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States of Consciousness

John Frederick C. Udtujan, MAN, RN

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Definition of Terms
To be conscious means to be aware.

Consciousness: Mental awareness of sensations and perceptions of external events as well as self-awareness of internal events including thoughts, memories, and feelings about experiences and the self.

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Definition of Terms
Waking Consciousness A state of clear, organized alertness Perceive times, places, and events as real, meaningful, and familiar

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Definition of Terms
Altered State of Consciousness (ASC) A condition of awareness distinctly different in quality or pattern from waking consciousness Distinct shifts in ones perceptions, emotions, memories, time sense, thoughts, feelings of self-control, and suggestibility. Heightened awareness is an important feature of many ASCs.

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Sleep
Sleep Innate, biological rhythm that is essential for survival and can never be entirely ignored Helps keep the brain healthy by regulating its temperature, conserving energy, and aiding brain development and repair A biological necessity, not a luxury
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Sleep
Microsleep Brief shift in brain activity to the pattern normally recorded during sleep Experienced by most people who have not slept for a day or two Coffee may help, but if one struggles to stay awake while driving, one should stop, quit fighting it, and take a short nap
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Sleep
Sleep Deprivation Sleep loss; being deprived of needed amounts of sleep The Guiness Book of Records: Randy Gardner at age 17 went 264 hours (11 days) without sleep. He needed only 14 hours of sleep to recover. Symptoms: slurred speech, poor concentration or inattention, inability to remember things clearly and name common objects, trembling hands, drooping eyelids, irritability, staring, increased pain sensitivity, and general discomfort Most symptoms are reversed by a single nights rest
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Sleep
Hypersomnia Excessive daytime sleepiness Common during adolescence since rapid physical changes during puberty increase the need for sleep Quality and quantity of sleep time tends to decrease during the teen years

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Sleep
Sleep-Deprivation Psychosis Loss of contact with reality, confusion, disorientation, delusions, and hallucinations that occur because of sleep loss

Delusions: fixed false beliefs that cannot be corrected by logic Hallucination: false sensory perception in the absence of a stimulus Hallucinations and delusions rarely appear before 60 hours of wakefulness
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Sleep
How can I tell how much sleep I really need? Pick a day when you feel well rested. Then sleep that night until you wake without an alarm clock. If you feel rested when you wake up, thats your natural sleep need. If youre sleeping fewer hours than you need, youre building up a sleep debt.

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Not all animals sleep, but like humans, those that do have powerful sleep needs. For example, dolphins must voluntarily breathe air, which means they face the choice of staying awake or drowning. The dolphin solves this problem by sleeping on just one side of its brain at a time! The other half of the brain, which remains awake, controls breathing (Jouvet, 1999). Exit

Sleep
Sleep Patterns Daily rhythms of sleep and waking Normal range of sleep: either 5 hours or less, 7-8 hours, 9 hours or more, 11 hours Short sleepers average 5 hours of sleep or less per night Long sleepers average 9 hours of sleep or more per night Majority of people sleep on a familiar 7- to 8-hour-per night or as much as 11 hours per night Total sleep declines steadily throughout life (from birth to old age) People older than 50 average only 6 hours of sleep a night

Sleep
Sleep Patterns Infants spend up to 20 hours a day sleeping, usually in 2- to 4hour cycles. As children mature, they go through a nap stage and eventually settle into a steady cycle of sleeping once a day. Midafternoon sleepiness is a natural part of the sleep cycle. Brief, well-timed naps can help maintain alertness in people like truck drivers and hospital interns, who often must fight to stay alert. Moderate sleep loss affects mainly vigilance and performance on routine or boring tasks. Higher animals and people deprived of sleep experience involuntary microsleep.
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Why Do We Sleep?
Whether you are awake or asleep right now depends on the balance between separate sleep and waking systems. Brain circuits and chemicals in one of the systems promote sleep. A network of brain cells in the other system responds to chemicals that inhibit sleep. The two systems seesaw back and forth, switching the brain between sleep and wakefulness The brain does not shut down during sleep. Rather, the pattern of activity changes.

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Measuring Sleep Changes


Electroencephalograph (EEG): Brain-wave machine; designed to detect, amplify and records electrical activity in the brain. Beta Waves: Small fast brainwaves associated with alertness and awakeness Alpha Waves: Large, slow brainwaves associated with relaxation and falling asleep Immediately before sleep, the pattern shifts from beta waves to alpha waves. As the eyes close, breathing becomes slow and regular, the pulse rate slows, and body temperature drops. Soon after, we descend into slow-wave sleep through four distinct sleep stages.
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Stages of Sleep
Stage 1: Small, irregular brainwaves and some alpha waves produced in light sleep Heart rate slows even more, breathing becomes irregular, the muscles of the body relax and may trigger a hypnic jerk Hypnic Jerk: Reflex muscle contraction/twitch People awakened at this time may or may not say they were asleep

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Stages of Sleep
Stage 2: Deeper sleep; sleep spindles (short bursts of distinctive brain-wave activity) appear Body temperature drops further Spindles mark the true boundary of sleep Within 4 minutes after spindles appear, most people will say they were asleep.

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Stages of Sleep
Stage 3: Deeper sleep; new brainwaves called Delta waves beings to appear, which are very large and slow. Signal a move to deeper slow-wave sleep and a further loss of consciousness

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Stages of Sleep
Stage 4: Deep sleep (the deepest level of normal sleep); almost purely Delta waves, and the sleeper is in a state of oblivion Most people reach deep sleep in about 1 hour If you make a loud noise during this stage, the sleeper will wake up in a state of confusion and may not remember the noise

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Changes in brain-wave patterns associated with various stages of sleep. Actually, most wave types are present at all times, but they occur more or less frequently in various sleep stages. Exit

Fig. 7.2 Sleep rhythms. Bars show periods of sleep during the fourth, fifth, and sixth weeks of an experiment with a human subject. During unscheduled periods, the subject was allowed to select times of sleep and lighting. In his case, the result was a 25-hour sleep rhythm. Notice how his free-running rhythm began to advance around the clock. When periods of darkness were scheduled (colored area), the rhythm quickly resynchronized with 24-hour days. (Adapted from Czeisler, 1981.) Table of Contents Exit

Fig. 7.3 Development of sleep patterns. Short cycles of sleep and waking gradually become the night-day cycle of an adult. While most adults dont take naps, midafternoon sleepiness is a natural part of the sleep cycles. (After Williams et al., 1964.)

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Fig. 7.4 These Siamese twins share the same blood supply, yet one sleeps while the other is awake. (Photo by Yale Joel, Life Magazine. Time, Inc.)

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States of Sleep
Rapid Eye Movements (REM) Sleep Associated with dreaming; sleep is very light
Body is very still during REM sleep Lack of muscle paralysis during REM sleep is called REM Behavioral Disorder

Non-REM (NREM) Sleep Occurs during stages 1, 2, 3, and 4; no rapid eye movement occurs Seems to help us recover from daily fatigue
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Fig. (a) Average proportion of time adults spend daily in REM sleep and NREM sleep. REM periods add up to about 20 percent of total sleep time. (b) Typical changes in stages of sleep during the night. Notice that dreams mostly coincide with REM periods.

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Sleep Disturbances
Insomnia Difficulty in getting to sleep, frequent nighttime awakenings, or waking too early Sleeping pills exacerbate insomnia; cause decrease in REM and Stage 4 sleep and may cause dependency Drug-Dependency Insomnia Sleeplessness that follows withdrawal from sleeping pills
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Types and Causes of Insomnia


Temporary Insomnia Brief period of sleeplessness caused by worry, stress, and excitement Avoid fighting it and read a book, for example, until youre struggling to stay awake Chronic Insomnia Exists if sleeping troubles last for more than three weeks Adopt regular schedule; go to bed at the same time each night, for example Tryptophan Amino acid (chemical) that increases serotonin levels and therefore leads to sleepiness
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Sleep Disturbances
Sleepwalking (Somnambulism) Occurs in NREM sleep during Stages 3 and 4
Sleeptalking Speaking while asleep; occurs in NREM sleep

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Some Other Sleep Disturbances


Nightmares Bad dreams Occur during REM sleep May occur once or twice a month; brief and easily (unfortunately) remembered Imagery Rehearsal Mentally rehearse the changed dream before you go to sleep again; may help to eliminate nightmares

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Night Terrors
Total panic occurs; hallucinations may occur Occurs during Stage 4 sleep Most common in childhood; may occur in adults Not remembered

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Physiological Sleep Problems


Narcolepsy Sudden irresistible sleep attacks May suffer from catalepsy: Sudden, temporary muscle paralysis leading to complete body collapse

Sleep Apnea Interrupted breathing during sleep; cause of very loud snoring Can be treated by surgery, weight loss, breathing mask

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Sudden Infant Death Syndrome (SIDS; Crib Death)


Sudden, unexplained death of healthy infant (infants should sleep on back or on side to try to prevent) Remember Back to sleep

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Fig. Infants at risk for SIDS are often attached to devices that monitor breathing and heart rate during sleep. An alarm sounds to alert parents if either pulse or respiration falters. SIDS rarely occurs after an infant is 1 year old. Babies at risk for SIDS should be placed on their sides or on their backs. (Photo courtesy of Healthdyne, Inc.)
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Dreams
Psychodynamic (Freudian) Theory: Emphasizes internal conflicts, motives, and unconscious forces Wish Fulfillment: Freudian belief that many dreams are expressions of unconscious desires. There is much evidence to refute this Dream Symbols: Images that have a deeper symbolic meaning Activation-Synthesis Hypothesis: Dream content may be affected by motor commands in the brain that are not carried out
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Hypnosis
A social interaction in which one person (the hypnotist) suggests to another (the subject) that certain perceptions, feelings, thoughts, or behaviors will spontaneously occur.

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Hypnos: Greek god of sleep

Hypnosis
Altered state of consciousness characterized by intensely narrowed attention and increased openness to suggestion Mesmer: Believed he could cure diseases by passing magnets over body; true animal magnetism (mesmerize means to hypnotize) Must cooperate to become hypnotized

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Dan Francis/Mardan Photography

Fig. Arrange three chairs as shown. Have someone recline as shown. Ask him to lift slightly while you remove the middle chair. Accept the applause gracefully! (Concerning hypnosis and similar phenomena, the moral, of course, is Suspend judgment until you have something solid to stand on.)
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Hypnosis (cont.)
Hypnotic Susceptibility: How easily a person can be hypnotized dddd Basic Suggestion Effect: Tendency of hypnotized people to carry out suggested actions as though they were involuntary

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Hypnosis Cans and Cannots


Hypnosis CAN
Help people relax Reduce pain Get people to make better progress in therapy

Hypnosis CANNOT
Produce acts of superhuman strength Produce age regression Force you to do things against your will
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Facts and Falsehood


Those who practice hypnosis agree that its power resides in the subjects openness to suggestion.

Can anyone experience hypnosis? Can hypnosis enhance recall of forgotten events?

Yes, to some extent.


No.

Facts and Falsehood


Can hypnosis force people to act against their will?
Can hypnosis be therapeutic? Can hypnosis alleviate pain? No.
Yes. Self-suggestion can heal too.

Yes. Lamaze can do that too.

Stage Hypnosis
Simulation of hypnotic effects Tricks of the Trade
Waking Suggestibility: People on stage do not want to spoil the act, so they will follow any instruction Selection of Responsive Subjects: Any volunteer who does not get hypnotized in the group on stage and does not follow instructions is thrown off The Hypnosis Label Disinhibits: On stage, once you are in a hypnotic trance, your responsibility for actions is removed; you can do whatever you want!
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More Stage Hypnosis Tricks of the Trade


Hypnotists as Director: Once they are in a trance, the volunteers are suddenly the shows stars, and they will act like it. The hypnotists only need to direct them Stage Hypnotists Use Tricks: Stage hypnosis is 50% deception and 50% taking advantage of the situation Conclusion: Stage hypnotists entertain; they rarely hypnotize

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Sensory Deprivation (SD)


Any major reduction in amount or variety of sensory stimulation Benefits
Sensory enhancement Relaxation Changing habits

Benefits called REST: Restricted Environmental Stimulation Therapy


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Fig. A sensory isolation chamber. Small floatation tanks like the one pictured have been used by psychologists to study the effects of mild sensory deprivation. Subjects float in darkness and silence. The shallow body-temperature water contains hundreds of pounds of Epson salts so that the subjects float near the surface. Mild sensory deprivation produces deep relaxation.
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Drugs and Altered States of Consciousness


Psychoactive Drug: Substance capable of altering attention, judgment, memory, time sense, self-control, emotion, or perception Stimulant: Substance that increases activity in body and nervous system Depressant: Substance that decreases activity in body and nervous system

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Fig. Spectrum and continuum of drug action. Many drugs can de rated on a stimulationdepression scale according to their effects on the central nervous system. Although LSD, mescaline, and marijuana are listed here, the stimulation-depression scale is less relevant to these drugs. The principal characteristic of such hallucinogens is the mind altering quality.
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Physical Dependence
Addiction based on drug tolerance and withdrawal symptoms Drug Tolerance: Reduction in bodys response to a drug Withdrawal Symptoms: Physical illness following withdrawal of a drug

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Psychological Dependence
Drug dependence based on psychological or emotional needs Drug is necessary to maintain comfort and wellbeing Crave drug and its rewarding qualities

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Polydrug Abuse
Accounts for the vast majority of deaths due to drug abuse When mixed, the effects of drugs are multiplied by drug interactions (one drug enhances the effect of another) that are responsible for thousands of fatal drug overdoses True whether the mixed drugs were legally or illegally obtained

Uppers/Stimulants
Amphetamines Cocaine MDMA Caffeine Nicotine

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Amphetamine
Synthetic stimulants that excite nervous system Dexedrine and Methamphetamine are two types of stimulants Large doses cause nausea, vomiting, extremely high blood pressure, fatal heart attacks, and disabling strokes After an amphetamine binge, people suffer from crippling fatigue, depression, confusion, uncontrolled irritability, and aggression Repeated use damages the brain Exit

Stimulants
Methamphetamine Street names include bergs, glass, meth, crank, or crystal Can be snorted, injected, or eaten Created the largest drug problem: ruined lives through addiction and fueled violent criminal subculture Potent smokable form produces an intense high and leads very rapidly to compulsive abuse and severe drug dependence

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Amphetamine
Amphetamine Psychosis Loss of contact with reality because of amphetamine use; user tends to have paranoid delusions that someone is out to get them; acting on these delusions, they may become violent, resulting in suicide, self-injury, or injury to others

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Cocaine
CNS stimulant derived from leaves of coca plant; also used as local anesthetic Street names: coke, snow, blow, snuff, flake Rock cocaine (crack, rock, or roca) smokable form of cocaine; cheaper form that produces very high abuse rates From 1886-1906, Coca-Cola did indeed have cocaine in it! Highly addictive drug: similar in effect to amphetamine on the CNS but cocaine is snorted and quickly metabolized, so its effect last only for about 15 to 30 minutes while amphetamines effects lasts several hours
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Cocaine
Cocaine induces immediate euphoria followed by a crash. Crack, a form of cocaine, can be smoked. Other forms of cocaine can be sniffed or injected.

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Cocaine
Capacity for abuse and social damage rivals that of heroin Casual or first-time users risk having convulsions, a heart attack, or a stroke Cocaine increases the chemical messengers dopamine (produces a rush of pleasure) and noradrenaline (arouses the brain). Powerful combination makes one a compulsive user
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Cocaine
Cocaine Withdrawal The brain adapts to cocaine abuse in ways that upset its chemical balance, causing depression when cocaine is withdrawn. First, there is a jarring crash of mood and energy Within a few days, the person enters a long period of fatigue, anxiety, paranoia, boredom, and anhedonia (inability to feel pleasure) A person who gets through withdrawal may crave cocaine months or years later
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Cocaine
Signs of Cocaine Abuse: Compulsive Use If cocaine is available, say, at a party, you cant say no to it Loss of Control Once you have had some cocaine, you will keep using it until you are exhausted or the cocaine is gone Disregarding Consequences You dont care if the rent gets paid, your job is endangered, your lover disappears, or your health is affected; youll use cocaine anyway

Designer Drugs/Club Drugs


Chemically engineered version of an existing drug; made to skirt drug laws Drugs that are associated with raves and all-night dance parties and concerts Drugs also are used to help people commit other crimes, like robbery and physical assault. They are used on both men and women. The term "date rape" also can be misleading because the person who commits the crime might not be dating the victim. Rather, it could be an acquaintance or stranger. Can act as CNS depressants, CNS stimulants, or hallucinogens Include: MDMA/Ecstacy, GHB, RoHypnol (date rape drug or predator drug), LSD, methamphetamine, and Exit ketamine

MDMA/Ecstacy
Chemically similar to amphetamine; created by small variations in the drugs structure Risks of using MDMA are unclear Produces a rush of energy + makes the user feel closer to others and heightens sensory experiences Causes brain cells to release extra amounts of serotonin and repeated use damages serotonergic brain cells

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MDMA/Ecstacy
Physical effects: dilated pupils, elevated BP, jaw clenching, loss of appetite, and elevated body temperature Diminishes sexual performance, impairing erection in 40% of men and retarding orgasm in both men and women May cause severe liver damage, fatal heat exhaustion, and death when combined with high levels of physical activity (such as at a rave dance) Ectasy users at rave parties try to prevent the overheating (elevated body temperature or hyperther- mia) by drinking water to cool themselves which may help to a small degree, but the risk of fatal heat exhaustion is real
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MDMA/Ecstacy
Users more likely to abuse alcohol and other drugs, to neglect studying, to party excessively, and to engage in risky sex Ecstasy use at rave parties does intensify the impact of music because the end result is often overstimulation of the brain, which can result in rebound depression Feelings of anxiety or depression can persist for months after a person stops taking ecstacy Heavy users typically perform poorly in tests of learning and memory and show some signs of Exit underlying brain damage

RoHypnol
Related to Valium, cheap, and 10x more potent Lowers inhibitions and produces relaxation or intoxication. Larger doses can induce short-term amnesia and sleep Date rape drug because its odorless and tasteless Any drug that can be used to assist in the execution of drug facilitated sexual assault (DFSA) Street names: Roofies, forget pill, Mexican valium, mind eraser, rib, rope, whiteys, roofies Comes as a pill that dissolves in liquids. Some are small, round, and white. Newer pills are oval and green-gray in color. When slipped into a drink, a dye in these new pills makes clear liquids turn bright blue and dark drinks turn cloudy. But this color change might be hard to see in a dark drink, like cola or dark beer, or in a dark room. Also, the pills with no dye are still available. The pills may be ground up into a powder.

RoHypnol
Used to spike drinks, which are given to the unwary; victims are then sexually assaulted or raped while they are unconscious. Effects can be felt within 30 minutes of being drugged and can last for several hours. If you are drugged, you might look and act like someone who is drunk, trouble standing, slurred speech, or may pass out. Be aware that drinking too much alcohol is by far the most common prelude to rape

RoHypnol
Effects can be felt within 30 minutes of being drugged and can last for several hours. If you are drugged, you might look and act like someone who is drunk, trouble standing, slurred speech, or may pass out. Be aware that drinking too much alcohol is by far the most common prelude to rape

GHB
Gamma-hydroxybutyrate Forms: a liquid with no odor or color, white powder, and pill. It might give the drink a slightly salty taste. Mixing it with a sweet drink, such as fruit juice, can mask the salty taste Often manufactured in homes with recipes and ingredients purchased on the Internet Can be produced by combining degreasing solvent with drain cleaner Street names: goop, scoop, max, Georgia home boy, cherry meth, liquid ecstacy, soap, PM, energy drink CNS depressant that relaxes and sedates the body

GHB
Used at nightclubs and raves Users describe its effects similar to alcohol Takes effect in about 15 minutes and can last 3 or 4 hours. It is very potent: A very small amount can have a big effect. So it's easy to overdose on GHB. Most GHB is made by people in home or street "labs." So, you don't know what's in it or how it will affect you. Mild intoxication produces euphoria, a desire to socialize, and a mild loss of inhibitions Intoxicating effects lasts 3-4 hours, depending on the dosage

Ketamine
Street names: Black Hole, Bump, cat Valium, green, jet, K, K-Hole, Kit Kat, psychedelic heroin, purple, special K, super acid Comes as a liquid and a white powder. Very fast-acting. You might be aware of what is happening to you, but unable to move. It also causes memory problems. Later, you might not be able to remember what happened while you were drugged. Symptoms of use: distorted perceptions of sight and sound, lost sense of time and identity, out of body experiences, dream-like feeling, feeling out of control, impaired motor function, problems breathing, memory problems, numbness, loss of coordination, aggressive or violent behavior

GHB
At lower doses, may relieve anxiety and produce relaxation At higher doses, its sedative effects may result in nausea, a loss of muscle control, and either sleep or loss of consciousness 2 out of 3 frequent users have lost consciousness after taking GHB Heavy users who stop taking GHB have withdrawal symptoms such as anxiety, agitation, tremor, delirium, and hallucinations Overdose causes coma, breathing failure, and death. GHB inhibits the gag reflex, so some users choke to death on their own vomit

Caffeine
Stimulates the brain by blocking chemicals that normally inhibit or slow nerve activity Effects become apparent with doses as small as 50 milligrams, the amount found in cup of brewed coffee Present in soft drinks/colas, chocolate, coffee, tea, nonprescription drugs such as stay-awake pills and cold remedies Physically, it causes sweating, talkativeness, tinnitus (ringing in the ears), and hand tremors Psychologically, it suppresses fatigue or sleepiness, increases feelings of alertness

Caffeine
May be hazardous to pregnant women if used excessively; may cause birth defects. Those who consume as little as 2 cups a day increase the risk of having a miscarriage Caffeinism: Physiological dependence on caffeine; seen in people who drink 15-20 cups of coffee a day Symptoms of caffeinism: Insomnia, irritability, loss of appetite, chills, racing heart, elevated body temperature Caffeine encourages the growth of breast cysts in women, and may contribute to bladder cancer, heart problems, and high BP As few as 2.5 cups of coffee a day can be a problem Withdrawal symptoms include anxiety, depression, fatigue, headaches, and flu-like symptoms

Nicotine
Natural stimulant found mainly in tobacco The most widely used psychoactive drug next to caffeine and alcohol In large doses may cause stomach pain, vomiting, diarrhea, cold sweats, dizziness, confusion, muscle tremors In very large doses may cause convulsions, respiratory failure, and death Most first-time smokers get sick on 1 or 2 cigars Regular smokers build tolerance for nicotine Heavy users may inhale 40 cigars a day without feeling ill
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Nicotine
Addictive: average age of first use is 15, and it takes about a year before dependence sets in Smoking responsible for 97% of lung cancer deaths in men, 74% in women; increased risk for reproductive disorders (decreased fertility), stroke, respiratory diseases Withdrawal symptoms include headaches, sweating, cramps, insomnia, digestive upset, irritability, and a sharp craving for cigars. These may last from 2-6 weeks and may be worse than heroin withdrawal Sum: DONT SMOKE; SMOKING KILLS (SO DOES CHEWING TOBACCO) A 30-minute exposure to 1 pinch of smokeless tobacco is equivalent to smoking 3-4 cigars

Downers
Depressant drugs Most widely used include alcohol, barbiturates, GHB, and benzodiazepine tranquilizers Barbiturates and tranquilizers are sometimes referred to as solid alcohol

Barbiturates
Sedative drugs that depress brain activity Seconal and Amytal are two types Street names: downers, blue devils, yellow jackets, lows, goof balls, red, pink ladies, rainbows, or tooies Medically used to calm patients or to induce sleep Mild dosages have effects similar to alcohol intoxication Higher dosages cause severe mental confusion or hallucinations Often taken in excess amounts because a first dose may be followed by others, as the user becomes uninhibited or forgetful Overdose first causes loss of consciousness, then they depress brain centers that control heartbeat and breathing resulting to death.
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Sedatives
GHB (Gamma-Hydroxybutyrate): Central Nervous System (CNS) depressant that relaxes and sedates; combination of degreasing solvent and drain cleaner

Sedative effects may result in nausea, loss of muscle control, and either sleep or a loss of consciousness Inhibits gag reflex, so some choke to death on their own vomit Addictive and deadly

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Tranquilizers
Lower anxiety and reduce tension Valium, Xanax, Halcion, and Librium are four types RoHypnol: Related to Valium, cheap, and 10x more potent; lowers inhibitions and produces relaxation or intoxication. Larger doses can induce short-term amnesia and sleep Date rape drug because its odorless and tasteless (Roofies) Any drug that can be used to assist in the execution of drug facilitated sexual assault (DFSA) Street names: forget pill, Mexican valium, mind eraser, rib, rope, whiteys Used to spike drinks, which are given to the unwary; victims are then sexually assaulted or raped while they are unconscious. Be aware that drinking too much alcohol is by far the

Tranquilizers
Repeated use of barbiturates can cause physical dependence. Some abusers suffer severe emotional depression that may ends in suicide. Tranquilizers used too high at a dosage or for too long can lead to addiction. Combining barbiturates or tranquilizer with alcohol is risky. All too often depressants are gulped down with alcohol or added to a spiked punch bowl. This is the lethal brew that left a young woman named Karen Ann Quinlan in a coma that lasted 10 years, ending with her death from pulmonary failure.

Alcohol
Common name for Ethyl Alcohol, the intoxicating element in fermented and distilled liquors NOT a stimulant but DOES lower inhibitions, but a depressant The worlds most favorite depressant NOT an aphrodisiac, since it impairs sexual performance in males (William Shakespeare Drink provokes the desire, but it takes away the performance Binge Drinking: consuming five or more drinks in a short time, or four or more for women Serious sign of alcohol abuse May lead up to 10 percent loss of brain power, especially memory capacity can have a long-term impact on a persons chances for success in life In short, getting drunk is a slow but sure way to get stupid

Alcohol
Signs of Alcohol Abuse: May use the following questionnaire adapted from College Alcohol Problems Scale. If the person can answer yes to even one of the following questions, then he/she may have a problem with drinking. As a result of drinking alcoholic beverages I 1. engaged in unplanned sexual activity. 2. drove under the influence. 3. did not use protection when engaging sex. 4. engaged in illegal activities associated with drug use. 5. felt sad, blue, or depressed. 6. was nervous or irritable. 7. felt bad about myself. 8. had problems with appetite or sleeping.

Alcohol
When people are tempted to drink too much, their main reason for stopping is that other people were quitting and deciding theyd had enough. What sets alcohol abusers apart is that they also drink to cope with negative emotions, such as anxiety and depression. Alcohol abuse increases with the level of stress in peoples lives. People who drink to relieve bad feelings are at great risk of becoming alcoholics. Treatment: begins with sobering up the person and cutting off the supply, referred to as detoxification (literally, to remove poison). Next step is to try to restore the persons health Strong tendency for abusive drinkers to deny they have a problem. The sooner they seek help, the better.

Fig. The behavioral effects of alcohol are related to blood alcohol content and the resulting suppression of higher mental function. Arrows indicate the typical threshold for legal intoxication in the United States. (From Jozef Cohen, Eyewitness Series in Psychology, p. 44. Copyright by Rand McNally and Company. Reprinted by permission.)

How a Drinking Problem May Develop (Jellinek, 1960)


Initial Phase: Social drinker turns to alcohol to relieve tension or feel good Crucial Phase: Person begins to lose control over drinking Chronic Phase: Person is now alcohol dependent
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Treatment for Alcohol Abuse and Dependence


Detoxification: Withdrawal of the person from alcohol; occurs in a medical setting and is tightly controlled; oftentimes necessary before long-term treatment begins

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Alcoholics Anonymous (AA) and Alternatives


Alcoholics Anonymous (AA): Worldwide selfhelp organization composed of recovering alcoholics; emphasizes admitting powerlessness over alcohol usage and wanting to recover

Spiritual component Free; around for over 70 years!

Rational Recovery, and Secular Organizations for Sobriety (SOS): Nonspiritual AA Alternatives
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Some Hallucinogens
Hallucinogen: Substance that alters or distorts sensory perceptions Lysergic Acid Diethylamide (LSD): Hallucinogen that can produce hallucinations and other psychotic symptoms Mescaline (Peyote) and Psilocybin (Magic Mushrooms) PCP (Angel Dust): Initially can have hallucinogenic effects; also an anesthetic and has stimulant and depressant effects

Marijuana
Cannabis Sativa (Marijuana; Pot): Leaves and flowers of the hemp plant Active Chemical: THC Street names: MJ, pot, grass, Ganja Effects: Relaxation, time distortion, perceptual distortions Higher doses can cause paranoia, hallucinations, & delusions Psychologically, NOT physiologically, addictive Hashish: Resinous material scraped from leaves of the hemp plant; higher concentration of THC

THC (delta-9-tetrahydrocannabinol): is the major active ingredient in marijuana (hemp plant) that triggers a variety of effects, including mild hallucinations.

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Hemp Plant

Marijuana
THC accumulates in the bodys fatty tissues, especially in the brain and reproductive organs. Even if a person smokes marijuana just once a week, the body is never entirely free of THC. Scientists have located a specific receptor site on the surface of brain cells where THC binds to produce its effects. These receptor sites are found in large numbers in the cerebral cortex, which is the seat of human consciousness. In addition, THC receptors are found in areas involved in the control of skilled movement. Naturally occurring chemicals similar to THC may help the brain cope with pain and stress. However, when THC is used as a drug, high dosages can cause paranoia, hallucinations, and dizziness.

Fig. This thin slice of a rats brain has been washed with a radioactive THClike drug. Yellowish areas show where the brain is rich in THC receptors. In addition to the cortex, or outer layer of the brain, THC receptors are found in abundance in areas involved in the control of coordinated movement. Naturally occurring chemicals similar to THC may help the brain cope with pain and stress. However, when THC is used as a drug, high dosages can cause paranoia, hallucinations, and dizziness (Julien, 1998).

Marijuana
Potential for abuse lies primarily in the realm of psychological dependence, not physical addiction. For about a day after a person smokes marijuana, his or her attention, coordination, and short-term memory are impaired. Frequent marijuana users show small declines in learning, memory, attention, and thinking abilities. When surveyed at age 29, nonusers are healthier, earn more, and are more satisfied with their lives than people who smoke marijuana regularly. People who smoke five or more joints a week score 4 points lower on IQ tests.

Long-Term Health Risks of Using Marijuana


Marijuana smoke contains 50 percent more cancer-causing hydrocarbons and 16 times more tar than tobacco smoke does. May cause precancerous changes in lung cells Marijuana temporarily lowers sperm production in males, and users produce more abnormal sperm. This could be a problem for a man who is marginally fertile and wants to have a family In experiments with female monkeys, THC causes abnormal menstrual cycles and disrupts ovulation. Other animal studies show that THC causes a higher rate of miscarriages and that it can reach the developing fetus. As is true for so many other drugs, it appears that marijuana should be avoided during pregnancy. THC can suppress the bodys immune system, increasing the risk of disease.

Long-Term Health Risks of Using Marijuana


In animals, marijuana causes genetic damage within cells of the body. It is not known to what extent this happens in humans, but it does suggest that marijuana can be detrimental to health. Activity levels in the cerebellum are lower than normal in marijuana abusers. This may explain why chronic marijuana users tend to show some loss of coordination There is some evidence that THC damages parts of the brain important for memory. Children whose mothers smoked marijuana during pregnancy show lowered ability to succeed in challenging, goal-oriented activities.

Long-Term Health Risks of Using Marijuana


Marijuana smoke contains 50 percent more cancercausing hydrocarbons and 16 times more tar than tobacco smoke does. May cause precancerous changes in lung cells May suppress immune system, perhaps increasing risk of disease THC may cause a higher rate of miscarriages Activity levels in the cerebellum are lower than normal in pot users Pot may damage some of the brains memory centers

Dream Interpretation
Freud: Four dream processes (mental filters) that hide true purposes of dreams
Condensation: Combining several people, objects, or events into a single dream image Displacement: Directing emotions or actions toward safe or unimportant dream images Symbolization: Expressing feelings or ideas symbolically in dreams; not literal expression Secondary Elaboration: Making a dream more logical and adding details while remembering it
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Dream Interpretation: A Different View


Perls: Most dreams are a special message about what is missing in our lives, what we avoid doing when awake, or feelings that we need to re-own

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Lucid Dreaming
Person feels fully awake within the dream and feels capable of normal thought and action

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