CLUB/PARTY DRUGS

1. CLUB/PARTY DRUGS Overview of popular club/party drugs, their side effects and what to look for:

2. Presentation Overview • Drug overviews, what they are and what are their effects. • How to handle overdose • How to interact with clients who may be using substances.

3. ALCOHOL

4. ALCOHOL POSITIVE • relaxation • mood lift • lowered inhibitions / reduced social anxiety • kills pain

5. ALCOHOL NEUTRAL • slurred speech • flushed skin • drowsiness, sleepiness • difficulty focusing eyes • tolerance with repeated use within a few days

6. ALCOHOL NEGATIVE • decreased coordination • nausea, vomiting (vomiting while unconscious can kill) • reduced impulse control • emotional volatility (anger, violence, sadness, etc) • dizziness and confusion • blackouts and memory loss at high doses • coma and death at extreme doses • brain and liver damage (cirrhosis) with heavy use • lowered inhibitions and increased confusion can lead to unwanted and negative sexual encounters (date rape) • hangover, lasting 12-36 hours, from mild to severe after heavy use

7. HOW TO TELL IF SOMEONE IS USING ALCOHOL • Smell of alcohol on clothes or breath, • glazed eyes. • Intoxication • slurred speech • unsteady walk • impaired coordination • slowed reflexes.

8. MARIJUANA

9. MARIJUANA EFFECTS POSITIVE • mood lift • relaxation, stress reduction • creative, philosophical or deep thinking : ideas flow more easily • increased awareness of senses. (eating, drinking, smell) • change in experience of muscle fatigue. Pleasant body feel. Increase in body/mind connection. • pain relief (headaches, cramps) • reduced nausea, increased appetite (used medically for this)

10. MARIJUANA EFFECTS NEUTERAL • general change in consciousness increased appetite, snacky-ness • slowness • tiredness • blood shot eyes • mouth dryness, • racing thoughts (especially at high doses)

11. MARIJUANA EFFECTS NEGATIVE • nausea, especially in combination with alcohol, some pharmaceuticals, or other psychoactives • coughing, asthma, upper respiratory problems • difficulty with short term memory during effects and during periods of frequent use • racing heart, agitation, feeling tense • mild to severe anxiety • panic attacks in sensitive users or with very high doses (oral use increases risk of getting too much)

12. MARIJUANA EFFECTS NEGATIVE (2) • headaches • dizziness, confusion • paranoid & anxious thoughts more frequent • possible psychological dependence on cannabis • clumsiness, loss of coordination at high doses • can precipitate or exacerbate latent or existing mental disorders

13. HOW TO TELL IF SOMEONE IS USING MARIJUANA • blood shot eyes • Slow talking/ slow moving • sticky-mouth/ cotton mouth • interrupts linear memory. Difficulty following a train of thought.

14. VIAGRA

15. VIAGRA • Viagra (sildenafil) belongs to a group of medicines that helps to maintain an erection that is produced when the penis is physically stimulated. • Two new drugs for erectile disfunction, Levitra and Cialis are new to the market. Their side effect and interactions are similar to Viagra.

16. VIAGRA SIDE EFFECTS Common • flushing • headache • nasal congestion • stomach discomfort following meals Less Common • abnormal vision including blurred vision, seeing shades of colors differently than before, or sensitivity to light • bladder pain • cloudy or bloody urine • dizziness • increased frequency of urination • diarrhea

17. VIAGRA DRUG INTERACTIONS • Protease Inhibitors (Crixivan, Invirase, Norvir, Viracept, Fortovase, Agenerase, Lopinavir): Increases the amount of Viagra in your blood and prolongs the action of Viagra. Cimetidine (e.g. Tagamet) • Mibefradil (e.g. Posicor): These medicines may increase the unwanted effects of Viagra, unless lower starting doses of Viagra are used. • Nitrates, such as nitroglycerin (e.g. Nitrostat or Transderm-Nitro): Viagra increases the lowering of blood pressure by nitrates too much and their use together is not recommended.

18. VIAGRA DRUG INTERACTIONS (2) • The combination of Viagra and poppers is dangerous because the two drugs affect the human body in about the same way, lowering a person's blood pressure. The vessels get larger and that lowers your blood pressure and that lowers the amount of blood that goes through your heart and into your brain. • Crystal and Viagra can cause a sudden shift in heart pressure causing chest pains, heart attacks or a stroke. • Figures show men who have sex with other men and use both crystal methamphetamines and Viagra were six times more likely to contract syphilis than those who do not use either.

19. CRYSTAL OR SPEED: • Speed (amphetamine or methamphetamine) is a stimulant drug. • It produces alertness, confidence and raises levels of sexual energy and stamina. • It reduces appetite and lessens the desire and ability to sleep. • Regular use can produce a need to increase the dose to get the same effect, and can lead to physical dependence on the drug. Speed can produce a powerful craving for more of the drug. Long-term use can result in serious mental and physical problems.

21. HOW IS SPEED USED? ·  Speed can be swallowed, snorted, smoked, or injected. ·  Swallowing is the safest method of using speed. The effects come on gradually and last longer than with other methods. ·  Snorting speed takes effect faster than swallowing but it can damage the nose. ·   Smoking speed takes effect immediately and can more easily lead to addiction. ·    Injecting is the riskiest method of using speed.

22. WHAT ARE THE RISKS OF INJECTING? · The dose reaches the brain almost immediately, increasing the possibility of overdose. · Impurities are introduced directly into the bloodstream and can cause infections. · Repeated injections damage the veins, leading to abscesses. · Sharing syringes can cause hepatitis and HIV, the virus that can cause AIDS.

23. SIDE EFFECTS TO LOOK FOR: ·Hyperactivity · The 'comedown' off speed can make your patron tired, lethargic and depressed. This may tempt users to take more. ·  Paranoia. Extended use of speed can cause psychosis. The user may think that everybody is out to get them, or that they are being followed or watched. ·  Mixing speed with other drugs, particularly other stimulants, can increase the risk of adverse reactions. ·  Speed users are at higher HIV and hepatitis risk through unsafe sex and needle sharing. ·  Although rare, speed can cause seizures, heart attacks, strokes, and death from overdose.

24. HOW TO TELL IF SOMEONE IS USING CRYSTAL • grinding teeth • obsessive picking of the face or body • hallucinations, (auditory or visual), euphoria • extreme energy • no sleep for 2-3 days • dramatic weight loss • paranoia and aggressive behavior • Watery eye’s • Runny nose

25. WHAT IS KETAMINE? ·Ketamine hydrochloride ("KITTY" or "K") was originally created for use as a human anesthetic, and is still used as a general anesthetic for children, persons of poor health, and in veterinary medicine. · Ketamine belongs to a class of drugs called "dissociative anesthetics," which separate perception from sensation. Other drugs in this category include PCP, DXM and nitrous oxide (laughing gas). ·  Ketamine usually comes as a liquid in small pharmaceutical bottles, and is most often cooked into a white powder for snorting.

27. WHAT ARE THE EFFECTS? · At lower doses it has a mild, dreamy feeling similar to nitrous oxide. Users report feeling floaty and slightly outside their body. Numbness in the extremities is also common. · Higher doses produce a hallucinogenic (trippy) effect, and may cause the user to feel very far away from their body. · This experience is often referred to as entering a "K-hole" and has been compared to a near death experience with sensations of rising above one's body. While in a K-hole it is very difficult to move. People usually remain seated or lying down during the experience.

28. WHAT IS THE DOSAGE? · Most people snort small lines or "bumps" for a mild, dreamy effect. The effect comes on within about 5 to 10 minutes. · 100mg is usually enough to enter a K-hole.   · If liquid is injected into the muscle, less is needed to enter a K-hole. Effects can be felt within four minutes. (Ketamine is never injected into the vein). · If swallowed, the effects come on in 10 - 20 minutes.

29. HOW TO TELL IF SOMEONE IS USING KETAMINE • impaired motor function • sense of invulnerability • muscle rigidity • aggressive/violent behavior • slurred or blocked speech • an exaggerated sense of strength • and/or a blank stare.

30. WHAT IS GHB? • GHB (Gamma hydroxybutyrate) usually comes as an odorless liquid, slightly salty to the taste, and sold in small bottles. It has also been found in powder and capsule form. • It is classified as a sedative-hypnotic, and was originally developed as a sleep-aid.

32. WHAT ARE THE EFFECTS? · At lower doses GHB has a euphoric effect similar to alcohol, and can make the user feel relaxed, happy and sociable. · Higher doses can make the user feel dizzy and sleepy, and can sometimes cause vomiting, muscle spasms, and loss of consciousness. · Overdoses will always cause loss of consciousness (temporary coma), and will slow down breathing. Sometimes, and particularly if mixed with alcohol, GHB can slow breathing down to a dangerously low rate, which has caused a number of deaths.

33. WHAT IS THE DOSAGE? · It's hard to find the proper dose with GHB. A teaspoon might be perfect one time, but an overdose the next time. It depends on body weight, and how much food is in the stomach, and other random factors. · The effects may not peak for up to two hours, and many overdoses have occurred from people not waiting long enough before taking more. · Mixing GHB with alcohol or other depressants is extremely dangerous and has caused many deaths due to respiratory failure. · Passing out on GHB by itself is also dangerous and potentially life-threatening.

34. HOW TO TELL IF SOMEONE IS USING GHB • It vary vastly between each use and individual users, but can include; • Euphoria , sweating, tremors • difficulty breathing, weakness, nausea • drowsiness, dizziness, confusion, impaired coordination

35. WHAT IS ECSTASY? · Ecstasy is MDMA, or 3,4-Methylenedioxymethamphetamine. It belongs to a family of drugs called "entactogens," which literally means "touching within." Other drugs in this category include MDA, MDE and MBDB. · Before it was made illegal in 1985, MDMA was used by psychiatrists as a therapeutic tool.

37. WHAT ARE THE EFFECTS? • MDMA is a "mood elevator" that produces a relaxed, euphoric state. It does not produce hallucinations. • MDMA takes effect 20 to 40 minutes after taking a tablet, with little rushes of exhilaration which can be accompanied by nausea. 60 to 90 minutes after taking the drug, the user feels the peak effects. • Sensations are enhanced and the user experiences heightened feelings of empathy, emotional warmth, and self-acceptance.

38. WHAT ARE THE EFFECTS?Cont. · The effects of 'real' ecstasy subside after about 3-5 hours. · Users report that the experience is very pleasant and highly controllable. Even at the peak of the effect, people can usually deal with important matters. · The effect that makes MDMA different from other drugs is empathy, the sensation of understanding and accepting others.

39. WHAT IS THE DOSAGE? • E is almost always swallowed as a tablet or capsule. A normal dose is around 100-125 mg. MDMA releases the brain chemical serotonin, elevating mood and acting as a short-term antidepressant. Compulsive users may be unconsciously trying to self-medicate for depression. • Frequent or high doses have been linked to neurotoxic damage in humans.

40. WHAT IS ARE THE RISKS ? • There have been some deaths associated with MDMA. Usually these have been a result of heatstroke from physical exertion over long periods of time in hot clubs without replenishing lost body fluids. • Much of what is sold as "ecstasy" on the black market actually contains other drugs, some of which can be more dangerous than MDMA, like PMA, speed, DXM and PCP.

41. HOW TO TELL IF SOMEONE IS USING ECSTASY • muscle tension • involuntary teeth clenching • rapid eye movement • abundant energy • chills • sweating • dilated eyes

42. POPPERS • Poppers" is the popular name for various alkyl nitrites, • Amyl nitrite is made and sold illegally, but most poppers are isobutyl nitrite or butyl nitrite sold in small brown bottles as "video head cleaner," "room deodorizer," or "leather cleaner." • The exact contents of these products are not known, and they are not safety tested.

44. WHAT ARE THE EFFECTS AND RISKS? • Poppers are used by sniffing the vapors from an open bottle. The effects are felt within a few seconds and last for 1-2 minutes. • Poppers cause muscles around blood vessels to relax, making your heart speed up to pump more blood. Oxygen-rich blood reaching the brain produces a "rush" sensation. • Because poppers cause muscles in the anus to relax, they are often used during sex. • If swallowed call 911 or Poison Control. • Contact with the skin causes irritation and rashes. Extensive use can damage the nose and lungs.

45. WHAT ARE THE EFFECTS AND RISKS?Cont. • Some people experience headaches, sensations of spinning or falling, and loss of erection. • Poppers are highly flammable. Keep away from cigarettes, candles, and lighters. • Studies show that poppers reduce the functioning of the immune system for several days after use. • Because poppers cause blood vessels to open, it is easier to get an infection, including sexually transmitted diseases such as HIV.

46. WHAT ARE THE EFFECTS AND RISKS?Cont. · Poppers pose extra risks for people who have suppressed immune systems, heart problems, low or high blood pressure, a history of cerebral hemorrhaging, anemia, or are pregnant. · Combining poppers with stimulants like speed and cocaine increases risks. Combining poppers and Viagra is dangerous because both cause blood pressure to drop.

47. HOW TO TELL IF SOMEONE IS USING POPPERS • headache, • flushing of the face • increased pulse • dizziness

48. WHAT IS COCAINE? · Cocaine Hydrochloride ("coke," "blow") is a white powder derived from the leaves of the coca plant, which grows mainly in South America. · Crack cocaine is made by chemically altering cocaine powder into crystals or "rocks" which are easily smokable.

50. COCAINE USAGE · Most often cocaine is snorted in small lines. The effects come on gradually and peak after about 15-30 minutes. ·When injected or smoked, in the form of "crack," the effects come on immediately and much more intensely.