JUST SAY KNOW: FACTS ABOUT PSYCHOACTIVE DRUGS

Rick Csiernik, King’s University College at Western University

rcsierni@uwo.ca,

Definitions PSYCHOACTIVE DRUG – alter the CNS while also affecting the ANS

DEPENDENCY- physical and psychological

ADDICTION – physical dependency + psychological dependency + social context of drug use

Psychoactive Drug Substances that alter brain functioning by decreasing, increasing or disrupting central nervous system activity.

This in turn produces changes in mood, perception, sensation, need, consciousness, and other psychological functions and ultimately produces changes in behaviour.

These substances influence a great number of physiological functions mediated by the autonomic nervous system that are outside the realm of conscious control such as respiration, cardiovascular function and hormonal balance.

Psychoactive Drugs & Addiction

.

.

Biological

Social Psychological

ADDICTION

BiosocialBiopsycho

Psychosocial

What Psychoactive Drugs Do

Categories Depressants – Benzodiazepines, Barbiturates, Alcohol, Solvents, Antihistamines

- Opioids (Codeine, Morphine, Oxycontin, Heroin, Methadone)

Stimulants - Cocaine, Amphetamines, Ritalin, Decongestants, Nicotine, Caffeine

Hallucinogens – LSD, Ecstasy, Ketamine, Cannabis

Psychotherapeutic Agents – Anti-Depressants, Anti-Psychotics, Mood Stabilizers

What is NOT an addiction

Eating Disorders

Compulsive Behaviours: Shopping, Internet Use, Sex

Problem Gambling

Why are these not an addiction?

No Psychoactive Change to Brain

Different Treatment Approach

Different Treatment System

Different Policies

STOP │ │ CONTACT ─────┼────────────┐INTEGRATED (casual/occasional)─────┬──────────┐WITH DRUG │ │ USE │ │ │ │ │ │ │ │ ┌─STOP │ │ │ │ │ │ │ EXPERIMENTATION └──────EXCESSIVE───┼─RETURN─────────┘ │ (curiosity/peer USE │ │ pressure) ├─STABLE │ │ STATE │ │ ┌─STOP │ │ │ │ └──────ADDICTION│ │ ├─STABLE │ │ STATE │ │ │ ├─PROGRESS │ │ │ └─RETURN────┘  

Treatment Philosophy

Client Responsibility

For Solution

high low

Client

Responsibility high MORAL ENLIGHTENMENT

For Problem

low COMPENSATORY MEDICAL

PREVENTION & HEALTH PROMOTION

EARLY IDENTIFICATION

self family friends school family physician/medical system

workplace/Employee Assistance Program social agencies legal system clergy

Community Resources

●Self Help Groups

●Medical Treatment

●Leisure Activities

●Legal Services

●Employment Assistance

●Financial & Debt●Counselling

●Marital & FamilyCounselling

WithdrawalManagementAnd Daytox

Assessment &Referral

CaseManagement

ADDICTION RESOURCES

Outpatient CounsellingHarm Reduction Initiatives

Concurrent Disorder ProgrammingShort Term Residential Programs

Recovery HomesAlternative Living Environment/Housing Supports

RELAPSE PREVENTION

Drug Testing

◦ Appropriate selection bias

◦ People with positive results Likely to have issues

◦ People are selected for drug testing based on existing parenting concerns

◦ Continued use recreational use

◦ Substantial negative consequences

Effective use of Drug Tests Drug testing provides an objective basis to demonstrate that drug

use or drug involvement has occurred

The meaning of the drug test in any one case is dependent on contextual factors

◦ What behaviours does this person exhibit while using?◦ How has use affected this person in the past?

What Can Drug Testing Tell Me ?

Through hair & urine analysis:◦ That the subject used a drug during a particular period of time◦ That the subject is frequently associating with drugs or heavy users (hair analysis)

◦ Determination of passive exposure ◦ Child exposures use in the context of parenting◦ Improving; unchanged; ongoing use◦ What are the implications with prescription drugs (methadone, medical marijuana,

sedative-hypnotics)

What Drug Testing Cannot Tell You

The exact pattern of drug use

How intoxicated the subject gets when using

How the drug use impacts the subjects parenting abilities

The method of drug administration◦ I.V. / oral / smoked / insufflated

Whether someone is abusing a drug that they are prescribed◦ (opioids including methadone, medical marijuana, sedative hypnotics like Ativan, anti-depressants like Prozax)

Drug testing does NOT indicate addiction nor dependency

References

Csiernik, R. (2014). Just Say Know: A Counselor’s Guide to Psychoactive Drugs. Toronto: Canadian Scholars Press.

Csiernik, R. (2011). Substance Use and Abuse: Everything Matters. Toronto: Canadian Scholars Press.