Prepared by J. Mabbutt & C. MaynardNaMO

September 2008

3: The Drugs

1. During the session drug, types, classifications, street names & use statistics will be overviewed

2. Participants will be involved in an activity to explore why people use different types of drugs

3. At the end of the session, nurses & midwives will have a greater understanding of the types of drugs & their use enabling an increase in knowledge & confidence in practice

3: The DrugsObjectives

A drug is:

“… any chemical substance which, when taken into the body alters its function physically and psychologically”

“… any substance people consider to be a drug with the understanding that this will change from culture to culture and from time to time”

– WHO (1989); Krivanek (1982)

3: The DrugsDrugs defined

From Commonwealth Government /NCETA 2004 – GP Trainers Illicit Drug Issues CD Rom

Psychoactive drugs are generally defined as substances which alter:

– mood

– cognition (thoughts)

– behaviour

3: The DrugsPsychoactive Drugs (1)

From Commonwealth Government /NCETA 2004 – GP Trainers Illicit Drug Issues CD Rom

Affect mental processes and behaviour

Affect thought processes and actions

Alter perceptions of reality

Change level of alertness, response time and perception of the world

Achieve effects by interacting with the Central Nervous System (CNS)Carmichael (2001)

3: The DrugsPsychoactive Drugs (2)

From Commonwealth Government /NCETA 2004 – GP Trainers Illicit Drug Issues CD Rom

Is a common activity

Is part of a range of human behaviours

Can be classified in many ways, including legal status, drug effects

Alters mood or consciousness, although there are other ways to achieve this: e.g. skydiving, meditation, extreme (and non-extreme) sport, sex. Children, for example, love to alter their consciousness by ‘spinning around’

3: The DrugsPsychoactive Drug Use

From Commonwealth Government /NCETA 2004 – GP Trainers Illicit Drug Issues CD Rom

Psychoactive drugs may be classified according to their:

1. status• legal• chemical• medical• social

2. action and properties• depressant• stimulant • hallucinogenic etc

From Commonwealth Government /NCETA 2004 – GP Trainers Illicit Drug Issues CD Rom

3: The DrugsDrug Classifications

Depressants Stimulants Hallucinogens

Alcohol Amphetamine (methamphetamines / ‘ice’)

LSD, magic mushrooms

Benzodiazepines Barbiturates

Nicotine Ecstasy (MDMA)#

Opioids (heroin, morphine, methadone)

Cocaine PCP, Ketamine

Solvents (glue / amyl or butyl ni trite)

Caffeine Cannabis* (in high doses)

GHB Ecstasy (MDMA)# Other (e.g. nutmeg/mace, N 2O,

Cannabis*

*Cannabis has unique properties – CNS depressant but hallucinogenic effects at high doses.#Ecstasy (MDMA) can also be hallucinogen and stimulant

From Commonwealth Government /NCETA 2004 – GP Trainers Illicit Drug Issues CD Rom

3: Classifying Psychoactive Drugs

Cannabis

Cocaine

Ecstasy

Powder – Amphetamine/Methamphetamine

Base – Amphetamine/Methamphetamine

‘Ice/Crystal’ Methamphetamine

Pills – Methamphetamine

‘Substance dependence’ is a condition characterised by a combination of physical changes, psychological states and behaviours that gives drug use greater priority over other activities.

Carmichael (2001, p. 30)

3: The DrugsDependence

From Commonwealth Government /NCETA 2004 – GP Trainers Illicit Drug Issues CD Rom

The two best known and used criteria come from the:

– Diagnostic & Statistical Manual of the American Psychiatric Association DSM-IV TR (2000) and the

– World Health Organisation (WHO) International Classification of Diseases 10th Edition (ICD-10 1993)

Both have a list criteria relating to dependence

If three or more of the criteria have occurred a 12 month period the person meets the criteria for dependence

3: The DrugsDependence diagnosing criteria

From Commonwealth Government /NCETA 2004 – GP Trainers Illicit Drug Issues CD Rom

Body Drug Body Increase Sudden Body in has adjusts dose cessation in balance effect needed of drug balance

for effect causes withdrawal

3: Tolerance and withdrawal

CEIDA Core Traning Manual

Tolerance

Occurs when more of the drug is needed to produce the initial effect

Dependence

The need to keep taking a drug to feel physically and or mentally OK – Dependence requires a high level of tolerance

Withdrawal

The effects on the body and mind of a person who suddenly stops taking a drug, after becoming dependent on it

3: The DrugsTolerance, Dependence & Withdrawal

• Break into two groups

• Both groups list:

• All the ways drugs can get into the body

• Why this method may be used for a certain drug

• Each group has 5 minutes before they report back to the whole group and this is written up on the board

3: The DrugsHow people use drugs – Activity

Approved name of drug Street name Price in NSW, 2004-5 *

Alcohol Grog, piss, booze, sauce

Amphetamines Speed, goey, whiz, uppers, oxblood, point, crystal, crystal meth, ice, shabu

1 weight gram $90–$500

Benzodiazepines benzos, rowies, moggies, downers, sleepers, tummies, series, pills

Cannabis marijuana, grass, pot, shit, ganja, mull, hash, durry, green, dope, cone

Leaf- Ounce (28 g) $150Head- Ounce (28 g) $200 Hydroponic- (28 g) $250 Hash/resin- Deal (1g ) $50

Cocaine Snow, coke 1 gram $150–$300

Ecstasy E, eccies, XTC, fantasy, GBH, liquid ecstasy, good speed

1 tablet/capsule $30–$70

Heroin/opioids Hammer, H, shit, smack, horse, harry, white, skag, junk

1 taste/cap (0.1–0.3 g) $50 Full gram $200–$500

* Adapted from the Illicit Drug Data Report. 2004–05 Australian Crime Commission

3: Appendix 6: Street names of drugs

* Adapted from the Illicit Drug Data Report. 2004–05 Australian Crime Commission

Approved name of drug Street name Price in NSW, 2004-5 *

Ketamine Special K Varied across States: ACT – $65 S.A. – $200

Lysergic acid diethylamide (LSD)

Acid, blotter, trips, wangers, tabs, dots $10 to $25 per tab

Methylene Dioxyamphetamine (MDA)

Adam 1 tablet/capsule $30-$70

Methylene Dioxymethamphetamine (MDMA)

Ecstasy, Utopia, E, XTC 1 tablet/capsule $30-$70

Phencyclidine (PCP) Angel dust

PMA Dr Death

Psilocybin Magic mushrooms, gold tops

Solvents glue, tol, toluene, bute, nitrus, amyls, petrol, super, aerosol paint-chroming

3: Appendix 6: Street names of drugs

* Adapted from the Illicit Drug Data Report. 2004–05 Australian Crime Commission

0

2

4

6

8

10

12

Tobacco Alcohol Illicits

TobaccoDeaths

AlcoholDeaths

Illicit DrugDeaths

3: Percentage of all deaths attributable to Tobacco, Alcohol and Illicit drugs, in Australia 2003

0

10

20

30

40

50

60

70

80

Tobacco Alcohol Illicits

TobaccoDeaths

AlcoholDeaths

Illicit DrugDeaths

3: Percentage of Drug related deaths attributable to Tobacco, Alcohol & Illicit drugs, Australia 2003

0

5

10

15

20

25

30

35

40

45

Tobacco

Lung cancer

COPD

IHD

Stroke

Oesphagcancer

Other

3: Percentage of Tobacco related deaths in Australia 2003 by condition

0

5

10

15

20

25

30

Alcohol

Abuse

Suicide / Selfinflict

Road accid

Oesophagcancer

Breast cancer

Other

3: Percentage of Alcohol related deaths in Australia 2003 by condition

0

5

10

15

20

25

30

35

40

45

50

Illicit

Heroin polyDrug

Hep C

Suicide selfinflict

Hep B

Other

3: Percentage of Illicit drug related deaths in Australia 2003 by condition