This document discusses substance abuse and prevention. It begins by outlining the objectives of recognizing different types of substances and their effects, distinguishing between mild, moderate and extreme drug use disorders, recognizing the underlying brain chemistry of addiction, signs and symptoms of substance use, and treatment modalities. It then defines substance abuse and lists individual factors associated with it such as developmental, environmental and genetic factors. It describes the main drug epidemics by decade since the 1970s and classifies common drugs like stimulants, depressants and hallucinogens. It provides details on specific drugs like cocaine, heroin, methamphetamine, marijuana, opioids and alcohol, outlining their short and long term effects. It lists physical, behavioral and drug-

1. Kırşehir Ahi Evran Üniversitesi
Sağlık Bilimleri Enstitüsü
‘substance abuse and prevention’
Prepared by :
 Alı Falh abdlhasan
201217154
Supervised by :
Dr. Öğr. Üyesi HİLAL SEKİ ÖZ

2. Objectives
• Recognize the different types of substances and their effects.
• Draw a distinction between mild, moderate, and extreme drug
use disorders.
• Recognize the underlying chemistry of drug use disorders in
the brain.
• Recognize the signs and symptoms of substance use.
• Identify treatment modalities and the continuum of care
• Prevention & control of drug abuse.

3. Substance abuse
• Substance abuse, also known as drug abuse, is the use of a drug
in amounts or by methods which are harmful to the individual
or others. It is a form of substance-related disorder. Differing
definitions of drug abuse are used in public health, medical and
criminal justice contexts. In some cases, criminal or anti-social
behavior occurs when the person is under the influence of a
drug, and long-term personality changes in individuals may
also occur.
(Ksir, Ray& Charles 2002)

4. Individual Factors Associated with Substance Abuse
• Developmental
• Environmental
• Social
• Genetic
• Co-occurring mental disorders
(U.S. Department of Health and Human Services, 2016)

5. Drug Epidemics of the Decades
1970s 1980s–1990s
2000s
2010s

6. Drug Classifications
• Stimulants
• Central Nervous System Depressants
• Hallucinogens

7. Stimulants
• Medications that increase alertness, attention, energy, blood pressure,
heart rate, and breathing rate
• Short-term effects: Increased alertness, attention, energy;
increased blood pressure and heart rate
• Long-term effects: Heart problems, psychosis, anger, paranoia

8. Central Nervous System Depressants
• Medications that slow brain activity, which makes them useful for
treating anxiety and sleep problems
• Short-term effects: Drowsiness, slurred speech, poor
concentration, confusion, dizziness, problems with movement and
memory, lowered blood pressure, slowed breathing.
• Long-term effects: Unknown

9. Hallucinogens
• Substances that distort the perception of reality
• Short-term effects: increased heart rate, nausea, intensified
feelings and sensory experiences, changes in sense of time
• Long-term effects: speech problems, memory loss, weight loss,
anxiety, depression and suicidal thoughts

10. Common Drugs
Substance
abuse
Alcohol
Opioids
Marijuana
Metha
mpheta
mine
Heroin
Cocaine

11. Alcohol
• A depressant, which means it slows the function of the central
nervous system
• Short-term effects: Reduced inhibitions, slurred speech, motor
impairment, confusion, memory problems, concentration
problems
• Long-term effects: development of an alcohol use disorder, health
problems, increased risk for certain cancers.
(National Institute on Alcohol Abuse and Alcoholism; National Institute on Drug Abuse, 2018a)

12. cocaine
• A powerfully addictive stimulant drug made from the leaves of the
coca plant native to South America
• Short-term effects: Narrowed blood vessels, enlarged pupils,
increased body temperature, heart rate, and blood pressure,
headache, abdominal pain and nausea, euphoria
• Long-term effects: Loss of sense of smell, nosebleeds, nasal
damage and trouble swallowing from snorting, infection and
death of bowel tissue from decreased blood flow.
(National Institute on Alcohol Abuse and Alcoholism; National Institute on Drug Abuse, 2018a)

13. Heroin
• An opioid drug made from morphine, a natural substance extracted
from the seed pod of various opium poppy plants
• Short-term effects: Euphoria, dry mouth, itching, nausea,
vomiting, analgesia, slowed breathing and heart rate
• Long-term effect: Collapsed veins, abscesses (swollen tissue with
pus), infection of the lining and valves in the heart, constipation
and stomach cramps, liver or kidney disease, pneumonia.
(National Institute on Alcohol Abuse and Alcoholism; National Institute on Drug Abuse, 2018a)

14. Methamphetamine
• A stimulant drug chemically related to amphetamine but with
stronger effects on the central nervous system
• Short-term effects: Increased wakefulness and physical activity,
decreased appetite, increased breathing, heart rate, blood
pressure, temperature, irregular heartbeat
• Long-term effects: Anxiety, confusion, insomnia, mood problems,
violent behavior, paranoia, hallucinations, delusions, weight loss.
(National Institute on Drug Abuse, 2018a)

15. Marijuana
• Made from the hemp plant, Cannabis sativa. The main psychoactive
(mind-altering) chemical
in marijuana is delta-9-tetrahydrocannabinol, or THC.
• Short-term effects: Enhanced sensory perception and euphoria
followed by drowsiness/relaxation; slowed reaction time;
problems with balance and coordination
• Long-term effects: Mental health problems, chronic cough,
frequent respiratory infections.
(National Institute on Drug Abuse, 2018a)

16. Opioids
• Pain relievers with an origin similar to that of heroin. Opioids can
cause euphoria and are often used non-medically, leading to
overdose deaths.
• Short-term effects: Pain relief, drowsiness, nausea, constipation,
euphoria, slowed breathing, death
• Long-term effects: Increased risk of overdose or addiction if
misused.
(National Institute on Drug Abuse, 2018a)

17. Signs and Symptoms of Substance Abuse
Physical
Signs
Behavioral
Signs
By Drug

18. Physical Signs
• Inability to sleep, awake at unusual times, unusual laziness.
• Loss of or increased in appetite, changes in eating habits
• Cold, sweaty palms; shaking hands.
• Red, watery eyes; pupils larger or smaller than usual
• Unusual smells on breath, body or clothes.
• Extreme hyperactivity; excessive talkativeness.
• Slowed or staggering walk; poor physical coordination.
• Needle marks on lower arm, leg or bottom of feet.

19. Physical Signs (cont’d)
• Nausea, vomiting or excessive sweating.
• Tremors or shakes of hands, feet or head.
• Irregular heartbeat.
• Runny nose; hacking cough
• Puffy face, blushing, or paleness
• Frequent rubbing of the nose
• Frequent twisting of the jaw, back and forth
• Deterioration of hygiene or physical health.

20. Behavioral Signs
• Change in overall attitude/personality with no other identifiable cause.
• Drop in grades at school or performance at work; skips school or is late for
school.
• Change in activities or hobbies.
• Chronic dishonesty.
• Sudden oversensitivity, temper tantrums, or resentful behavior.
• Difficulty in paying attention; forgetfulness.
• General lack of motivation, energy, self-esteem, “I don’t care” attitude.
• Change in habits at home; loss of interest in family and family activities.
• Paranoia
• Silliness or giddiness.
• Moodiness, irritability, or nervousness.

21. Behavioral Signs (cont’d)
• Excessive need for privacy; unreachable.
• Secretive or suspicious behavior.
• Car accidents.
• Change in personal grooming habits.
• Possession of drug paraphernalia.
• Changes in friends; friends are known drug users.
• Unexplained need for money, stealing money or items
• Possession of a false ID card
• Missing prescription pills
• Complaints of a sore jaw (from teeth grinding during an ecstasy high)
• Presence of unusual number of spray cans in the trash.

22. Signs of Intoxication, by Specific Drug
• Marijuana
Glassy, red eyes; loud talking and inappropriate laughter followed by sleepiness; a
sweet burnt scent; loss of interest, motivation; weight gain or loss.
• Alcohol
Clumsiness; difficulty walking; slurred speech; sleepiness; poor judgment; dilated
pupils.
• Cocaine, Crack, Meth, and Other Stimulants
Hyperactivity; euphoria; irritability; anxiety; excessive talking followed by
depression or excessive sleeping at odd times; go long periods of time without
eating or sleeping; dilated pupils; weight loss; dry mouth and nose.
• Heroin
Needle marks; sleeping at unusual times; sweating; vomiting; coughing and
sniffling; twitching; loss of appetite; contracted pupils; no response of pupils to
light.

23. Signs of Intoxication, by Specific Drug (cont’d)
• Depressants (including barbiturates and tranquilizers)
Seems drunk as if from alcohol but without the associated odor of alcohol;
difficulty concentrating; clumsiness; poor judgment; slurred speech; sleepiness;
and contracted pupils.
• Inhalants (Glues, aerosols, and vapors)
Watery eyes; impaired vision, memory and thought; secretions from the nose or
rashes around the nose and mouth; headaches and nausea; appearance of
intoxication; drowsiness; poor muscle control; anxiety; irritability
• Hallucinogens
Dilated pupils; bizarre and irrational behavior including paranoia, aggression,
hallucinations; mood swings; detachment from people; absorption with self or
other objects, slurred speech; confusion.

24. The Brain Science of Addiction
• American Society of Addiction Medicine (ASAM)
“Addiction is a primary, chronic disease of brain reward, motivation,
memory and related circuitry. Dysfunction in these circuits leads to
characteristic biological, psychological, social, and spiritual
manifestations. This is reflected in an individual pathologically
pursuing reward and/or relief by substance use and other behaviors.”

25. Drug Use and Addiction
Brain imaging studies show physical changes in areas of the brain
when a drug is ingested that are critical to:
• Judgment
• Decision making
• Learning and memory
• Behavior control
These changes alter the way the brain works and help explain the
compulsion and continued use despite negative consequences.
(National Institute on Drug Abuse, 2018b)

26. Effects of Cocaine on the Brain

27. Treatment for drug addiction
 Hospitalization,
 Behavioral Therapies,
 Occupational Therapy,
 Change in addict’s social environment.

28. Prevention and Control of Drug Abuse
Requires knowledge of :
 Causes of drug-taking behavior,
 Sources of illicit drugs,
 Drug laws,
 Treatment programs,
 Community organizing skills.
Persistence and cooperation of various individuals
and agencies.

29. Elements of Prevention
• Education,
• Treatment,
• Public policy,
• Law enforcement.
 Education and treatment goals same:
Reduce demand for drugs
 Public policy and law enforcement goals same:
Reduce supply and availability of drugs.

30. Thank you