Substance-Related Disorders

Types of Disorder

Substances-Induced

• Intoxication
• Withdrawal
• Various psychiatric symptoms.

Substance Use

• Dependence
• Abuse.

Substances Abused

Stimulants

• Amphetamines (uppers, speed, ice)
• Cocaine (crack, coke)
• Designer drugs (ecstasy)
• Coffee and tea
• Nicotine
• Soft drinks containing caffeine.

Hallucinogens

• Lysergic acid diethylamide (LSD or acid)
• Certain types of mushrooms (gold Tops)
• Angel dust
• Marijuana, Hashish
• Peyote or buttons.

Depressants

• Heroin
• Gamma Hydroxybutyrate (GHB, G)
• Downers, reds, benzodiazepines
• Barbiturates
• Narcotics
• Alcohol
• Various inhalants (eg petrol, thinners, glue).

Pharmaceuticals

• Multiple medications.

Substances: Stimulants and Hallucinogens

Stimulants

• All act by either directly or indirectly increasing the amount of substances like adrenalin in the brain and nervous system
• Keep you awake, more alert, able to party all night
• Hunger is suppressed by adrenalin, so appetite decreases
• May change the user’s mood.
• Simulant.

Amphetamines

• Usually crystalline – looks like clear grains of sand or rock salt
• Common Street Names – “Uppers”, “Speed”, “Ice”
• Keep people awake & feeling like “partying all night”
• Suppresses appetite.

Cocaine

• Cocaine (crack, coke)
• Most potent and most rapidly acting of the stimulants
• May be snorted (doing lines) smoked (as crack or as free base) or applied to mucous membranes (inside mouth, under tongue etc).

Ecstasy

• An amphetamine variant
• More activity on mood alteration
• Most users don’t drink alcohol, the opposite effect
• Often drinking bottles of water all night during activity.

Meth Amphetamines (MDMA) Common street name – Ice

• Sweet smell
• Highly addictive
• Makes people “pipe hungry”
• Crystals can be smoked, dissolved in a drink or placed under the tongue
• Greater effect on Central Nervous System than other stimulants.

Signs and Symptoms

• Increased wakefulness / physical activity
• Rapid breathing
• Hyperthermia
• Euphoria
• Irritability / confusion / tremors / convulsions.

Hallucinogens

Signs and Symptoms

• Dilated pupils
• Possible paranoia
• Seeing things (colours and patterns)
• “Out of touch” with reality
• Common objects can have mesmerising effect.

Source: Health Direct, 2019e.

Substances: Depressants

How They Work

Depressants don’t actually make you depressed, they depress the function of your nerve cells and brain. The brain cells that are often depressed first are the inhibitory cells, because of this, the person might become excited, disoriented or aroused.

Types of Depressants

Heroin

What do you see?

• Very drowsy and may be scratching nose
• Often unconscious
• Pinpoint (very small) pupils
• Often breathing very slowly and shallowly
• May be cyanosed (blue face, tongue etc.)
• Respiratory arrest is common
• May have fresh needle marks or bleeding.

Gamma Hydroxy Butyrate (GHB)

• GHB is a essentially a de-greasing solvent or floor stripper mixed with drain cleaner.

Effects of GHB

• In big doses causes rapid coma
• Also causes profuse vomiting
• Patient unable to protect airway against vomit
• Patient may die from respiratory arrest or from the effects of inhaling vomit
• If they wake up, they may have effects for weeks afterward.

Common Street Names for GHB

• ‘G’ (most common)
• ‘Gamma-OH’
• ‘Liquid E’
• ‘Heaven’
• ‘Fantasy’
• ‘Georgia Home Boy’
• ‘Grievous Bodily Harm’.