Drug addiction Z. Rozkydal •Drug addiction • •Addiction to psychotropic substances • • •Natural drugs: marihuana, cannabis • •Synthetic drugs: pervitin, extasy, cocain • alcohol, benzodiazepins • toluen, trichlorethylen .. • • •Drugs • •Soft drugs- low risk of addiction • •Coffee, tabacs, marihuana, speed, •alcohol in low intake • • • •Hard drugs- high risk of addiction • •heroin, cokain, crack, pervitin, LSD, extasy •Types of addiction WHO • •Alcohol- barbiturates (ethanol, barbiturates) •Amfetamin (amfetamin, metamfetamin, extasy) •Halucinogen (LSD, mushrooms) •Hashish (marihuana, hashish) •Opiates (opium, morphin, codein, heroin) •Inhalation (toluen, chlorine substances) •Cocain (cokain, crack) •Classification • •Drugs from cannabis: marihuana, hashish • •Opiates: heroin, braun • •Stimulative drugs: cokain, amfetamin (speed), pervitin, extasy • codein, morphin • •Halucinogens: LSD, meskalin, psilocybin • •Psychotropic drugs: sedatives, hypnotics •Situation in Czech republic • • •1. Alcohol •2. Nicotine •3. Drug abuse and drug addiction •4. Gambling •Mental addiction • •Desire to repeat drugs for pleasant feeling • • • • •Somatic addiction • •Unpleasant symptoms in withdrawal of drug •Abstinence syndrom •Alcohol poisoning • 1.Stage – excitation 0,5 – 1 promil • euphoria • •2. Stage- hypnotic 1–2 promiles • loss of balance and coordination of • movement, dysarthria • low sensation of pain • •3. Stage- narcotic above 2 promiles promiles • nausea, vomiting, lethargy • unconsciousness • •4. Stage- asphyctic 3,5–5 promiles • stop of breathing and circulation • death •Signs • •Depression of CNS •Impairement of all mental and physical functions • •Strong smell of alcohol •Empty bottles around •Impaired consciousness •Deep breathing •Later shalow breathing •Weak rapid pulse •Dilated pupils with poor reaction to light •Vomiting •Hypotermia • •Caution- underlying condition: head injury, stroke • hypoglycaemia, heart attack • •First aid • •Prevent aspiration of vomiting fluid • •Do not induce vomiting • •Protect him from the cold • •Maintain open airways • •Check breathing and circulation • •Assess other conditions- head injury .. • •In unconsciousness- rescue position, monitor vital signs • •CPR • •Opioids • •Opium- extract from unripe poppy heads •Papaver somniferum •It contains alcaloids- morphin •Other opiods- codein, pethidin, heroin •Production of poppy: Afganistan, Thailand, Barma, Laos • •Signs •Euphory, painless feeling, phantastical visions, extasy •Happiness •Depressions of breathing, miosis •Somnolence, sopor, unconsciousness •Poisoning with opioids • •Signs •Classical trias: depression of breathing- low rate, flat breathing • miosis with reaction of pupils • unconsciousness •Hypotension, lung oedema, redness of the skin, sleepiness • •First aid •If conscious: monitgor vital signs • avoid aspiration •If unconsciousness: rescue position • •Management •Ventilation, intubation, •Antidotum- naloxon •Abstinence symptoms • •Desire for drug, tachycardia, tachypnoe •Sweating, watering from the eyes, mydriasis •Muscle pain, spams .. • •Complications • •Infections around injections in the skin •lymphadenitis, lymphangoitis •Hepatitis, HIV •Pneumonia, lung absceses •Arthritis, osteomyelitis •Bacterial meningitis, mozkové abscesy •Polyneuropathy •Heroin • •It is diacetylmorphin •Produced from morphium • •Use •Oraly, snuffing, smoking, i.v., i.m. • •Very dangerous • High risk of addiction • •Fatal - •Cocain • •Erythroxylon coca •Alcaloid •Stimulans, local anaestheticum • •Use •Snuffing, smoking, chewing • •Signs •Dilation of pupils •High blood pressure, high rate, arrythmia •Halucinations, vomiting, paranoia •Muscle spams, Hypothermia, •Risk of stroke, rhabdomyolysis •Unconsciousness • •Dry inflorescence of cannabis sativa •It contains canabinoids •Different amount of canabinoids •- 80 types, usually more than 0,3 % of THC •Tetrahydrocanabinod- THC, main effect •Others- CBD, CBN, THCV, CBC. •Different preparation and different quality (Europe, Caribic, •Africa, America, India (up to 20 % of THC) •Use with tabacco in cigaretts, pipes, chewing, milk, oil, tee. • •Signs: •Good feeling, pleasant dreams, deep sense for music •Smile, euphoria •Muscle pain, imaginary images, unpleasant sensations •Marihuana •Psychic addiction only •Among soft addictions •The person is able to stop using marihuana •Using marihuana does not lead to fatal situation •The amount for death- 25 000 joints • • •First aid • •To stop smoking joints •Fresh air •Monitor vital signs • •Marihuana •Amphetamins • •Pervitin and extasy • •Signs • •Nausea, trismus, muscle pain, sweating, tachycardia •Hypothermia, muscle spasm •Loss of cordination of movement, rhabdomyolysis •Renal failuire, multiorgan failure •Shock • •First aid • •Rescue position •Monitor vital signs •Removal to hospital •LSD • •Diethylamid of lyserg acid • •Halucination • •The casualty sees what other do not see •He thinks he can fly .. •He sees with fingers… • •Somatic addiction is low •It is used in psychiatry •Popular among students in some countries • • •