Marijuana

Drugs

8th Annual FTA Drug & Alcohol Program National Conference Phoenix, AZApril, 20131AboutCourseEffects and Consequences of Prohibited Drug UseDoes not include alcoholDoes not include OTC/Rx drugsMeets requirements of section 655.14(b)(1)SpeakersMike Redington, US DOT Volpe Center, Senior Auditor, FTA Drug & Alcohol Project OfficeLaurena Stoddard, Cahill Swift, LLC, Senior Auditor249 CFR Part 655.14(b)(1) -required 60-minute trainingEffects & consequences of prohibited drug useon personal health, safety and the work environment, and on the signs and symptoms that may indicate prohibited drug use.3Drug Use Work Environment75% of adult illicit drug users are employed*Transportation: 4th most likely profession/trade for illicit users.Users are more likely to:Change jobs frequentlyBe late or absent from work regularlyBe less productive employeesBe involved in a workplace accidentFile a workers compensation claimSteal from fellow employeesUse health benefitsUse sick time

*National Institute on Drug Abuse (www.drugabuse.gov)4Drug Use Work EnvironmentIllegal Drug Abusers10x more likely to miss work3x more likely to be late2.5x more likely to have absences >= 8 days3.6x more likely to have on-the-job accident5x more likely to injure self on-the-job5x more likely to file workers comp claim2.2x more likely to ask for early dismissal

*National Institute on Drug Abuse (www.drugabuse.gov)5Drug Use Employment HistoryIllegal Drug Users - Employment History2x more likely to have multiple employees in a year3.3x more likely to have been fired2x more likely to have left voluntarily

*National Institute on Drug Abuse (www.drugabuse.gov)6Drug Use Cost to SocietyAnnual cost to society (U.S.) = $193,000,000,000 ($193 Billion)Lost Productivity = $120.3 BillionLost Productivity due to IncapacitationLack of MotivationIncarcerationTreatment FacilityHospitalPrisonMedical claims average 300% - 400% of non-abusers

10% 20% of deaths at workplace, test positive for drugs or alcohol

7Dependence & HarmSource: The Lancet

8Marijuana

9Most commonly abused drugEstimated 15.2 million past-month users*US ranks first for prevalence of useTHC is the main active ingredient

Usually found as:Dried plantBlocks of resin (hash)Oils or tinctures

*2008 National Survey on Drug Use and Health (NSDUH)10UseSmokedJoint, Pipe or Bong/water-pipeVaporizedIngestedOils or food

11EffectsWhen smoked: effect almost immediateLasts 1-3 hoursWhen consumed: effects 30-60 min. laterCan last up to 4 hoursBinds to cannabinoid receptors in brainReceptors are high-density in areas that influence pleasure, memory, thinking, concentration, movement, coordination and sensory and time perceptions

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EffectsSource: The Wall Street Journal13Signs and SymptomsBalance problems-coordinationAlertness, perception, reflexes Red or bloodshot eyesMemory difficultiesHungerSleepy

14Effects on MemoryLong-term users memory recall still impaired one week after last useup to 4 weeks to return to base-line recallEffects can build up and deteriorate critical life skills over timeMay be worse in those with mental disorders or because of the normal aging process

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16Physical HealthHeart rate speeds upSmoke consists of toxic mixture, effecting lungs and throat

17Quiz time!!!!Marijuana is made up of parts of a plant called __________.Cannabis sativaFernIvyThe chemical in marijuana that causes the user to feel high is _______.DopamineNorepinephrineDelta-9-tetrahydrocannabinol (THC)

18Marijuana users experience short-term memory loss because of the drugs effect on __________.The heartThe hippocampusThe basal gangliaDrivers on marijuana have an increased risk of getting into an accident because of _______.Slowed reaction timeImpaired judgmentBoth A & B

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Cocaine202nd most commonly abused drug*1.9 million past-month users*Originally derived from coca bush leaves

Usually found as:Hydrochloride salt or powderCrack or Freebase

*National Institute on Drug Abuse (www.drugabuse.gov)21

UseSnortedInjectedSmokedGlass pipes, light bulbs, water bottles, soda cans, etc.

22EffectsWhen injected: effect immediateLasts 10-20 minutes or more to startWhen smoked (crack): effect almost immediateLasts 5-10 minutes or more to startWhen snorted: effect within a couple minutesLasts 15-30 minutesBlocks removal of dopamine

23ToleranceBlue: High Black: Depression24

Source: Mikael Hggstrm, Wikimedia Commons25Signs & SymptomsNosebleedsDilated pupilsRestlessnessTalkativenessAnxietyNot hungry or sleepyIncreased temperature, heart rate & blood pressure

26Physical HealthStrokes, brain seizures & hemorrhageHeart attacks & hemorrhageConvulsionsGangrene (injection into artery instead of vein)Liver Damage - HepatitisDEATH

27Quiz time (again)!!!!Cocaine:Comes from coca leavesIs made syntheticallyComes from coca leaves or is made syntheticallyOnce the drug starts leaving the brain, the user experiences a_______ that includes depression, irritability and fatigue.A dipSleepy hazeA crashA let down

28The euphoric effects of cocaine last about:5-20 minutes an hour45 minutes to an hourTrue or False: If used a couple times, a person knows how much and what effects the drug will have on them.

29Amphetamines

30Meth is 4th most commonly abused substance of a million past month usersHallucinogens ecstasy included is 3rd most commonly abused substance1 million past month users

Sources: NIDA & SAHMSA31Amphetamines-general1930s - First used for nasal congestion1937 prescription tabletStill used in prescriptions todayMUST HAVE CURRENT PRESCRIPTION

Used during WWII to keep soldiers going and pilots for long missionsAs use spread, so did abuse32Physical EffectsHyperactivityDilated pupilsFlushingTachycardia / BradycardiaDiarrhea / ConstipationDizzinessTremorsSeizure, stroke, coma, heart attack & Death

33Psychological EffectsEuphoriaConcentrationEnergyAnxietyIrritabilityAggressionRepetitive and obsessive behaviorsParanoia34WithdrawalMay last for days, weeks or monthsMental FatigueMental DepressionIncreased appetiteAnxietyAgitationExcessive sleep/vivid dreamsSuicidal ideationTolerance developed rapidly

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MDA (3,4-methyldioxyamphetamine)Usually pill form, but can be powderEffects last for 5-6 hours, but up to 10Serotonin & dopamine releaseEuphoric & empathogenic effectsMore psychedelic than EcstasyMore toxic than EcstasyAgitation, sweating, increased blood pressure, heart rate & body temp, convulsions & death

36MDEA (3,4-methylenedioxy-N-ethylamphetamine, a.k.a. Eve)Usually pill form not common anymoreEffects last for 3-5 hoursSerotonin, norepinephrine & dopamine releaseEuphoric & loved up effectsNot as pronounced as EcstasySomewhat of a stoning effect

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MDMA (Ecstasy)Usually pill formPrimary precursor Safrole500 ml of Safrole = 1300-2800 120mg tabletsEffects last for 2-3 hours, comedown 2 hoursSerotonin, norepinephrine & dopamine releaseEuphoric & empathogenic effectsCaused by indirect secretion of oxytocin38

Common Reported EffectsStrong sense of inner peace & self acceptanceDiminished aggression, hostility & jealousyExtreme mood lift with accompanying euphoria

Feelings of empathy, compassion & forgiveness towards othersIntensification of bodily sensesStimulation, arousal & hyperactivity 39Physical Side EffectsDifficulty concentratingJaw clenching/chewing/grinding obsessionGrinding of teeth during sleepLack of appetiteDry mouth/thirst

40Psychological After EffectsReported to last up to 3-7 days afterAnxiety and paranoiaDepressionIrritabilityFatigueImpaired attention, focus & concentrationLow drive and motivationResidual feeling of empathy and sense of closeness

41Physiological After EffectsReported to last up to 3-7 days afterDizziness, lightheadedness or vertigoLoss of appetiteDiarrhea or constipationInsomniaExhaustionJaw sorenessMemory: significant short & long term verbal memory impairment (70-80% of users)

42Purity is unknown to usersCan contain other active ingredientsSometimes not even MDMA

43MethamphetaminesSpeed or crystal swallowed or snortedCrank injectedIce/Glass smoked (most common)Serotonin, norepinephrine & dopamine releaseFDA approved for treatment of ADHD & exogenous obesity

44Very high potential for abuse & addictionSame physical & psychological effect as amphetaminesWithdrawal symptoms last up to 10 daysDepression, fatigue, excessive sleeping & increased appetiteMental depression from withdrawal longer and more severe than cocaineTolerance varies widely between individualsMethamphetamines

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AcetoneAnhydrous ammoniaBattery acid (sulfuric acid)Brake cleaner (toluene)Cold tablets containing pseudoephedrineDrain cleaner (sodium hydroxide)FreonIodine crystalsPaint thinnerReactive metals (sodium or lithium)Red phosphorusStarting fluid (ether)Meth Labs46Long term effects:Psychiatric disordersCognitive impairmentSerious heart diseaseAmphetamine psychosisAnxiety & violent behaviors

47Health issues:Meth MouthHygieneIncreased risk of STDs Increased risk of blood-born diseases

48Quiz time!!!!Psychological after effects of ecstasy can last _____.1-2 days3-7 daysSeveral weeksA month or moreMeth is found as 3 main types. Which is not one of them?Ice/GlassCrankRocket FuelCrystal/Speed

49True or False: Ritalin is an amphetamine sometimes prescribed for the treatment of attention deficit hyperactivity disorder in children.

True or False: Amphetamines are stimulants.

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Opiates51OpiumImmature flower podIncisedMilky juice collectedJuice is distilledMedicinal products:MorphineCodeinePapaverineNon-Medicinal:Heroin

52MorphineDiscovered in 1804Distributed in 1817Commercially sold in 1827High potential for addiction, tolerance and psychological dependenceRelieves severe/agonizing pain/sufferingActs directly on central nervous system15 min-1 hr to feel effectsEffects last 4-5 hours

53Side EffectsEuphoriaConstipationTolerance & AddictionLong drawn out withdrawalEasy to overdose causing asphyxia & deathSleepiness/wakeful alternate statesLow blood pressureMasks possible illness

54Effects on Human PerformanceImpaired visual memoryDifficulty following instructionsPropensity toward impulsive behaviorDiminished reflexesDepressed consciousness

55Codeine2nd most predominant alkaloid in opiumIsolated in 1832Most widely used opiate in the worldPhysical & Psychological addictionSide effects include:Itching, nausea, drowsiness, & constipation

whatiscodeine.com56HeroinSynthesized from morphineMarketed by Bayer in 18981.5-2 x more potent than morphine

No acceptable medical use in US currentlyOften cut with meth or cocaineSimilar effects/side effects as morphine

wikimedia commons57Quiz time!!!!True or False. Opiates like heroin are stimulants.

A side effects of opiate use is:Better reflexesHigh blood sugar levelsEnergyConstipation

58Dependence on heroin can be ______.PsychologicalPhysicalBoth A & BTrue or False: A significant risk from opioid use is overdose.

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PCP60Developed in 1926Used as an anestheticHallucinations & neurotoxic effectsRecreational use in 60sPowder & Liquid formMost often smokedLow doses:Numbness, intoxication effectsModerate doses:Analgesia and anesthesia effectsHigh doses: convulsions

61Psychological effectsSevere changes in body imageParanoiaDepersonalizationHallucinationsSuicidal impulsesAggressive behaviorVariable mood alterationSymptoms like schizophrenia62Quiz time!!!!True or False. At high doses, PCPs effect may resemble the symptoms associated with schizophrenia.

What does PCP look like?TabletCapsuleLiquidPowderAll of the above

63True or False: PCP use often causes a user to feel detached, distant and estranged from his surroundings. Numbness, slurred speech and loss of coordination can be accompanied by a sense of strength and invulnerability.

True or False: PCP is illegal to buy, sell or posses in the USA.

64Other DrugsKetamine, LSD, Shrooms, PeyoteHallucinogenic, effect senses & coordinationGHBDrowsiness, nausea, visual impairmentKhatHypertension, insomnia, gastric disorders

65Opiate Testing To Be ExpandedDHHS / SAMSHAApproved Recommendations of Drug Testing Advisory Board (DTAB)Include Oxycodone, Oxymorphone, Hydrocodone, HydromorphoneSchedule II Prescription DrugsInclude in Mandatory Guidelines for Federal Workplace Drug Testing ProgramsFederally-Regulated Drug Testing Programs - DOT66Semi-SyntheticSimilar to Morphine (Stronger)Taken Orally for PrescriptionHigh potential for addiction, tolerance and psychological dependenceRelieves severe/agonizing pain and coughActs directly on central nervous systemTime ReleasedBroken, chewed or injected for quick effectEffects lasts up to 12 hoursOxycodone / Hydrocodone / Hydromorphone

67Side EffectsNausea, VomitingDizziness, HeadacheHypoventilationDry MouthDrowsiness, Changes in Sleep CycleLower Heart Rate and Blood PressureLoss of AppetiteSweating, Itching68Effects on Human PerformanceImpaired memoryImpaired reactionsLoss of StrengthDepressed consciousness

69Oxycodone / Hydrocodone / HydromorphoneHydrocodone Most Frequently Prescribed Opiate in U.S. (111 Million Prescriptions in 2003)Oxycodone Production - 3.5 Tons (1993) to 41 Tons (2003)70ResourcesNational Institute on Drug Abuse (NIDA):http://www.drugabuse.gov/Substance Abuse & Mental Health Services Administration:http://www.samhsa.gov/Coalition Against Drug Abuse:http://www.drugabuse.com/Office of National Drug Control Policy:http://www.whitehouse.gov/ondcp DOT Office of Drug & Alcohol Policy & Compliancehttp://www.dot.gov/odapc Partnership for a Drug Free Americahttp://www.drugfree.org

71Thank you

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