Substance Abuse and You

1. Substance Abuse and You Essential Skills to Success Authors: Jonathan Mong& Marianne Schwarz; VFMP UBC Medicine 2015 Presenters:

2. Outline • Who we are • Topics: • 1. Commonly used drugs + what they do to the body • 2. Reasons for use and risk factors for abuse • 3. Consequences of abuse • 4. Recovery: mental tapes, coping strategies, stages of recovery, etc.

3. Addiction – physiological and mental • Different from “dependence” • Physical and psychological need for something • Accompanied by self-destructive behaviours

4. Withdrawal • Physical and psychological symptoms that appear when off of a substance • Can have common symptoms for many substances

5. Sleeping pills • Some people use these to stay or fall asleep • Common drug:Ativan, Imovane • Work by blocking electrical signals from going to your brain

6. Sleeping Pills • The Good • Helps to sleep • Relaxant • The Bad • Addiction • Nausea, headaches • Memory impairment • The Ugly • Comatose • Death

7. Acetaminophen • The Good • Reduce pain (e.g. headache, muscle aches) • The Bad • Overdose causing vomiting, which can lead to… • The ugly • Overdose (causing liver failure, kidney failure, death)

8. Anabolic Steroids • Similar actions to testosterone • Often taken to try to build muscle mass • Can affect cells everywhere and not just in your muscles

9. Anabolic Steroids • The Good • Bulk up • Appear “manly” • The Bad • Acne • Bruising • Cancer • Depression • Aggression • Testicular shrinking • Stunted growth • The Ugly • ...

10. …

11. Marijuana • Taken for a variety of reasons: to relax, reduce pain, etc. • Increases amount of substance in your brain that makes you feel good • “Opening a door”

12. Marijuana • The ‘Good’ • Pain control • Relaxant • The Bad • Loss of motivation • Decreased awareness • The Ugly • Increased risk of schizophrenia • Legal complications

14. Cocaine • Prevents substance in brain from being broken down normally • “Can’t clean up the mess”

15. Cocaine • The Good • Gives you energy • Gives you a “high” • The Bad • Heart troubles • Infections, enlarged heart, irregular rhythm • Seizures • The Ugly • Sudden heart attack • Stroke

16. Case • Jack is 28 year-old • Confused wandering Downtown Eastside • “Jerky” movements • Fever and chills • “Muscles hurt all over.” • Feels ants crawling under his skin • Agitated

17. Questions/Ideas • What did you notice is happening to Jack? • Any ideas to explain this?

18. Patterns of Use • Non User • People who do not use the substance • Initial User • People who try the substance for the first few times • Irregular User • People who use the substance in social settings • Regular User • People who use the substance in many settings • This is non-harmful regular or planned use • Problem User • People who show addictive behaviour towards the substance • Dependent User • People who are fully addicted to the substance • Physical and mental withdrawal symptoms can present • People driven to acquire and use substance

19. Motivations • Mental or physical pain • To fit in socially • To treat the symptoms of an illness • To prevent withdrawal • Escape from reality

20. Risk Factors • Genetics • Personal characteristics • Health or mental illness • Gender • Early drug use • Lack of healthy relationships

21. Risk Factors • Family • Physical abuse • Culture • Stress • Trauma • Availability of substances • Peer group

22. Case, part 2 • Calms down • Car accident 1 year ago • No major trauma, but had trouble sleeping after • Prescribed a sleeping pill by his doctor • Jack says he became “dependent on it” • After prescription, he ran out and he started drinking heavily

23. Ideas/Questions • Any new ideas about what is happening with Jack? • What substances could he potentially be abusing?

25. Social Consequences Can have minimal impact or affect: • Family • Relationships • Job and finances • Housing • Physical health • Mental health

26. Case • Jack remembers his father using alcohol extensively when work was hard • Father was abusive towards Jack and his mother • Left the house, has not seen his father since • Felt more popular when drinking

27. Ideas/questions • What do you think are Jack’s motivations for using alcohol and sleeping pills? • What are his risk factors for substance abuse?

28. Recovery – Stages of Change • Precontemplation • Contemplation • Preparation • Action • Maintenance • Relapse

29. Recovery – Assessing your thoughts • Mental tapes are old recordings of voices that play in our head from time to time • These tapes can be distracting to the process of recovery, e.g. • “I’m worthless because I’m not able to kick my drug habit.” • “I’ll never be able to live a real life because I drink too much alcohol and there’s nothing I can do about it.” • “If I don’t use alcohol then nobody will like me.” • “When I got high last time I had the best time of my life. The same thing will happen when I get high again tonight.”

30. Recovery – HALT Principles • Relapse is more likely to happen if you are: • Hungry • Angry • Lonely • Tired • If you feel like you’re being overwhelmed by any of these, it’s important to “check in with yourself.”

31. Case • 1 year later • Sees same doctor • Has tried to stop drinking several times but has always started up again • Wants to “kick the habit” • Staying in a friend’s basement • Currently unemployedbut optimistic

32. Back to Jack… • Jack sounds like he wants to stop his substance abuse. Do you think he is prepared to start the process of recovery?

33. Resources • Your doctor • Community clinics • Needle exchange programs • Dial 211- Alcohol and Drug Line - Refers to a full range of counselling and treatment services across BC. BC • Dial 811 - HealthLink BC • Online resources • Mood gym

34. Thank you! • Questions?