617 Substance Abuse

Kimberly Harding
Book of poems and drug information

N 201

Table of contents
Introduction…………………………………………………………………3
Depressants…………………………………………………………………4-5
Stimulants…………………………………………………………………6-8
Opioids……………………………………………………………………10-11
Alcohol…………………………………………………………………….12-14
Nicotine……………………………………………………………………16-18
References……………………………………………………………………19

Introduction

The following flipbook is presented to display the various forms of substance abuse
and evoke the emotions behind it. Poems are presented from a medication or personal
standpoint with backgrounds to visualize and read the effects of substance abuse.
Celebrities who succumbed to each drug class are presented to attach a
face to a drug in an effort to learn visually and feel through music. "Hurt" by Johnny
Cash is a song about substance abuse to portray the emotional side of substance
abuse. 


Depressants
Drugs that relieve anxiety, irritability, and tension when used properly

Indications:
Benzodiazepines: treat seizure disorders ,relieve anxiety, induce sleep, sedate

Barbiturates: sedatives, anticonvulsants, induce anesthesia

Treat chronic pain (marijuana, controversial issue)
Examples:

Two classes of depressants: Benzodiazepines and barbiturates
Flunitrazepam, known as “roofies” used with alcohol and other drugs commonly

Marijuana: not a benzodiazepine or barbiturate
Mechanism of Action and Drug Effects

Increase the action of the GABA, the acid in the brain that inhibits nerve transmission in
the CNS; Alteration of GABA action in CNS = relief of anxiety, sedation, and muscle
relaxation

THC in marijuana bind chemically to CNS receptors in CNS
Risks

Contraindicated in patients with allergies, dyspnea, airway obstruction, glaucoma
Adverse Effects

CNS: drowsiness, sedation, loss of coordination, blurry vision, headaches, insomnia,
nausea, vomiting, abdominal cramps, dry mouth, memory and attention deficit
problems, Benzodiazepines and barbiturates missed together= death!

Treatment:
Benzodiazepines: Valium tapered dose, Flumazenil (antidote), Barbiturates: 7-10 or
10-14 day taper

If time could turn back to my adolescence I’d more than likely have a better grip on
taking depressants

Started as a teen taking barbiturates and benzodiazepines

For muscle weakness, anxiety, and severe irritability
They stimulate my Gaba neurotransmitter and in turn I would use them as my outside

protector

I tried some of everything Valium, Ambien, Xanax
Nothing worked for, just wanted to relax

The benzos were only temporary, yet I still took them much more than necessary
I didn't agree, however, I didn't see what others could see

I was always out of it, loss or coordination
My life had decreased to little stimulation causing unnerving frustration

Suddenly realized I was overly dependant
was heavily sedated

I was prescribed Flumazenil to reverse this mess I'm in
I saw my parents in the hospital room, having a fit

They pretty much lost it learning I mixed pills with barbiturates
I was only going to have some alcohol and a sandwich to get adequate rest

Unsure of how I passed this life lesson test

Bypassed respiratory arrest and cheated death
Now, I am in rehab to detoxify

All these new changes
trouble concentrating, sweating, tremors
Unsure of how to deal with my new arrangement

stimulants

Drugs that enhance brain activity, causing an increase in alertness, attention, and energy

Indications:

Stimulants are used to treat a variety of ailments including obesity, ADD/ADHD,
narcolepsy, and depression

Examples:

Cocaine, methamphetamine, caffeine, nicotine, amphetamine, MDMA (Ecstasy)

Three classes of amphetamines: Racemic, Dextroamphetmine, methamphetamine
(strong effect on CNS)

Cocaine is snorted or injected and gives temporary illusion of endless power and energy
then depressed and craving more, highs to lows

Mechanism of Action and Drug Effects:

Release biogenic amines (primarily norepinephrine) from their storage sites in nerve
terminals

CNS effects: wakefulness, alertness, and decreased sense of fatigue, Cardiovascular
effects: increased blood pressure/heart rate, dysrhythmias

Risks

Needle Sharing: HIV, AIDS, Hepatitis B and C

Harmful therapeutic effects for participants who are diabetic, have cardiovascular
problems, high blood pressure Tourette’s, allergies

High potential for addiction if abused

Adverse Effects

Restlessness, syncope, tremors, hyperactivity, weakness, insomnia, fever, euphoria,
panic attacks, paranoia, suicidal/homicidal, dry mouth, excessive sweating, diarrhea,
nausea, vomiting

Treatment

Supportive friends and family
Rehabilitation facilities

Not a specific pharmacologic treatment to diminish cravings, reduce toxicity, no
antidotes

This is going to sound like such a rant, but this is
how I feel when on stimulants

Elevation of mood, reduced fatigue
All need is amphetamines

I know I need to stop, yet I just can’t

Cocaine is a feeling, I want it when I want it
I don’t wanna hear it, I need to feel it
In my veins, in order to erase the pain

Quenches my desire, takes me higher, will never
reveal my supplier

Dibble and dabble in crystal meth but that stuff is
nearly puts you to death

Started making pseudoephedrine in the house with a friend
then after a few big sales never saw her again

I use just to be free, but its supposed to given for

narcolepsy
I hate when I run out of my stash, then I have to do

things for cash
I get depressed, edgy, fidgety because I REALLY need

money
Never been through withdrawals, I just keep on the same agenda

knowing one day I could go into a coma or cerebral

hemmorrage



opioids
Opioids are used as pain relieving substances
Indications:

To relieve pain and diarrhea, reduce cough, and induce anesthesia, treat opioid
dependance
Examples:
Heroin, oxycodone, codeine, hydrocodone, hydromorphone, morphine, meperidine
Mechanism of Action and Drug Effects
Block receptors in the CNS, blocking perception of pain
Produce drowsiness, euphoria, tranquility, mood changes, narcosis/stupor
Risks
Contraindicated in pregnant women, asthmatics, paralytic ileus
Adverse Effects
Affects CNS and non-CNS
Primary effects are in CNS: miosis, diuresis, convulsions, nausea, vomiting, respiratory
depression
Non-CNS: vasodilation leading to hypotension, constipation, bladder spasms, urinary
retention, dilation of cutaneous blood vessels, desire for drugs, muscle cramps, malaise
Treatment
Detox programs
Naltrexone, Vivitrol: opioid antagonist, Suboxone




Alcohol
A legal, sedative drug that changes the way a person feels

Indications:
Few legitimate uses of ethanol and alcohol exist

Ethanol is a solvent for drugs, ethanol sponges treats fever, oily topical skin
medications, skin disinfectant when applied topically
Mechanism of Action and Drug Effects

Known as ethanol (ETOH)
Results in CNS depression, dissolves membranes within CNS

Moderate or large amounts may depress respirations
Small amounts of ethanol (red wine) have been known to have cardiovascular benefits

Consumed in large amounts, produces alcoholic hepatitis and/or liver cirrosis
Tetratogenic ethanol inhibits embryonic cellular proliferation early in gestation, fetal
alcohol syndrome, characterized by craniofacial abnormalities, CNS dysfunction in
prenatal and postnatal growth retardation to the infant

Risks

Intensifies sedative effects of any meds working in the CNS (benzodiazepines,
antidepressants, opioids, sedative hypnotics)

Increases viability of blood thinners, increasing the risk of bleeding
Adverse Effects

Wernicke’s encephalopathy, Korskoff’s psychosis, nicotinic aid deficiency, neuro/
mental disorders

Large amounts produce lethal respiratory depression
Possible cardiomyopathy with long term use

Treatment
Ethanol withdrawal can be life threatening: most important maintaining a patent airway
Benzodiazepines, fluid and nutrition replacement
Antabuse: alters metabolism of alcohol, not a cure, “last resort”
Acamprosate: used to maintain abstinence from alcohol in patients





nicotine
Isolated from tobacco leaves
Indications:

Not used therapeutically
Significant as it highly addictive and toxic properties
Nicotine used in other drug products in an effort to reduce cravings and promote
smoking cessation
Examples
Cigarettes, chewing tobacco, cigars
Mechanism of Action and Drug Effects
Stimulates the autonomic ganglia of nicotinic receptors
Transient stimulation is major action of nicotine
Stimulates CNS, respiratory stimulation, followed by depression
Stimulates the GI system producing increased bowel activity and tone, maybe even
diarrhea
Risks
Possible lung cancer, lung disease, stroke
Artificial airway
Adverse Effects
Tachycardia, hypertension
Vomiting, increased motor activity
Cravings: resulting in irritability, restlessness, hypotension, bradycardia
Death from respiratory failure

Treatment
Smoking cessation: Nicoderm patch, nicotine gum, nicotrol inhaler, zyban, chantix




Tried my first cigarette at the age of 14, since then I’ve been addicted to Nicotine,
that release of epinephrine does more harm than good.
I would stop if I could.

Nicotine has taken over my life, my brain, affecting my muscles, and adrenal glands. I get anxious,
nauseated, and tachycardic and attempt to recall how this habit got started

Now at 43, admitted to the ICU with severe COPD, allowed this disease to get the best of me
Fallen into a deep depression and the hospital staff still trying to educate on smoking cessation.

Diagnosed with respiratory failure, don't even know how long I’m going to stay here
Asked about taking nicotine charcoal, patch, or gum to assist with my nicotine withdrawal

I’m acting like a drugged fiend all because of the nicotine, multiple alarms ringing in my ears, staff around
me because of my low heart rate, I’ve got nausea and vomiting, diarrhea and now I’m severely
agitated. Quarantined in my head and body because of this severe addiction to nicotine

References

Club-Dhrtutpg:s/.n/ectlu. (b2-d0r1u2g)s..Snteitm/utalag/nsttdimruugladnetpreenhdaba/ncy. Retrieved from:

DFTrawnswlawte.yBoRu.tu(2b0e.1c2o)m. /Jowhantcnhy?cva=svht1, hPuwrftn.h[V5pidceo File]. Retrieved from: https://

Drugs.com. (2017). Drug-related deaths - notable celebrities. Retrieved from:
https://www.drugs.com/celebrity_deaths.html

Hull, J.G. and Stone, L.B. (2004). Alcohol and self-regulation. In Eds R.F. Baumeister
and K.D. Vohs. Handbook of self-regulation. London: the Guilford Press.

Lilley, L. L., Collins, S. R., Snyder, J.S., & Savoca, D. (2014). Pharmacology and
the nursing process. St. Louis, Mo: Mosby.


THE END