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Substance Abuse and Addiction
Course
Rationale
Throughout history, cultures have used psychoactive drugs for various Unit V
purposes such as recreation, rituals, ceremonies, and medicinal purposes. A major concern for today’s medical professionals is substance abuse and its effect on society. To live a healthy lifestyle throughout one’s lifespan an understanding of the relationship between unsafe behavior and personal Unit XI
Objectives
Upon completion of this lesson, the student will be able to:  identify the most commonly abused drugs and list their effects; Essential
 evaluate and explain why it is important to stay drug and alcohol-free; Question
 develop strategies for preventing the use of tobacco, alcohol, and Discuss the following myths and or false statements: TEKS
• Marijuana is not addictive. The truth is, statistically, 1 in 10 will • Using certain drugs, even once, means you’re automatically addicted. Prior Student
Learning
• Children should be permitted to drink in the presence of their parents because a drink or two is “harmless.” Estimated time
• Children who start drinking in their early teen years are much more likely to develop problems with alcohol than those who wait until they • Drug use and addiction is linked to at least half of the major crimes in this country, as at least half of the suspects arrested for violent crimes, such as homicide and assault, were under the influence of drugs when they were arrested. • Stress is a major factor in drug use and abuse. • Sadly, nearly two-thirds of people in drug abuse treatment report that they were physically or sexually abused as children. Child abuse is a major contributing factor to drug addiction. Copyright Texas Education Agency, 2012. All rights reserved. Key Points
A. Major categories of substances that are abused: 1. Alcohol 2. Amphetamine 3. Caffeine 4. Cannabis 5. Cocaine 6. Hallucinogen 7. Inhalant 8. Nicotine 9. Opioid 10. Sedative, Hypnotic, or Anxiolytic 11. Club Drugs II. Substance Dependence and Substance Abuse A. Dependence: is being unable to stop using 1. Individual’s symptoms have persisted for at least 1 month 2. Individual must manifest three of the following symptoms: need for markedly increased amounts of substance to achieve desired effect Markedly diminished effect with continued use of same amount of substance b. Withdrawal c. substance is taken in larger amounts or over a d. a pattern of persistent desire e. great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects f. important social, occupational, or recreational activities are given up or reduced because of substance abuse g. substance use is continued despite knowledge B. Abuse: people making bad decisions, like having too many 1. Pattern of substance use by one (or more) of the following: a. recurrent substance use resulting in failure to fulfill obligations at school, home, or work Copyright Texas Education Agency, 2012. All rights reserved. b. recurrent substance use in situations in which it is c. recurrent substance-related legal problems d. continued substance use despite having persistent relationship problems caused by effects of substance 1. FAS: Fetal Alcohol Syndrome – causes mental and 2. DWI: driving while intoxicated 3. DUI: driving under the influence 4. BAC: Blood Alcohol Concentration 5. Alcoholism: addiction to alcohol – cannot keep from drinking, cannot manage time without drinking, and cannot stop drinking once they have started 6. Cirrhosis: scarring of the liver 7. Jaundice: yellowing of the skin and eyes 1. Daily use of alcohol necessary to function 2. Person unable to cut down or stop drinking 3. Binges last longer than 2 days 4. Person occasionally consumes as much as a fifth of liquor 5. Amnesia occurs during periods of intoxication (blackouts) 6. Inability to function at work or with friends and/or family 1. Slurred speech 2. Lack of coordination 3. Unsteady walking 4. Nystagmus: involuntary, rhythmic eyeball movement 1. Brain – decreased activity of the nervous system, thought processes are disorganized, memory and concentration are dulled, leads to brain damage resulting in loss of intellectual abilities 2. Liver – inhibits the liver’s ability to breakdown fats, fats accumulate leading to a fatty liver, the increased amount of fat keeps the liver cells from working and new liver cells being formed; cirrhosis – no blood flow through scarred area of the liver, causes the increase in blood pressure, Copyright Texas Education Agency, 2012. All rights reserved. hemorrhage, abdominal swelling, infection, jaundice 3. Blood Vessels – increase heart rate and blood pressure 4. Kidneys – increased urination, dehydration 5. Stomach – increased flow of gastric acids, inflammation, E. Tolerance – need to drink more to get the same effect F. Dependence – physiologically addicted G. Withdrawal – sleeplessness, sweating, tremors, and 1. Detoxification process --takes place in hospital or 2. Major treatment options frequently presented to recovering a. aversive therapy (Disulfiram/Antabuse therapy) form of behavior therapy that uses learning principles to cause patient to associate thought of drinking with unpleasant stimulus Disulfiram (Antabuse) is a drug that causes metabolism of alcohol to be blocked Result is buildup of toxic alcoholic by-product called acetaldehyde produces unpleasant symptoms: flushing, sweating, palpitations, dyspnea, hyperventilation, tachycardia, hypotension, nausea, and vomiting b. inpatient rehabilitation treatment program Intensive education and behavior modification to teach new coping skills to individuals who previously turned to alcohol Teach patient communication skills and stress management worldwide and is available in most communities Copyright Texas Education Agency, 2012. All rights reserved. The goal is to achieve a life of sobriety Related organizations for families of alcoholics (Al-Anon) a. to have fun b. to relax c. to feel more self-confident d. to fit in – peer pressure e. to get away with something 2. Negative social consequences – difficulties with family, 1. FAS – fetal alcohol syndrome, a cause of mental 2. Shorter, smaller babies, slow body growth 3. Facial abnormalities 4. Poor coordination 5. Heart defects 6. Poor attention span, nervousness, hyperactivity 1. #1 cause of death for teenagers in the US 2. Decreases the ability to judge distances, speeds, turns 3. Decreases abilities and limitations 4. Increases risk taking 5. Slows reflexes 6. Adds to forgetfulness 7. Decreases the ability to concentrate 1. Stage 1: physiological and psychological dependence, 2. Stage 2: cannot stop drinking, defensive, denial, tolerance, 3. Stage 3: drinking is visible, uncontrollable 1. Amphetamines 2. Dexedrine 3. Methamphetamine (speed) 4. Appetite Suppressants Copyright Texas Education Agency, 2012. All rights reserved. 1. Used to treat obesity 2. Used by students to stay alert and study 3. Used by truck drivers to stay awake 4. Used by soldiers to decrease fatigue and increase 7. Elevated blood pressure 8. Tachycardia 9. Nausea and vomiting 10. Chills or perspiration 1. Increase heart rate and breathing 2. Anxiety, sleeplessness 3. Tolerance, dependence 4. Methamphetamine (crank, speed, ice) cause paranoia and E. Today’s evidence suggests that amphetamine and related drugs produce both dependency and withdrawal states F. Most dangerous drugs presently available 1. Can produce toxic psychosis in mentally stable people 2. Death from over dosage (usually associated with hyperpyrexia, convulsions, and cardiovascular shock) G. Amphetamine-induced psychotic disorder clears in a matter of days or weeks following withdrawal of drug H. Withdrawal depression may reach suicidal proportions – may be treated with tricyclic antidepressants 1. Marijuana – hemp plant Cannabis, the leaves and flowers are smoked, eaten, drunk. Over 400 chemicals present 2. Hashish – dark brown resin from the tops of the cannabis 3. Purified delta-9-tetrahydrocannabinol (THC) – chemical that causes the psychoactive effect; stored in fatty tissue, Copyright Texas Education Agency, 2012. All rights reserved. especially in brain cells, liver, lungs, kidneys, and reproductive organs; acts as a poison and prevents proper formation of DNA B. Marijuana is the most commonly used substance in this 1. Widely prescribe for variety of ailments during the 19th century – coughing, fatigue, migraine, asthma, delirium tremens, etc. a. ability to cause euphoria b. tendency to produce sedation – effects last 2 to 4 hours from smoking and 5 to 12 hours from ingestion c. sensory perception changes d. decreased body temperature, increased heart g. mood changes can be influenced by mood and h. personality problems with increased use k. decreased concentration and coordination l. decreased immune system function m. decreased testosterone, decreased sperm n. use during pregnancy causes condition in baby a. tachycardia b. perception of slowed time c. intensified subjective perceptions d. apathy e. elation f. dry Copyright Texas Education Agency, 2012. All rights reserved. a. appear to be dose related and environment in A. Cocaine abuse is a problem of almost epidemic proportions in B. Derived from leaves of coca plant which is indigenous to 1. Leaves chewed by natives for many years for ceremonial 2. Can be snorted, smoked, or injected 3. Rapid acting and powerful stimulant 4. Increases risk of heart attack, heart rhythm irregularities, 5. Increased risk of HIV with use of shared needles for C. Intoxication Symptoms: cocaine “high” is similar to that of 1. Euphoria 2. Exhilaration 3. Powerful sense of well-being and confidence 4. Agitation 5. Dilated 6. Elevated blood pressure 7. Tachycardia and tachypnea 8. Nausea and vomiting 9. Chills or perspiration 10. Paranoia, hallucinations 11. Psychological and physiological dependence D. Commonly abused form of cocaine is crack
1. Inexpensive, very potent, readily available 2. Smokable form of cocaine 3. Danger or injury/death from explosion or fire 4. Causes insomnia, hallucinations, paranoia, and seizures as well as all of the common physiological symptoms like increased heart rate and blood pressure and lung damage Copyright Texas Education Agency, 2012. All rights reserved. E. crack/cocaine intoxication marked by: 1. Excitement, euphoria, restlessness, stereotyped movement, gnashing, grinding, or clenching teeth F. tolerance and physical dependency develops G. toxic psychosis with visual, auditory, and tactile hallucinations A. not categorized by intoxication or withdrawal – instead by their B. psychedelics C. alter mood, thought, and the senses D. episodes of hallucinogenic flashbacks can occur at unpredictable times for years following termination of drug E. Includes LSD, DMT, PCP, inhalants, and mescaline a. increases heart rate and blood pressure b. chills, fever, loss of appetite, nausea c. panic attacks, anxiety, accidental suicide d. flashbacks a. distorts senses b. muscle coordination is impaired c. false sense of power and strength; results in d. can cause permanent psychiatric disorders e. flashbacks – a recurrence of the effect of the a. glue, spray paints, aerosols, gasoline b. decreases the central nervous system c. effects nausea, sneezing, cough, nosebleeds, fatigue, lack of coordination, loss of appetite kidney, bone marrow, brain, and lung damage Copyright Texas Education Agency, 2012. All rights reserved. 1. Belligerence 2. Impaired social functioning 3. Dizziness 4. Nystagmus 5. Lack of coordination 6. Slurred 10. Tremor 11. Muscle weakness 12. Stupor or coma 13. Euphoria 1. Nicotine: addictive drug found in cigarettes 2. Stimulant: a drug that increases activity of the central 3. Tar: thick, sticky, dark fluid produced when tobacco burns 4. Carcinogen: a cancer causing substance 5. Carbon monoxide: a colorless, odorless, poisonous gas in cigarette smoke that passes through the lungs into the blood 6. Leukoplakia: thick, white, leather appearing spots in the inside of a smokeless tobacco user’s mouth, it is precancerous 7. Passive smoke: cigarette, cigar, or pipe smoke inhaled by 8. Mainstream smoke: smoke the smoker blows off 9. Sidestream smoke: smoke that comes from the burning 10. Cilia: hair like projections in the respiratory tract, keep 11. Chronic bronchitis: bronchi are irritated, cilia do not work, 12. Emphysema: destruction of air sacs in the lungs through 13. Lung cancer: cancer of the lungs, one of the leading 14. Addictive: physiologically, psychological dependence 15. Physiological addiction: body has a chemical need for the Copyright Texas Education Agency, 2012. All rights reserved. 16. Psychological addiction: person thinks they need the drug 17. Withdrawal: symptoms when substance that they are B. Cigarettes: have more than 4,000 chemicals, at least 43 known 1. Nicotine is the addictive stimulant that increases blood 2. Tar: carcinogen, coats and penetrates the airway and a. COPD: chronic obstructive pulmonary disease a. small fetal growth and low birth weight b. increased chance of miscarriage and stillbirths c. growth and development during childhood d. nicotine – transfers during breast feeding e. children of cigarette smokers have increased respiratory problems, poor lung functions, and are twice as likely to develop lung cancer 5. Pipe and cigar smokers are more likely to develop lip, 6. Smokeless tobacco: mouth sores, leukoplakia, may turn into cancer of the mouth; also an increased chance of developing cancer of the lip, throat, damage of the teeth, gums, and digestive system Copyright Texas Education Agency, 2012. All rights reserved. C. Tobacco dependence withdrawal symptoms 1. Depressed mood 2. Insomnia 3. Irritability, frustration, and anger 4. Anxiety 5. Difficulty concentrating 6. Restlessness 7. Decreased heart rate 8. Increased appetite or weight gain A. Includes opium, heroin, morphine, meriperidine (Demerol), 1. Heroin: has no medical use in the United States; depresses the central nervous system; causes coma and/or death with large doses; tolerance; withdrawal from drug is difficult and painful; and increased risk of HIV infection from contaminated needles B. The most addictive drugs abused C. Depresses areas of the brain that reduce hunger, thirst, and D. Demerol, morphine, and codeine used in healthcare facilities E. Methadone used to treat heroin addiction F. Intoxication symptoms: 1. Euphoria 2. Drowsiness (“nodding out”) 3. Constriction of pupils (dilation if major overdose) 4. Dysphoria, 6. Tachycardia 7. Fever 8. Lacrimation 9. Rhinorrhea 10. Piloerection 11. Sweating 12. Diarrhea Copyright Texas Education Agency, 2012. All rights reserved. A. CNS depressants such as Librium, Valium, Seconal, and SeraxB. Used to relieve anxiety, “chill-pills” – produce feelings of relaxation and inhibition; decreases heart rate and respiratory rate C. This class of drugs most often abused because they create D. Extremely addictive causing physiological and psychological E. Intoxication symptoms – cognitive confusion (memory 1. Coarse tremors of hands, eyelids, and tongue 2. Nausea and vomiting 3. Malaise or weakness 4. Autonomic hyperactivity 5. Anxiety 6. Depressed or irritable mood A. This is a sedative category which relaxes the central nervous B. Synthetic drugs made from barbituric acid C. Prescribed to treat insomnia, high blood pressure, and epilepsy D. When taken with alcohol, they tend to enhance effect E. Symptoms: 1. mood shifts 2. restlessness 3. euphoria 4. excitement 5. confusion 6. hallucinations 1. cramps 2. nausea 3. delirium 4. convulsions G. Dependent individuals need to be withdrawn very slowly since Copyright Texas Education Agency, 2012. All rights reserved. 1. tablet, powder, capsule 2. usually consumed orally 3. effects can last from 3-24 hours 4. causes euphoria and intoxication 5. depression, paranoia, and sometimes violent and irrational a. loss of appetite b. nausea and vomiting c. blurred vision d. increased heart rate and blood pressure e. chills f. sweating g. tremors h. insomnia i. convulsions j. heat k. exhaustion l. dehydration B. Rohypnol – sedative, ten times as strong as Valium 1. taken orally 2. causes intoxication 3. can cause deep sedation, respiratory distress, blackouts 4. short term amnesia 5. can cause aggression 6. called the “date rape drug” C. Anabolic Steroids – synthetic derivative of male hormone 1. used illegally to increase athletic performance 2. increases aggressiveness and strength 3. side effects a. increased blood pressure, acne, liver damage, b. males – baldness, depression, aggressiveness, decreased sperm production, decreased testicular size, increase breast growth and body and facial hair c. females – breast shrinkage, growth of facial hair, Copyright Texas Education Agency, 2012. All rights reserved. d. mood swings e. increase risk of HIV infection with shared needles XIV. Addiction – it is a disease like hypertension or diabetes A. Tolerance B. Physiological and psychological dependence C. Withdrawal D. Intervention – interrupting the addiction E. Recovery – process that happens over time 1. counseling 2. support groups – 12 step programs like AA – Alcoholics 3. Alcohol and Drug treatment centers (Costs Americans 1. codependency – being overly concerned with other people’s behaviors and problems, feeling responsible to fix and control those problems 2. enabling – trying to protect the person having trouble a. get help from outside the family b. counselors c. support groups A. Healthcare workers (high risk due to available of drugs) 1. highest addiction rate – anesthesiologists B. Family history of substance abuse C. Emotional problems D. Ineffective coping mechanisms E. History of childhood physical or sexual abuse F. “Addictive” personalities Activity
I. Write a critical analysis on an article related to substance abuse (e.g. Addiction As a Disease, Can the Addicted Brain Change Back? The Role of Biology and Addiction, Gateway Drugs. (See Materials) II. Cut out smoking advertisements and bring them to class; divide the students into small groups and have them discuss a. What message does the advertisement imply? b. What group is the advertisement targeting? c. Does the advertisement really have anything to do with smoking? Copyright Texas Education Agency, 2012. All rights reserved. d. What is the purpose of the advertisement? III. Create anti-drinking and anti-drug advertisements that can be placed around the school for red ribbon week, prom week, homecoming week, etc.
Assessment
Successful completion of the Substance-Related Disorders Quiz
Successful completion of the critical analysis of a substance abuse article
Materials
http://www.pbs.org/wnet/closetohome/science/index.html -- Informational site
for activity.
Key for Quiz
Critical Analysis Rubric
Art supplies: construction paper, markers, scissors, glue, poster board, etc.
The Addicted Brain, Films for the Humanities & Sciences (800) 257-5126
#DPM1363. Excellent documentary video that examines the biochemistry of
addiction and addictive behavior
Accommodations for Learning Differences
For reinforcement, the student will create a chart identifying substance
related disorders and symptoms
For enrichment, the student will research and develop charts and graphs
depicting the cost of substance abuse to our society (e.g. treatment costs,
law enforcement costs, etc.)

National and State Education Standards
National Health Science Cluster Standards
HLC06.02 Safety, Health, and Environmental
Health care workers will understand the fundamentals of wellness and the
prevention of disease processes. They will practice preventive health
behaviors among the clients.
TEKS
130.204 (c) 8A comply with specific industry standards related to safety and
substance abuse
Texas College and Career Readiness Standards
English Language Arts
II. B. Understand new vocabulary and concepts and use them accurately in
reading writing and speaking.
Copyright Texas Education Agency, 2012. All rights reserved. Critical Analysis Rubric
NAME _______________________________ DATE ______________ PERIOD ________ Scoring criteria
Excellent
Needs Some
Needs Much
Improvement
Improvement
The critical analysis has all
required parts from
introduction to body to
conclusion.
The critical analysis is
concise but complete.
The critical analysis
demonstrates that the
writer comprehends
addiction and related
disorders.
The critical analysis
demonstrates accurate
spelling, grammar, and
punctuation.
The overall content of
critical analysis emphasizes
appropriate points.
The writer shows an
understanding of sentence
structure, paragraphing,
and punctuation.
The source of the critical
analysis is clearly and
accurately documented.
The critical analysis
demonstrates correct use
of medical language.
NOTE: N/A represents a response to the performance, which is "not appropriate." Copyright Texas Education Agency, 2012. All rights reserved. Quiz—Substance-Related Disorders

NAME _____________________________ DATE ______________ PERIOD ________
TRUE / FALSE (Circle correct answer.)
1. Individuals who are abusing alcohol might use it daily in order to function.
2. Valium is a good aversive therapy for alcoholics. 3. Medical supervision is necessary for alcohol detoxification. 4. Amphetamines depress the central nervous system. 6. The byproduct of cocaine that is inexpensive, and very potent is 7. There are no adverse reactions to marijuana. 8. Unpredictable hallucinogenic flashbacks can be caused by LSD. 9. Withdrawal from nicotine might result in drowsiness and lethargy. 10. Sedatives can depress the central nervous system, but are not addictive. Copyright Texas Education Agency, 2012. All rights reserved. Key: True/False Quiz
Substance-Related Disorders

1. T
2. F
3. T
4. F
5. T
6. F
7. F
8. T
9. F
10. F
Copyright Texas Education Agency, 2012. All rights reserved.

Source: http://texashste.com/documents/curriculum/health_science/substance_abuse_and_addiction.pdf