2015 drug trends_handouts

8/4/2015
Overview of Drugs
Be in the Know:
Old School to New School Gateway Drugs,
Opiate Epidemic & the World of Synthetics
 Effects of Drugs on Spiders
Stephanie Siete
Director of Community Education
CommunityBridgesAZ.org
Being in the Know
 Be knowledgeable – get educated
 Can’t talk to your kids if you don’t know what to say
 Tell others: friends, neighbors, golf partner, coworkers, sister, etc.
 Take action… learn and react
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Who?
 Law enforcement
 Street
 New recruits
 SRO
 Medical
 Doctors/nurses
 pharmacists
 Citizens
 Neighborhood watch
 Home owners
 Corporate sites
 Parents
 Therapists, realtors?
 Fire
 Admin
 EMS
 New hire
 School staff
 Teachers
 Counselors
 Safety
Recognize signs and symptoms… Don’t ignore!
Ask questions – start conversations
Properly dispose of medications at community sites
Show/tell others what to do and where
Why?
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Be nosey
Share what you know with others
Protect your community
Help an individual
Engage with them…
Save a life
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8/4/2015
The Rule of 5
Drugs look like candy
You never know what you are getting
o5 years of age
o This is the average age experts advise you
should start having the drug talk
o5 year plan
o How old is your kid? What do you want
them to know 5 years from now?
o Start talking
Los Pollos Hermanos
Meth (Candy) Buckets
Flavored Cocaine
Push ‘em toward their PASSION
o #1 Reason teens use drugs…
o Boredom
o What are you passionate about?
o
o
o
o
o
o
o
o
o
Sports/Fitness – team, classes, 5K
Dancing – classes, fun, events
Pets – rescue, shelters, volunteer, vetinarian
Music – singing, listening
Reading – for fun, as a volunteer
Writing – songs, poetry, books
Teaching – any classes
Art – are the creative? Photography, drawing, painting
Computers – games, social media, websites
“Teens' behavior is strongly
associated with their parents'
behavior and expectations, so
parents who expect their
children to drink and use drugs
will have children who drink
and use drugs."
Love this Life
o Commit to long term planning
o Friday is not long term planning
o What do you want to do? Where do you want to go?
o Take the lead
o Be strong, independent, confident… do what matters
o Make decisions now for later
o Choose wisely
o Know your choices impact others
o … and your future
o Reduce your risks and…
o Extend your opportunity of life
12.5
Average age to start experimenting with drugs and alcohol
Joseph A. Califano, Jr., CASA's chairman and founder and
former U.S. Secretary of Health, Education, and Welfare
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8/4/2015
Social Norms in
the Media
Failed drug test…again
Roles models help define Norms
Where the norms come from are IMPORTANT
o Parents
o Teachers
o Grandparents
o Music instructor
o Counselors
o Sports coaches
o Positive Peer – after
school program
o Neighbors
o Aunts/Uncles
o Pastors
o SROs
o Youth group
leaders
o Bosses
o Important adults
I was banging 7 gram rocks and finishing them! That’s how I roll!
What are we fighting?
 Teen brain
 Lack of life experience
 We all suffered from it
 Today vs. when you were growing up
 Irrational brain
 Drug addicted
 Addicts “normal” is different
Center on Addiction and Substance
Abuse - Columbia
 www.CASAfamilyday.org
 www.casacolumbia.org
 Family Activity Kit
 Behaviors
 Inappropriate vs. appropriate
 “learned” or self taught
 Technology
 Easy access to early exposure
Prevalent Drugs of Abuse:
Alcohol
Cigarettes
Marijuana
* Prescription Drugs
Source: Monitoring the Future Survey, Institute for
Social Research, University of Michigan, 1999.
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8/4/2015
Highs in the Home
You don’t need to know a drug dealer to get high
 Cabinets
 Medicine
 Prescription, OTC
 Liquor
 Office
 Dust off, whiteout, markers,
 Kitchen
 Air freshener, cleaners, aerosols
 Garage
 Paints, cleaners, etc.
Inhalants
 Not classified as drugs, classified as poisons
 “Inhalants kill more first time users than any
other substance used as a drug” Buzzed, 2014
 Deprives oxygen to the brain
 Examples:
 paints, whip cream canisters,
markers, whiteout, cooking spray,
superglue, gasoline,
nitrous oxide “whippets”,
aerosols – hairspray, etc.
 www.inhalants.org
Risks of Energy Drinks
for Teens
o Potential harms, caused by too
much caffeine or similar ingredients heart palpitations, seizures, strokes
and even sudden death
o Some cans - 4 to 5 times more caffeine than soda
o Energy drinks are the fastest growing US beverage
market
o 2011 sales expected to top $9 billion
o 1/3 of teens & young adults regularly consume energy drinks
Clinical report on energy drinks expected soon from American Academy of Pediatrics that may include guidelines for doctors
Medical Journal: Pediatrics, February, 2011
How do you recognize difference?
 An energy drink
has a supplement
facts label
 An alcohol energy
drink does NOT
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8/4/2015
Palcohol
http://cojac.ca.gov/youth/pdf/ae
d_flyer4.pdf
Neknominate
 “Neknomination”
 Neknominate- Lethal drinking-game sweeps social
media
Pocket Shots
 Powdered alcohol
 Just add water to bag
 Equivalent to standard
mixed drink
 Approved by US Alcohol
and Tobacco Tax and Trade
Bureau
 Expected to hit shelves in
Summer of 2015
 http://www.palcohol.com/
Purple Drank
 Recreational drug popular in
the hip-hop community
 Promethazine (antihistamine),
codeine (narcotic), maybe some
vicodin, jolly rancher, sprite
 Slang: Sizzurp, Screw,
Lean, Syrup, Purple Tonic,
Texas Tea and Purple Sprite
 Effects: drowsiness,
sedation, blurred vision,
euphoria, nervousness,
insomnia & hallucinations
E-cigarettes
 According to the FDA, electronic
cigarettes are battery-operated devices
the turn nicotine or other chemicals into
a vapor that is inhaled by the user
 Use on the rise among teens
 Easy to conceal other drug use
 Liquid nicotine = potential hazard
 “Vaping” or using “Dabs”
 Vaping Pens…
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8/4/2015
What does it look like?
How do they work?
Vaping pens
 E-cigarettes include a small battery and cartridge
 The battery is designed to generate an electric charge
when the device is inhaled
 The charge sets off vapor in the cigarette tube
 The nicotine-filled mist gives the taste and experience
of smoking without the smoke
 http://abc7.com/news/e-cigarette-lodges-into-ceilingafter-exploding-in-oc-mans-hands/551894/
Regular Cigarettes, Electronic Cigarettes,
Vaporizer Pens
Electronic Cigarettes and Liquid
Nicotine Exposures - AAPCC
Year
2011
2012
2013
2014
2015
Through June 30, 2015
Number of Cases
271
460
1,543
3,783
1732
Butane Honey Oil
aka… Dabs, Budder, Wax, Shatter, Earwax
 Passing butane through a tube packed with marijuana
 Leaves extracted resin behind as a sticky, thick oil –like
substance
 Risk of explosion
 Higher THC concentration
15% vs. 90% THC
 Usually smoked/vaporized taken orally
The BHO Process
www.dailydabs420.com
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8/4/2015
Some West Coast BHO Explosions
YouTube
Third Death in Colorado Linked to
Marijuana Edibles
http://www.foodsafetynews.com/2015/03/third-death-in-colorado-linked-to-edible-marijuana/#.VUqoaLctFdg
1.
Honey, Budder, Wax, Shatter
Girl passes out after hit of wax
The Dabumentary on Dabbing, Wax and BHO
Colorado dad pleads not guilty to shooting his wife dead in front of
their three sons after 'hallucinating on pot candy’ March, 2015
 Kristine Kirk, 44, was shot dead at her Denver home in April 2014. She was on the
phone to 911 reporting her husband's 'scary' behavior. He was 'talking about the end
of the world', she said to the dispatcher
2.
Wyoming college student Levy Thamba Pongi, 19, who took a leap
from a Denver hotel balcony after eating pot-infused cookies.
“Marijuana intoxication” was listed by the coroner as a significant
factor in his death.
3.
Luke Goodman, 23, killed himself Saturday, March 27, 2015 in a
condo at Colorado’s Keystone Ski Area. Goodman’s family and
friends suspect that edible marijuana was a factor in the selfinflicted gunshot death. His mother, Kim Goodman, blames her son’s
death on “a complete reaction to the drugs.”
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8/4/2015
Teens who routinely smoke marijuana
risk a long term drop in their IQ
 Findings fit earlier signs that drug is especially harmful
to developing brain
 Study participants were tested for IQ at age 13, likely
before significant marijuana use, and again at age 38
 Mental decline was seen only in those who started
regularly smoking pot before age 18
 Quitting didn’t remove the problem – still at decline at 38
Proceedings of the National Academy of Sciences, 2012
What does CBD do?
THC vs. CBD
Tetrahydrocannabinol
 Psychoactive ingredient in
marijuana (high)
 Can cause paranoia or
anxiety
 Mind altering
 Induce sleepiness
Cannabidiol
 Non-psychoactive (no
high – does not act on
same receptors as THC)
 May reduce anxiety
 May have antipsychotic
properties - reducing the
psychosis-like effects of
THC
 Promote wakefulness
Effects
Medical Properties of CBD
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Antiemetic
Anticonvulsant
Antipsychotic
Anti-inflammatory
Anti-oxidant
Anti-tumoral/Anti-cancer
Anxiolytic/Anti-depressant
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Reduces nausea and vomiting
Suppresses seizure activity
Combats psychosis disorders
Combats inflammatory disorders
Combats neurodegenerative
disorders
 Combats tumor and cancer cells
 Combats anxiety and depression
disorders
Rx Drug Use – An Epidemic
Prescription drug misuse and abuse effects
every county, city and town in Arizona.
Consider the facts:
 “Prescription drug abuse is the nation's fastest-growing
drug problem”
 Arizona currently ranks 6th highest in the nation for
individuals misusing and abusing prescription drugs.
White House Office on National Drug Policy
 1.3 million emergency room visits in 2010, a 115% increase
since 2004
 3 out of 4 Arizona youth who have misused
prescription drugs in the past 30 days report getting
them from friends, family or right out of the home.
 Overdose deaths on opioid pain relievers surpassed
deaths from heroin and cocaine for the first time in 2008
 Hospitalizations and emergency department visits for
poisonings (Rx drugs are a leading cause) cost Arizona
nearly a half a million dollars per day in 2012.
http://www.azcjc.gov/ACJC.Web/Rx/toolkit/WELCOMELETTER-Prevention%20Works%20AZ-%20Handout.pdf
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8/4/2015
Accidental Rx Overdoses
Opiate Vs. Opioid
Both opiates and opioids are in
some way derived from opium
 Opiate - narcotic analgesic
derived from an opium
poppy (natural)
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
close relatives of opium:
Codeine
Morphine
Heroin
 Opioid - narcotic analgesic
that is at least part synthetic
(molecule)
 Demerol
 Oxycodone
 Fentanyl
 Methadone
 Percodan
 Percocet
Opioids may act just like opiates in the human body, because of the similar molecules
Opioids drive continued increase in
drug overdose deaths
The Kindergarten Teacher????
Drug overdose deaths increase for 11th consecutive year
Drugs Deaths on the Rise in the US
 6,100 in 1980
 16,849 in 1999 (4,030 opioid analgesics)
 36,500 in 2008
 38,329 in 2010 (16,651 opioid analgesics)
 43,982 in 2013 (16,235 opioid analgesics)

In 2012 the number-one cause of death in 17 US
states was prescription drug abuse (Source: American Society of
Interventional Pain Physicians)
Page last updated: February 20, 2013
Content source: Centers for Disease Control and Prevention
More people are dying from drug overdoses than
from any other cause of injury death, including
traffic accidents, falls or guns
 Drug overdoses were responsible for 43,982 in 2013
 35,663 (81%) of which were unintentional
 That's a rate of 120 every day (45 per day for Rx pain relievers)
 6,748 people treated every day for the misuse or abuse of
drugs
 In comparison, in 2010:
 33,687 deaths from traffic accidents
 31,672 people from firearms
 26,852 died as a result of falling
Centers for Disease Control, 2015
The Rx Nation
o Every day 2,700 teens try a prescription drug to get
high for the first time
Partnership for Drug Free America, 2010
In 2010, nearly 60 percent of the drug overdose deaths
(22,134) involved pharmaceutical drugs
 Opioid analgesics, such as oxycodone, hydrocodone,
and methadone, were involved in about 3 of every 4
pharmaceutical overdose deaths (16,651), confirming
the predominant role opioid analgesics play in drug
overdose deaths
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8/4/2015
Teen Prescription Drug Abuse
According to the New PATS Data (2008-2012)
 One in four teens (24 percent) reports having misused or
abused a prescription drug at least once in their lifetime
 18 percent in 2008
 24 percent in 2012
 Translates to about 5 million teens. This is a 33 percent increase over
a five-year period
 Of those kids who said they abused Rx medications, one in five
(20 percent) has done so before age 14
 More than a quarter of teens (27 percent) mistakenly believe that
misusing and abusing prescription drugs is safer than using street
drugs
Parental Lax attitude about Teen Rx Use
According to the New PATS Data (2008-2012)
 One in six parents (16 percent) believes that using prescription
drugs to get high is safer than using street drugs
 More than half of teens (56 percent) indicate that it’s easy to get
prescription drugs from their parent’s medicine cabinet. About half
of parents (49 percent) say anyone can access their medicine
cabinet.
 One in five parents (20 percent) report that they have given their
teen a prescription drug that was not prescribed for them
 Survey also found that 17 percent of parents do not throw away
expired medications, and 14 percent of parents say they themselves
have misused or abuse prescription drugs within the past year
Arizona drug-related DUIs rising
“Prescription painkillers and
synthetic drugs such as ‘spice’ are
common culprits” Alberto Gutier,
director of the Governor’s
Office of Highway Safety
By Jim Walsh The Republic |
azcentral.com Tue Jan 15, 2013 10:55
AM
Adderall “College Crack”
The Problem?
Percentage of Pills by Drug Type in Arizona (2014)
• ~ 579 million Class II-IV pills
were prescribed in Arizona in
2014
• Pain Relievers had the highest %
of scripts, pills and average
number of pills per day;
accounting for 60.0% of all pills
prescribed
• Hydrocodone and Oxycodone
accounted for 81.4% of all pain
relievers prescribed in Arizona
• Why it matters = probability and
access!
All Other Rx Drugs
14.9%
Oxycodone
27.9%
Benzodiazepine
21.8%
Hydrocodone
20.9%
Other Rx Pain
Relievers
[PERCENTAGE]
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8/4/2015
PATS KEY FINDINGS: Released April 23, 2013
2012 Partnership Attitude Tracking Study,
sponsored by MetLife Foundation
 Be in the know
 Share what you know
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Talk to your kids
Safeguard your medicine
Dispose of Rx drugs properly
Family time/dinner
Set healthy examples
Set boundaries and enforce
them
 http://www.drugfree.org/newsroom/pats-2012
 www.medicineabuseproject.org
Hydrocodone
o According to DEA - hydrocodone most
frequently prescribed opiate in the US
o Over 139 million prescriptions for hydrocodone-containing
products dispensed in 2010
o Over 36 million in the first quarter of 2011
o Seizures of pills containing hydrocodone are
second only to those of oxycodone. In 2010,
almost 45,000 pills containing hydrocodone
were seized in the US
Hydrocodone
Oxycodone
o
o
o
o
OxyContin most recognized and abused form
Prescribed to relieve pain
Twice as strong as morphine
Time released (8-12 hours)
o Pills crushed and snorted or cooked down and injected to
break down time release component
o Strong, heroin-like, euphoric effects
o Expensive
o Dollars to milligrams: 10, 20, 40, 50 (ex)
o Other variations: Percocet and Percodan
Opioid History
 Perdue Pharmaceuticals – 1994 launches powerful new
opioid, OxyContin, to treat moderate to severe pain for
extended periods of time
 Endo Pharmaceuticals – In 2006 Opana hits the market
 The Joint Commission on Accreditation of Health Care
Organizations in 1999 required doctors to measure pain as
part of their basic assessment in a patient’s health
 Elevating pain measurement to same level of importance as heart rate
and temperature
Opioids
 Massive marketing push by pharmaceutical companies to increase
use and acceptance – “opioids are safe and effective”
 In 2007 the Department of Justice accused Purdue of deceptively
telling doctors OxyContin was safer and less addictive than other
drugs
 Purdue pleads guilty to misleading doctors and is fined $635
million
 Cephalon paid $425 million in fines for marketing Actiq opioid – lollipop
use to combat migraines and sickle cell pain
 Found to not be safe and effective
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8/4/2015
Oxymorphone
“Opana”
Zohydro ER
FDA approved
 Powerful semi-synthetic
opioid analgesic (painkiller)
 $25-$30 a pill
 Strategic goal of Endo Pharmaceuticals was to market Opana
to become the #2 painkiller for treating severe and long term
pain after OxyContin
 Doctors begin prescribing it over OxyContin
 Injecting Opana – according to FDA “abuse deterrent”
coating makes it easier to inject
 Increased HIV/AIDS cases as a result
 High dose hydrocodone
narcotic painkiller
 Zohydro contains as much
as 50 mg of hydrocodone
 Manufactured as a powder
in a capsule, rather than a
pill – easy to abuse
 10 times more powerful
than Vicodin
 US presently consumes 99%
of worlds hydrocodone
Rx Drug – Take Back Day
780,158 pounds of Rx drugs were collected from 6,072 sites
around the country on April 26. More than 4.1 million pounds of
prescription medications have been removed from circulation
during the 7 national take-back days the DEA has sponsored.
www.DEA.gov
Safeguard your
medicine and Rx drugs
Similar product, different brand
The Strategies
 Medreturn.com
 MedReturn, LLC is committed to providing a
safe, secure and environmentally friendly way
to help law enforcement agencies and
communities collect unwanted or expired
household medication, including prescriptions,
over-the-counter drugs and unused
pharmaceuticals
 1-877-218-0990
 AZ drop box locations
1.
Reduce Illicit Acquisition and Diversion of Rx Drugs
2. Promote Responsible Prescribing and Dispensing Policies and
Practices
3. Enhance Rx Drug Practice and Policies in Law Enforcement
4. Increase Public Awareness and Patient Education about Rx Drug
Misuse
5. Enhance Assessment and Referral to Treatment
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8/4/2015
Why go from Rx to Heroin?
 Cheaper
 Same effects
 Addiction drives behavior
Heroin
 Pure heroin is a white powder with a bitter taste that
predominantly originates in South America, Afghanistan and
Southeast Asia
 South American heroin has become the most prevalent type
available in the US
 Particularly in the Northeast, South and Midwest
 “Black tar” heroin is sticky like roofing tar or hard like coal
and is predominantly produced in Mexico and sold in U.S.
areas west of the Mississippi River
 Dark color from crude processing methods leaving behind
impurities
Heroin
o Illegal, highly addictive drug processed from
morphine, a naturally occurring substance
extracted from the seed pod of certain varieties of
poppy plants
o Most widely abused illicit narcotic in US
o Physical tolerance build up is fast
o Use to avoid pain of withdrawal “getting sick” seek to
“get well”
o Purity levels vary – too much pure heroin can
result in respiratory arrest and death
“Doda” or “Dode” –
Poppy Husk / Pod Tea
 Doda (aka Dode) is a powder made by
crushing opium poppy husks
 Typically prepared as an herbal tea or
added to water or tea
 Effects: euphoria, drowsiness, warming &
flushing, pupillary constriction; higher
doses can lead to nausea, itching,
vomiting, respiratory arrest leading to
death
 Openly sold in foreign countries & on the
Internet
 "the poor man's heroin" because it's a
narcotic derived from the same plant: the
opium poppy
o Overdose is a daily possibility
Heroin Purity
•
•
•
•
•
In 1980s = 3.6% pure
1990 = 18% pure
1998 = 41% pure
Today = 60-90% ???
No longer have to inject heroin to feel the
effect. Purity so high effects felt by snorting
or smoking
• 1996-1998 – 19 young people die of heroin
overdoses in Plano, Texas
• Purity levels ranged up to 75%
Heroin on the Rise in the US
 From 2007 to 2012, the number
of Americans using heroin
nearly doubled, from 373,000
to 669,000
 Past Month and Past Year
Heroin Use Among Persons
Aged 12 or Older: 2002-2012
 The number of people meeting
Diagnostic and Statistical
Manual of Mental Disorders,
4th edition (DSM-IV) criteria for
dependence or abuse of heroin
doubled from 214,000 in 2002
to 467,000 in 2012
National Survey on Drug Use and
Health - 2012
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8/4/2015
39% increase in heroin deaths
between 2012 and 2013
Many States Don’t Have Accurate
Heroin Overdose Figures
Centers for Disease Control and Prevention – January 12, 2015
Join Together – May 12, 2015
 Heroin deaths underreported
 Determining exactly how many people die of heroin
overdoses is difficult to pinpoint because many states
do not require reporting of specific details on drug
overdoses
 Information that is available is usually at least two
years old
 If everybody’s classified as multi-drug toxicity, you
have no idea what’s killing people
 8,257 people died of heroin-related deaths in 2013
 5,925 deaths in 2012
 Overdose deaths overall increased to 43,982 from 41,340
 Many more Americans die from prescription opioids. But
the rise in fatal heroin overdoses came as users of
prescription painkillers switched to the cheaper, illicit
street drug. The heroin deaths contributed to an overall 6
percent jump in drug overdose deaths in 2013 from 2012
Withdrawal
Heroin and Respiratory Arrest
 Lungs – Heroin suppresses
your cough reflex and slows
down your breathing, causing
hyperventilation. This can put
you at risk of lung disease. An
overdose of heroin can cause
respiratory failure and death.
 Nervous system – At higher
doses, sedation takes over
and you become drowsy. An
excessive dose can produce
stupor and coma, and
possible death.
Withdrawal Symptoms
 Symptoms
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Restlessness
Muscle and bone pain
Insomnia
Diarrhea and vomiting
Cold flashes with goose bumps
(“cold turkey”) and kicking
movements (“kicking the habit”)
 Users also experience severe
craving for the drug during
withdrawal, which can precipitate
continued abuse and/or relapse
America’s Heroin Epidemic:
http://www.nbcnews.com/storyline/americas-heroin-epidemic
6 Celebrities who struggled with Heroin use
 Withdrawal may occur within a few hours after use
 Withdrawal symptoms peak between 24–48 hours
after last dose and subside after about a week
 Some people have shown persistent withdrawal signs
for many months
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8/4/2015
Heroin
A Bad Batch?
 Heroin laced fentanyl
 Fentanyl up to 100 times stronger than morphine
 22 people died within a week in Pennsylvania (Feb. 2014)
 28 more people in Philadelphia died after using heroin laced
with the painkiller fentanyl between March 3 and April 20, the
city announced May 12th, 2014
 22 to 53 years of age
 Sold as “Theraflu” or “Bud Ice”
 The Dangers of Fentanyl-Laced Heroin - ABC News
 Actor’s Overdose Death Sheds New Light On Fentanyl-Laced
Heroin Issue « CBS Pittsburgh
In AZ… Heroin mimics Oxy
Desmethyl Fentanyl
derivative of the painkiller Fentanyl
• Dangerous new street drug 40 times
stronger than heroin
• Police also seized 1,500 kilograms of
ingredients that could produce at
least 3 million more pills
• “They were making one pill a second”
• The effects could be fatal
Heroin Addiction
Repeated heroin use
often results in
addiction—a chronic
relapsing disease that
goes beyond physical
dependence and is
characterized by
uncontrollable drugseeking no matter the
consequences
Supporting 1st Responders
 http://hookedaz.cronkitenewsonline.com/
Police
 Police officers have an extremely difficult job. Not to mention the fact that
they are in the public eye all the time. So you can see how alcoholism and
substance abuse can be a problem. Many Law Enforcement officials have a
big fear of coming forward with their problem for fear of losing their jobs.
The rate of suicide is somewhere between 3 and 5 times more than LODDs.
Firefighter
 Firefighter substance abuse and alcoholism is a major problem in the fire
service, with around 33% of the fire service suffering from some form of
PTSD from traumatic events they witness on a daily basis. Approximately
52% of PTSD sufferers will go to substance abuse, leaving around 18% of all
firefighters with an addiction of some sort.
E.M.S.
 Alcoholism and addiction are common for those who work in Emergency
Medical Services (EMS), due to the trauma and stress faced every day on
the job. Easy access to a variety of medications makes it very easy to fall
into the downward spiral of abuse and addiction. When this happens, they
typically lose their jobs, their families and sometimes their lives.
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8/4/2015
Unscript
“Krokodil”
http://communitybridgesaz.org/programs/outpatient-medical-detoxification/
 Unscript™ – A non-invasive
integrated system of education
and physician monitored medical
protocols specifically designed
to treat unintentional physical
dependence on prescription pain
medication.
 No ‘blaming, shaming, guilting”
or psychotherapy. Patients are
treated as men and women who,
while addressing a legitimate
medical condition, became
unintentionally dependent on
increasing doses of prescription
pain medication.
Desomorphine
Active component is codeine
Mixed w gasoline, paint
thinner, hydrochloric acid,
iodine and red phosphorous
Dirty cousin to morphine
Common in Russia and Germany –
few reported cases in US
Similar effects to heroin
3x times cheaper and easy to
manufacture
The "rotting" explains the drug's
nickname. At the injection site,
which can be anywhere from the
feet to the forehead, the addict's
skin becomes greenish and scaly,
like a crocodile's
Blood vessels burst and the
surrounding tissue dies. Gangrene
and amputations are a common
result, while porous bone tissue,
especially in the lower jaw, often
starts to dissipate, eaten up by the
drug's acidity
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What ingredients are used to make
methamphetamine?
 Over-the-counter cold and
asthma medications
containing ephedrine or
pseudoephedrine, red
phosphorous, red devil lye,
hydrochloric acid, drain
cleaner, battery acid,
lantern fuel, muriatic pool
acid, iodine and antifreeze
are among the ingredients
most commonly used
Ofc. L.Gill ASUPolice
End Results For Users
 Initially the injection site turns a yellow/green and the
surrounding flesh begins to grow lesions
 Lesions break open into gaping wounds.
 These areas are then highly susceptible to gangrene
 Continued use the flesh begins to eat away, sometimes to
the bone
 Vital organs of the user’s body began to decay and fail
 Longest know life span of an addict is 2-3yrs
 One year is the typical length
Kratom
 Opiate-like leaf from Southeast Asia
 Chewed as a leaf or in a tea
 Legal and unregulated in US
 Street names:
 Thang, Kakuam, Thom, Ketum, Biak
 Small doses acts as energy boost
 Is in the coffee family
 Larger doses creates mellow,
sedating effect
 Acting on opiate receptors
Ofc. L.Gill ASUPolice
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Kratom Overdoses
What is Vivazen?
 Liquid drink shot
 Powerful natural herbal dietary ingredients include botanicals
such as White Willow, Passion Flower, California Poppy and
Kratom, a botanical from the jungles of the South Pacific and
East Asia
 Potent ingredients help you to push through and overcome
the slow-down that often comes with intense physical
exertion
 Please note: Depending on your body weight, state of health
and physiology, Vivazen can have a powerful effect. In some
rare cases, certain first time users i.e. women or
lighter/sensitive individuals have noticed that it effects them
quite strongly
 Hallucinations
 Delusions
 Listlessness
 Tremors
 Aggression
 Constipation
 Nausea
25i-NBOMe
commonly mistaken today as LSD
 25i-NBOMe, 2-(4-iodo-2,5-dimethoxyphenyl)-N-(2methoxybenzyl) ethanamine, (25i) is a hallucinogenic drug
that was discovered in 2003 to aid in brain research
 In November 2013, 25i was declared illegal by the DEA
 25i is purchased online in foreign countries where the drug is legal
 25i is commonly found on blotter paper, similar to LSD
 found in liquid, powder, or pill form
 Street names: 25i, N-Bomb, Wizard, Future, Smiles, and Dime
 Potent and inexpensive
 Paranoia, seizure, cardiac arrest, death
 Manufacturing/production not consistent – dosages vary greatly
 Marketed as LSD, causing users to believe higher doses not fatal
Who is Molly?
25I-NBOMe
 “25-I” or “N Bomb”
 New synthetic version of LSD
 Use with a blotter and/or put it on your tongue
 Powerful hallucinations
 Deaths in Louisiana, California, North Dakota and
Arizona
 “25I” is an analog, or derivative of “2CI”
 How Synthetic Drugs are Killing our Kids - Dec. 2014
Molly is…
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Molecule
MDMA ??
“Anything”
Since 2005, emergency-room
cases are up 128 percent for
Molly. Molly caused more
than 10,000 emergencyroom admissions in 2011
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Spice is NOT Marijuana
 “Synthetic marijuana” dried herbs or other plant
material that has been sprayed or soaked with
chemicals
 Chemicals mimic those of the psychoactive substances in
marijuana (cannabinoids)
 Come from a laboratory rather than a natural source, so
they are classified as designer drugs
JWH
 Professor John W. Huffman at Clemson University received
a federal research grant to study marijuana effects of
marijuana on the brain. JWH was told he needed to create
substitute chemicals to study… the secret chemical
substitutes were ripped off and now are frequently abused
Possible Health Risks
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Thalidomide
 OTC tranquilizer released in the
late 1950s
 Marketed in 46 countries as sleep aid,
alleviating nausea “given with complete
safety to pregnant women and nursing
mothers without any adverse effect on
mother and child.”
 During 4 years it was on market, doctors
prescribed it as a nontoxic antidote to
morning sickness and sleeplessness—sold to
millions.
 Affected 100,000 pregnant women,
causing over 90,000 miscarriages and
thousands of deformities to the babies
who survived
 Effects: deaf, blind, curved spines, born
without arms or legs, shortened limbs,
heart and brain damage
Hallucinations, delusions, severe agitation, elevated
heart rate and blood pressure, vomiting, tremors,
and seizures
In the most severe cases users have blacked out for
several hours, had feelings of cardiac arrest, and/or
recorded feelings of psychosis
Some of symptoms such as increased agitation, elevated
blood pressure, and heart rates severely increase in
“Spice”
Marijuana label is mislabeling!
Spice is NOT pot
DAWN Report – Synthetic Drugs
December 4, 2012 (Drug Abuse Warning Network)
 In 2010:
 11,406 ER visits for synthetic cannabinoids
 ¾ or 75% of patients were ages 12-29 years of age
 The majority (76%) did not receive follow up care
after discharge from ER
 59% of 12-29 year old patients only presented with
spice – no other substance found
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In 2011…
According to the U.S. Drug Abuse
Warning Network, some 28,531
emergency room visits in 2011
were caused by known synthetic
cannabinoids, more than double
the 2010 number.
Spice cases by year
Spice Use 2015
A photo provided by Karen Stallings of her
sons, Joey Stallings, left, and Jeffrey Stallings.
Both were hospitalized this month after using
a synthetic substance called spice that mimics
marijuana but is far more potent.
Salvia – a Mexican herb
Magic Mint or Diviners Sage
• Marketed as legal cannabis substitute, yet quite
different & LEGAL
• Price - Dried leaf - 10-100 USD per ounce
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Year
2011
2012
2013
2014
Through July 6, 2015
Number of Cases
6,968
5,230
2,668
3,682
4,377
• Ex. two grams of dried Salvia leaves sell for $8 and a 10-times stronger
extract goes for about $25
• Effects: When smoked, Salvia generally comes on very quickly
• First effects - 20-60 seconds
• Peak effects within 5-20 minutes
• What happens with use?
• 2-dimensional hallucinations, out of body experiences, becoming an
object, traveling back in time, being in more places at once and
uncontrolled laughing
• Safety Suggestions: do not operate machinery or drive, have
someone present during use (sitter), no sharp objects nearby
• Repeated use of hallucinogens can promote a dissociation from
reality even when not taking the drug
• No Federal regulations… varies in states
www.salvia.net
Shooting Suspect Had Been Known to Use Potent,
and Legal, Hallucinogen
Sold As… “Code Words”
not tobacco…
Published: January 17, 2011
 Jared Loughner, 22, shoots 19 in Tucson, kills 6, including US Rep.
Gabrielle Giffords
 Salvia divinorum — which federal drug officials warn can closely
mimic psychosis — matched Mr. Loughner’s own comments
about how he saw the world, like his often-repeated assertion
that he spent most of his waking hours in a dream world that he
had learned to control
 Mr. Loughner, 22, was at one point a frequent user of the plant,
also known as diviner’s sage, which he began smoking while in
high school during a time in which he was also experimenting
with marijuana, hallucinogenic mushrooms and other drugs,
according to friends. Mental health professionals warn that drug
use can both aggravate and mask the onset of mental illness
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Potpourri
Herbal incense
Glass cleaner
Plant fertilizer
Insect repellent
Souvenir
Bath salts
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8/4/2015
What are Substituted Cathinones?
“Bath Salts”
 Derivatives of cathinone, a psychoactive substance with
stimulant properties occurring naturally in the khat plant
 effects are similar to amphetamines like ecstasy and cocaine
 Street names
 Abyssinian Tea, African Salad, Catha, Chat, Kat, Oat
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Powder and crystal form that crumbles easily
White to light brown in color
Sold in 50 mg to 500 mg packets/containers
Labeled “not for human consumption”
Sold for $5 to $75
Easily available online
Gravel
Highly addictive synthetic stimulant
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Similar to cathinone AKA bath salts (alpha-PVP)
Sold as plant fertilizer
“Gravel” rock like substance
Effects: Increased blood pressure, elevated heart rate,
violence, paranoia, hallucinations and brain damage
 Unknown long term effects; however may result in
deterioration of tissue around injection site
 Seizures have contained meth, Klonopin and bath salts
Sources: Drug Enforcement Administration, GC HIDTA BLOC Watch Center, Kingsport, Tennessee Police Department, Sullivan County Tennessee Sheriff’s Office.
Law enforcement and open news sources, Officer Donald Reid, 2012
What is Flakka?
 Similar to cathinone AKA bath salts (alpha-PVP)
 Rapid heart beat, heightened blood pressure and body
temperature
 “Cooks the body” temps over 106 degrees
 Psychosis, excited delirium, aggressive and violent
 Harm to self and others
 Cases in Florida, Ohio and Texas (March, 2015)
 Synthetic chemical that is currently legal
 “Flakka deaths rise to 18 in one Florida County” May 26, 2015
 User states he vaped flakka with an e-cigarette
Effects
 High similar to cocaine,
methamphetamine, MDMA (Ecstasy) or LSD
 Initial euphoria last 3-4 hours
 Psychosis, hallucinations, suicidal thoughts can last 3-4 days
 Unknown long term effects
 3-4 months after last initial use
 Cited as “imminent threat to public safety” by DEA
Law enforcement and open news sources, Officer Donald Reid, 2012
Bath Salts
Resources
Common Names
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Ivory Wave
Cloud 9
Ocean
Bliss
Eight Ballz
White Lightning
Hurricane Charlie
Charge Plus
Scarface
Red or White Dove
White Water Rapid
Amped Ladybug Attractant
Snowman Glass Cleaner
Joker
Scooby Doo
 http://www.tascaz.org/
 Banner Good Samaritan
Poison and Drug Information Center
24-hour phone: 1-800-222-1222
 www.dea.gov
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8/4/2015
Helpful Websites
WTF: Why Teens Fail & What To Fix
 whyteensfail.com
 Amazon.com
communitybridgesaz.org
drugfreeaz.org
drugfree.org/the-parent-toolkit/
getsmartaboutdrugs.com
ACPA.net
jointogether.org
http://www.azcjc.gov/ACJC.Web/Rx/default.aspx
Where can you find more information?
Call your local poison center at 1-800-222-1222.
Poison centers are open 24 hours a day, seven days
a week, every day of the year for poisoning
emergencies and for informational calls, too.
www.aapcc.org
Thank You!
Stephanie Siete
Director of Community Education
Access to Care - 24/7
877.931.9142
CommunityBridgesAZ.org
https://www.facebook.com/ParentsInTheKnowAZ
[email protected]
602.377.4591
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