Substance Abuse

• Street name: Booze, sauce
• mode of admin: Oral
• Behavior: Lack of control, sneaking drinks, hiding bottles of alcohol
• Affect: Hostility, argumentative, tearful, depressed, jealous
• Physiologic: lack of coordination, slurred speech, flushed face

• 6-8 hours: irritability, anxiety, insomnia, tremors, tachycardia, htn
• 6-96 hours: seizures, hallucinations
• 3-4 days: delirium tremens (DTs), restlessness, sensitivity to light, tremors

Symptoms: Sweating, pulse rate >100, increased hand tremors, insomnia, N/V, transient visual, tactile or auditory hallucinations or illusions, agitation, anxiety, grand mal seizures.

• 1. monitor fluid status; IV fluids
• 2. Administer magnesium sulfate to decrease irritability and prevent seizures
• 3. Administer Vitamin B1 (thiamine); ETOH inhibits absorption of B vitamins
• 4. Per order, administer benzodiazepines (valium or librium) to prevent DTs

• Type: Valium, Xanax, Ativan
• Street names: downers
• Mode of admin: Oral, IV
• Behavior: Sedative, lack of coordination
• Affect: Euphoria, emotional labile
• Physiologic: drowsiness, sleepy

• Seizures, tachycardia, altered perceptions, tremors and anxiety
• *RESPIRATORY DEPRESSION: ETOH + Downers

• Type: methamphetamine, amphet, dexedrine
• Street name: Crystal, meth, speed, uppers, pep pill, bennies
• Mode of admin: oral, injection, IV, smoking
• Behavior: hyper vigilance, increased energy, rapid speech, decreased appetite
• Affect: Euphoria, agitation, anxiety, irritability
• Physiologic: Tachy, arrhythmia, altered respiration, hypertension, headaches, visual disturbance, insomnia

May occur within a few hours (12 hours) to days, can last 1-2 weeks, cravings, chills, sweat, pain, muscle cramps, funny nose, irritability, diarrhea (flu like symptoms)

• Type: Morphine, heroin, codeine, dilaudid, methadone
• Street name: H, horse, Junk, dollies
• Mode of admin: Oral, IM, IV, SubQ
• Behavior: Sedated, slurred speech, motor retardation, psycho motor retardation
• Affect: Euphoria, agitation, decreased emotional pain, apathy, *out of touch
• Physiologic:Pinpoint pupils (may be dilated with severe hypoxia), drowsiness, N/V

Excessive need for sleep, fatigue, anhedonia, depression

*Treatment is Methadone (Synthetic heroin)

• Type: Marijuana, hash
• Street name: pot, Mary Jane, joint
• Mode of admin: Smoking, Oral
• Behavior: Passivity, Sexual arousal
• Affect: Pleasure that progresses to euphoria, apathy
• Physiologic: Dry mouth, tachy, dilated pupils, increased appetite, fatigue, impaired sperm count

Cravings and anxiety

• Type: Cocaine
• Street name: Coke, crack, blow, snow
• Mode of admin: Smoking, inhalation, injection, IV
• Behavior: Hyper vigilance, talkative, increased energy, heightened sexuality, violence
• Affect: Feelings of well being euphoria followed by depression, anxiety
• Physiologic: No or subtle symptoms, eventually can lead to insomnia, anorexia, dilated pupils, tachy,  increase in temp, HTN, N/V, weight loss, stuffy nose, runny nose, irritated nasal membranes

Severe cravings, fatigue, irritability

• 1. Per order Diazepam, phenobarbital, or Tofanil
• 2. Per oder, antidepressant (TCAs) may be given due to the depression
• 3. Per order, beta blocker for HTN and tachycardia

• Type: LSD, PCP, Mescaline
• Street name: Acid, Trip, tab, angel dust
• Mode of admin: oral, IV, smoking, inhalation
• Behavior: Inability to perform simple tasks, facial grimacing, muscle rigidity, violent or bizarre behavior
• Affect: Euphoria, anxiety, emotional liability, impulsiveness, hostility, depression
• Physiologic:Intense perceptions, sensation of slowed time, tachycardia, HTN, lack of coordination, salivation

• 1. Onset of high: 5 mins can last 4-6 hours to 2 days
• 2. Incredible power and strength
• 3. Similar symptoms to Schizophrenia
• 4. Side effects last several weeks
• depression, fatigue, memory loss, poor impulse control, hallucinations are common

• Examples: gas, paint thinner, glue, air fresheners, canned whip cream
• Occurs most often in youth
• Causes: Lightheaded, euphoria, excitement
• Side effects: Ventricular fibrillation, decreased cardiac output, brain damage, sudden death

• Risk factors: Poor cooping, heightened stress, economic factors, mental illness stigma
• Treatment: CBT (life long/chronic)