RHAB 3975 1st Edition Exam 1 Study Guide Central Nervous System CNS Depressants ALCOHOL Central nervous system depressant that is rapidly absorbed from the stomach and small intestine into the bloodstream Stimulant and depressant effects Hard to limit intake even in non addicts Impacts neurotransmitters Dopamine Serotonin GABA benzos Glutamate endorphin opiate receptors Decreases ability to inhibit impulses judgment sex driving internal filter can decrease access to PFC functions Attention alertness impacted even at low dosages Increases aggression sexual desire emotionality Ethyl alcohol or ethanol is an intoxicating ingredient found in beer wine and liquor Alcohol is produced by the fermentation of yeast sugars and starches A standard drink equals 0 6 ounces of pure ethanol or 12 ounces of beer 8 ounces of malt liquor 5 ounces of wine or 1 5 ounces a shot of 80 proof distilled spirits 12 fluid ounces of beer about 5 alcohol 8 to 9 fluid ounces of malt liquor about 7 alcohol 5 fluid ounces of table wine about 12 alcohol Plan to drive a vehicle or operate machinery 1 5 fluid ounces of hard liquor about 40 alcohol risks Injuries Drinking too much increases your chances of being injured or even killed Health problems Heavy drinkers have a greater risk of liver disease heart disease sleep disorders depression stroke bleeding from the stomach sexually transmitted infections from unsafe sex and several types of cancer Birth defects Drinking during pregnancy can cause brain damage and other serious problems in the baby Alcohol use disorders known as alcoholism and alcohol abuse POTENTIAL PHYSICAL EFFECTS Brain Alcohol interferes with the brain s communication pathways and can affect the way the brain looks and works can change mood and behavior and make it harder to think clearly and move with coordination Heart Drinking a lot over a long time or too much on a single occasion can damage the heart causing problems Cardiomyopathy Stretching and drooping of heart muscle Arrhythmias Irregular heart beat Stroke High blood pressure Liver Heavy drinking takes a toll on the liver and can lead to a variety of problems and liver inflammations including Steatosis or fatty liver Alcoholic hepatitis Fibrosis Cirrhosis POTENTIAL PHYSICAL EFFECTS Pancreas Alcohol causes the pancreas to produce toxic substances that can eventually lead to pancreatitis a dangerous inflammation and swelling of the blood vessels in the pancreas that prevents proper digestion Cancer Drinking too much alcohol can increase your risk of developing certain cancers including cancers of the Mouth Esophagus Throat Liver Breast Impacts many neurotransmitters GABA Judgment inhibition Dopamine reward seeking Endorphins sense of bliss well being Serotonin serenity Glutamate esp NMDA learning Blackouts long term memories of drinking episode lost although drinker is conscious mobile Binge drinking Alcohol Poisoning overdose Delirium Tremens More common than alcoholism esp in young adults Impacts brain development Smaller hippocampus lower brain activity Women get a higher Blood level faster due to Fat content Body size Hormones Stomach enzymes Fetal alcohol Syndrome Effects Brain Damage Central nervous system dysfunctions Lowered IQ Poor motor skills hand eye coordination Behavioral learning problems Heroin Cheese Black Tar Prep for IV OPIOIDS SYNTHETIC OPIATES Vicodin to heroin Vital to medicine Current epidemic is PAINPILL abuse OPIATES Oxycontin Morphine Vicodin Hydrocodone OPIOIDS SYNTHETIC OPIATES Opioids include Fentanyl Hydrocodone Oxycodone Oxymorphone Propoxyphene Hydromorphone Meperidine Diphenoxylate HEROIN 1874 White powder or black brown tar Snorted injected or smoked High 4 6 hrs Symptoms Appetite digestion slowed digestion Histamine release runny nose itching Small pupils slow response to light WITHDRAWAL Stage 1 6 8 hrs after last fix Yawning sweating runny nose eyes anxiety then insomnia aches irritability Stage 2 18 24 hrs Fever vital signs increase nausea vomiting cramps STAGE 3 24 36 hrs Explosive diarrhea dehydration DEPENDENCE VS ADDICTION Physical dependence is a normal adaptation to chronic exposure to a drug and is not the same as addiction Someone who is physically dependent on a medication will experience withdrawal symptoms when use of the drug is abruptly reduced or stopped Dependence is often accompanied by tolerance or the need to take higher doses of a medication to get the same effect Severity of Withdrawal Symptoms predicted by 1 Dosage 2 Frequency of Use 3 User expectations 4 Set Setting Pharmaceutical Therapeutics METHODONE Blocks other opiates agonist addictive synthetic opiate Naltrexone is an Antagonist Benzodiazepines Often prescribed for sleep and anxiety issues Tissue Dependence in 6 10 weeks Synergy with alcohol opiates Withdrawal dangerous Xanax x bars Valium etc BENZODIAZEPINES CNS Depressants CNS depressants act on the brain by affecting the neurotransmitter gammaaminobutyric acid GABA Neurotransmitters are brain chemicals that facilitate communication between brain cells Benzodiazepines Xanax x bars Valium Klonipin etc Rx most often for anxiety and or sleep related difficulties Tissue Dependence in 6 10 weeks Withdrawal dangerous can be life threatening Synergy with alcohol opiates Rohypnol Main Date Rape Drug Also used to enhance the effects of opiates Muscle relaxant amnesiac Tasteless odorless easily dissolved w carbonation The Main Date Rape Drug Tasteless odorless easily dissolved w carbonation Recreationally used to synergize opiates alcohol Schedule I in U S A super benzodiazepine GHB Gamma Hydroxybutyrate Liquid Ecstasy Home Boy Blue Nitro Popular w body builders for steroid like effects Recreational dose is very close to OD level OD coma death rape etc especially when used with alcohol COCAINE White powder from coca leaves Symptoms Heightened alertness confidence energy Dilated pupils runny nose loss of appetite Rebound Symptoms the opposite of those produced by drug occur after euphoria fades Occurs with all drugs but severity varies Includes hangovers and withdrawal addiction unnecessary Toxic when mixed with alcohol 1 Inhibits then destroys dopamine production cells 2 Reduces blood flow to brain Result Reduced capability for pleasure 3 Death by respiratory arrest stroke heart attack 4 Impairs judgment and can lead to risky sexual behaviors increasing risk for STDs 5 May experience severe paranoia a temporary state of full blown paranoid psychosis in which they lose touch