Prepared by J. Mabbutt & C. Maynard NaMO September 2008

1. 3: The Drugs Prepared byJ. Mabbutt & C. MaynardNaMO September 2008

3. 3: The DrugsObjectives 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

4. 3: The DrugsDrugs defined 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) From Commonwealth Government /NCETA 2004 – GP Trainers Illicit Drug Issues CD Rom

5. 3: The DrugsPsychoactive Drugs (1) Psychoactive drugs are generally defined assubstances which alter: • mood • cognition (thoughts) • behaviour From Commonwealth Government /NCETA 2004 – GP Trainers Illicit Drug Issues CD Rom

6. 3: The DrugsPsychoactive Drugs (2) • 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) From Commonwealth Government /NCETA 2004 – GP Trainers Illicit Drug Issues CD Rom

7. 3: The DrugsPsychoactive Drug Use • 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’ From Commonwealth Government /NCETA 2004 – GP Trainers Illicit Drug Issues CD Rom

8. 3: The DrugsDrug Classifications • 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

9. 3: Classifying Psychoactive Drugs *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

10. Cannabis Cocaine Ecstasy

11. Powder – Amphetamine/Methamphetamine Base – Amphetamine/Methamphetamine ‘Ice/Crystal’ Methamphetamine Pills – Methamphetamine

12. 3: The DrugsDependence • ‘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) From Commonwealth Government /NCETA 2004 – GP Trainers Illicit Drug Issues CD Rom

13. 3: The DrugsDependence diagnosing criteria • 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 From Commonwealth Government /NCETA 2004 – GP Trainers Illicit Drug Issues CD Rom

14. 3: Tolerance and withdrawal Body Drug Body Increase Sudden Body in has adjusts dose cessation in balance effect needed of drug balance for effect causes withdrawal CEIDA Core Traning Manual

15. 3: The DrugsTolerance, Dependence & Withdrawal 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

16. 3: The DrugsHow people use drugs – Activity • 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

17. 3: Appendix 6: Street names of drugs * Adapted from the Illicit Drug Data Report. 2004–05 Australian Crime Commission * Adapted from the Illicit Drug Data Report. 2004–05 Australian Crime Commission

18. 3: Appendix 6: Street names of drugs * Adapted from the Illicit Drug Data Report. 2004–05 Australian Crime Commission

19. 3: Percentage of all deaths attributable to Tobacco, Alcohol and Illicit drugs, in Australia 2003

20. 3: Percentage of Drug related deaths attributable to Tobacco, Alcohol & Illicit drugs, Australia 2003

21. 3: Percentage of Tobacco related deaths in Australia 2003 by condition

22. 3: Percentage of Alcohol related deaths in Australia 2003 by condition

23. 3: Percentage of Illicit drug related deaths in Australia 2003 by condition