desire or sense of compulsion to take the substance. Difficulty in controlling use. A physiological withdrawal state. Tolerance. Neglect of alternative pleasures and interests. Persistence of use despite harm to oneself and others. Acute opioid withdrawal symptoms:

Sweating Watering eyes Rhinorrhoea Yawning Feeling hot and cold Anorexia and abdominal cramps Nausea, vomiting and diarrhea Tremor Insomnia, restlessness, anxiety and irritability Generalized aches and pains Tachycardia, hypertension Goose flesh(goose bumps) Dilated pupils Increased bowel sounds Coughing

4.Homelessness and deprivation 5.Working in the sex industry Psychological problems: 1.Craving 2.Guilt 3.Anxiety 4.Loss of cognitive skills and memory Treatment and management: Naloxone (a pure opioid antagonist used for reversing opioid intoxication) has a rapid onset of action can be given IM, IV or subcutaneously Therapy is otherwise mostly supportive e.g. maintain airway, ventilation if necessary and IV fluids Psychosocial interventions talking therapies cognitive behavioural therapy family therapy key working should be delivered alongside pharmacological interventions Amphetamines Methylphenidate (Ritalin) It is a psycho stimulant drug It is used to treat the following: ADHD Nacrolepsy Mild CNS stimulant with more prominent effects on mental than on motor activities. Most commonly prescribed psycho stimulant and works by increasing the activity of the CNS. More potent than cocaine in its effect on dopamine transporters

Fatigue and insomnia tend to follow these acute symptoms. Cravings can last for up to 6 months. Acute heroin withdrawal symptoms tend to ease after 5 days. Methadone withdrawal symptoms can take 10-12 days to subside. Complications due to opioid dependence: Health problems: 1. Death (which may be due to overdose, suicide, accidents or health-related complications) 2. Skin infection at injection sites (can be severe; necrotising fasciitiscan occur) 3. Septicemia 4. Infective endocarditis 5. HIV infection 6. Hepatitis A, B and C infection 7. Tuberculosis infection 8. Venous and arterial thrombosis (due to poor injecting techniques) 9. Poor nutrition and dental disease Social problems: 1.Crime 2.Relationship problems 3.Child protection issues

EFFECTS Increasing or maintaining alertness combating fatigue improving attention college students > non college attending young adults study aid or to stay awake longer to enhance their mental abilities improving their concentration helping them to study Common Side effects: Nervousness Drowsiness Insomnia Abuse potential : effects similar to cocaine crushed insufflated (snorted) Injected Cocaine-like effects can also occur with very large doses taken orally. Withdrawal Symptoms Fatigue Unpleasant dreams Insomnia Motor dysfunction Depression Pemoline (Cyclert) used to treat the ff: ADHD Nacrolepsy Mechanism of Action inhibit the reuptake of dopamine and to increase the levels of dopamine and NE in the CNS. Side effects Rapid heartbeat high blood pressure Altered mental status Hallucinations

Seizures Depression Abuse Potential in attempts to lose weight stay awake for prolonged period Withdrawal Symptoms Worsening of symptoms Anxiety Depression Sleep problems Irritability Over-activity Phenmetrazine (Preludin) stimulant drug of the morpholine chemical class that was previously used as an appetite suppressant used in the treatment of obesity very similar in the chemical structure of amphetamines. high potential for abuse and addiction Side effects Blurred vision Nausea Constipation Diarrhea Dizziness Dry mouth Headache Contraindications Anorexia psychopathic personality disorders suicidal tendencies Abuse Potential Abuse of amphetamines and related drugs may be associated with intense psychological dependence and severe social dysfunction.

 This drug must be used short-term only because long-term use can lead to psychosis, which is often clinically indistinguishable from schizophrenia. Withdrawal Symptoms Fatigue Depression Cocaine (benzoylmethylecgonine) A crystalline tropane alkaloid that is obtained from the leaves of the coca plant. a stimulant of the CNS an appetite suppressant a topical anesthetic a powerful nervous system stimulant Its effects can last from 1530 minutes to an hour, depending on the route of administration. Cocaine alertness feelings of well-being Euphoria energy and motor activity feelings of competence & sexuality enhanced athletic performance where sustained attention and endurance is required. Anxiety paranoia restlessness With excessive dosage: Tremors convulsions body temperature Side Effects Dysphoria Depression Anxiety psychological and physical weakness pain compulsive craving

Withdrawal Symptoms Psychosis Depression Irritability Abuse Potential Repeated exposure to cocaine causes a change in genes that leads to altered levels of a specific brain protein. This protein regulates the action of a normally occurring brain chemical called dopamine. It is a chemical messenger in the brain associated with the cocaine's pleasurable "rush," the mechanism of addiction. CANNABINOIDS Cannabis (Marijuana) It is a green, brown, or gray mixture of dried, shredded leaves, stems, seeds, and flowers of the hemp plant Mexican Spanish Marihuana Street names: marijuana: Pot Herb Weed Grass boom Mary Jane gangster Chronic stronger forms of -Sinsemilla -hashish -hash oil

Typically smoked in cigarettes hollowed-out cigars, pipes or water pipes Some people mix it into food or brew it as a tea They all contain THC (delta-9tetrahydrocannabinol), the main active chemical in marijuana. Categories:

 Stimulant Depressant hallucinogen Short term effects: difficulty in thinking and problem solving problems with memory and learning loss of coordination distorted perception

Forms:

relieve nausea (cancer) AIDS (regain appetite) lowered IOP general analgesic effects oromucosal spray for Multiple Sclerosis

Unprocessed: a. Dried Cannabis flowers in natural herbal form cannabis or marijuana = refer to dried flowers and subtending leaves and stems of the female cannabis plant. most widely consumed form. Processed: a. Kief a powder, rich in trichomes, which can be sifted from the leaves and flowers of cannabis plants and either consumed in powder form or compressed to produce cakes of hashish. b. Hashish/ Hash a concentrated resin produced from the flowers of the female cannabis plant. often be more potent than marijuana and can be smoked or chewed. color most commonly light to dark brown but varying toward green, yellow, black or red. d. Residue (resin) builds up inside utensils used to smoke cannabis. has tar-like properties but still contains THC /other cannabinoids. Tar may also contain CBN, a breakdown product of THC. Glass pipes may be water-steamed at a low temperature prior to scraping in order to make the residue easier to remove.

Long term effects: Changes in the brain: Marijuana can affect the areas of the brain that play a part in response to stress, motivation, and reward. Respiratory problems: People who smoke marijuana have more respiratory problems such as having more mucus, a chronic cough, and bronchitis. Fertility implications: heavy users may experience disruptions in ovulation or produce less sperm, difficulty having children as they get older. Babies born may be more likely to have developmental and behavioral problems. Changes in blood pressure: continued use of marijuana can lead to BP, which may cause dizziness. It also seems to impair the body's ability to fight off infections and some other diseases. Emotional problems: Heavy users are more likely to report symptoms of depression. Feel more anxiety, more personality disturbances, an risk of developing schizophrenia Deaths associated to cannabis overdose are exceptionally rare. Fatalities resulting from cannabis overdose are said to most often occur after intravenous injection of hashish oil. Medical Use of Marijuana:

Route of administration: inhaling vaporized cannabinoids ("smoke") from small pipes, bongs (portable version of hookah with water chamber) paper-wrapped joints or tobacco-leafwrapped blunts. Marinol active ingredient : Dronabinol synthetic (delta-9-THC) - a naturally occurring component of Cannabis sativa L. (Marijuana) a light yellow resinous oil that is sticky at room temperature and hardens upon refrigeration. insoluble in water and is formulated in sesame oil. Capsules for oral administration: round, soft gelatin capsules (2.5 mg, 5 mg, or 10 mg) Effects: seizure (convulsions) paranoia, extreme fear fast heart rate feeling light-headed Fainting unusual thoughts /behavior Once it reaches peak levels in the blood, Marinol stays fairly steady and lasts twice as long as marijuana. Marinol is safe and approved for use by the Federal Drug Administration. INHALANTS NITROUS OXIDE first medically useful inhalant used for anesthetic purposes commonly known as laughing gas ETHER AND CHLOROFORM produced and used as anesthetics in the 1800s

these drugs were used only for pleasure, with many healthcare professionals becoming addicted to them INHALANT ABUSE referred as huffing Huffing act of purposely inhaling a chemical and then exhaling rapidly repeating the process to achieve the maximum amount of air flow through the lungs increases the amount of chemical that enters the blood through the lungs Common inhalants used in huffing are: Adhesives: Model airplane glue, rubber cement, household glue Anesthetics: Nitrous oxide, ether, chloroform Cleaning: Dry cleaning fluid, spot remover, and degreaser Food: Vegetable cooking spray, "whippets" (nitrous oxide) Gases: Nitrous oxide, butane, propane, helium Solvents: Nail polish remover, paint thinner, typing correction fluid and thinner, toxic markers, pure toluene, cigar lighter fluid, gasoline Aerosols: Spray paint, hair spray, air freshener, deodorant, fabric protector Symptoms of Inhalant Addiction Chronic inhalant abuse can produce other symptoms detrimental to proper bodily functions: both physiologic and psychological.

Initial effects of inhalants resemble alcohol intoxication, though hallucinations do accompany chronic inhalant abuse. Long term effects of inhalant abuse for adolescents can be severe. The symptoms of inhalant abuse are: Short term memory loss Loss of senses Irregular gait Lack of coordination Disorientation Depression Weight Loss Lack of concentration Spots or sores around the mouth Red or runny eyes and nose Chemical odor on the breath A drunken or dazed appearance Loss of appetite Excitability and/or irritability, anxiety Slurred speech Nausea and vomiting Behavioral problems Tremors Psychological problems A person who is abusing inhalants may also have paint or stains on the body or clothing. You may also find rags soaked with chemicals in the home or smell toxic fumes in areas where the addict is abusing inhalants. Complications from Inhalant Addiction The overall impact of inhalants upon the body can be devastating. Addiction to inhalants has a profound influence upon the health of all eleven major systems (respiratory, blood, central nervous system etc.), and brain function. Inhalant abuse can seriously impair every system in the body and can lead to: Damage to the peripheral nervous system

Inability of cells to relay sound to the brain Leukemia Lung damage Liver damage Lack of oxygen in the blood Kidney trouble Degeneration of muscle tone and strength Inflammation of the lungs Inhalant Withdrawal Symptoms Hand tremors Nervousness Excessive sweating Hallucinations Headaches Muscle Pains Psychosis Irritability Insomnia Aggression

Nicotine Psychoactive stimulating substance found in tobacco Behavioral and physiological effects of nicotine frequently lead to addiction. Stimulant that acts in the CNS and PNS at cells that are normally acted upon by the neurotransmitter acetylcholine.