| General: General and specific guides to detection of | | | | of |
| alcohol and drug use, and definition of | | | | paraphernalia including small spoons, razor blades, |
| addiction.Contents: | | | | mirror, |
| I. General Guide to Detection | | | | little bottles of white powder and plastic, glass or |
| II. Definition of Addiction | | | | metal straws.Depressants: Symptoms of alcohol |
| III. Pupil Dilation | | | | intoxication with no alcohol |
| IV. Signs and Symptoms | | | | odor on breath (remember that depressants are |
| V. Paraphernalia a) S/S Chart Version | | | | frequently used |
| VI. Drug Facts | | | | with alcohol). Lack of facial expression or animation. |
| VII. Articles and Other Resources | | | | Flat affect. |
| VIII. Drug Pictures/Resources | | | | Flaccid appearance. Slurred speech. Note: There are |
| IX. NI-COR Topics | | | | few readily |
| X. Additional Articles (Alcoholism, Drugs, Teenage | | | | apparent symptoms. Abuse may be indicated by |
| Addiction, Interventions) | | | | activities such as |
| XI. Overdose and Emergency Intervention | | | | frequent visits to different physicians for prescriptions |
| TechniquesI. Specific: General Guide to Detection | | | | to treat |
| Abrupt changes in work or school attendance, quality | | | | "nervousness", "anxiety"," stress", etc.Narcotics |
| of work, work output, grades, discipline. | | | | Prescription Drugs/Opium/Heroin/Codeine/ |
| Unusual flare-ups or outbreaks of temper. Withdrawal | | | | Oxycontin: Lethargy, drowsiness. Constricted pupils fail |
| from responsibility. General changes in overall attitude. | | | | to respond |
| Deterioration of physical appearance and grooming. | | | | to light. Redness and raw nostrils from inhaling heroin |
| Wearing of sunglasses at inappropriate times. | | | | in power form. |
| Continual wearing of long-sleeved garments particularly | | | | Scars (tracks) on inner arms or other parts of body, |
| in hot weather or reluctance to wear short sleeved | | | | from needle injections. |
| attire when | | | | Use or possession of paraphernalia, including syringes, |
| appropriate. Association with known substance | | | | bent spoons, |
| abusers. Unusual borrowing of money from friends, | | | | bottle caps, eye droppers, rubber tubing, cotton and |
| co-workers or parents. Stealing small items from | | | | needles. Slurred |
| employer, home or | | | | speech. While there may be no readily apparent |
| school. Secretive behavior regarding actions and | | | | symptoms of analgesic |
| possessions; poorly concealed attempts to avoid | | | | abuse, it may be indicated by frequent visits to |
| attention and suspicion such as frequent trips to | | | | different physicians or |
| storage rooms, restroom, basement, etc.II. Specific: | | | | dentists for prescriptions to treat pain of non-specific |
| DSM-IV Definition of Addiction | | | | origin. In cases |
| A maladaptive pattern of substance use, leading to | | | | where patient has chronic pain and abuse of |
| clinically significant impairment or distress, as | | | | medication is suspected, |
| manifested by three (or more) of the following, | | | | it may be indicated by amounts and frequency |
| occurring at any time in the same 12-month period:(1) | | | | taken.Inhalants: Substance odor on breath and clothes. |
| Tolerance, as defined by either of the following:a. A | | | | Runny nose. |
| need for markedly increased amounts of the | | | | Watering eyes. Drowsiness or unconsciousness. Poor |
| substance to achieve intoxication or desired effect.b. | | | | muscle control. |
| Markedly diminished effect with continued use of the | | | | Prefers group activity to being alone. Presence of |
| same amount of the substance.(2) Withdrawal, as | | | | bags or rags |
| manifested by either of the following:a. The | | | | containing dry plastic cement or other solvent at |
| characteristic withdrawal syndrome for the | | | | home, in locker |
| substanceb. The same (or a closely related) | | | | at school or at work. Discarded whipped cream, |
| substance is taken to relieve or avoid withdrawal | | | | spray paint or |
| symptoms. (3) The substance is often taken in larger | | | | similar chargers (users of nitrous oxide). Small bottles |
| amounts or over | | | | labeled |
| a longer period than was intended (loss of control).(4) | | | | "incense" (users of butyl nitrite).Solvents, Aerosols, |
| There is a | | | | Glue, Petrol: Nitrous Oxide - laughing gas, whippits, |
| persistent desire or unsuccessful efforts to cut down | | | | nitrous. |
| or control | | | | Amyl Nitrate - snappers, poppers, pearlers, rushamies. |
| substance use (loss of control). (5) A great deal of | | | | Butyl Nitrate - locker room, bolt, bullet, rush, climax, red |
| time is spent | | | | gold. Slurred speech, |
| in activities necessary to obtain the substance, use | | | | impaired coordination, nausea, vomiting, slowed |
| the substance, | | | | breathing. Brain damage, |
| or recover from its effects (preoccupation).(6) | | | | pains in the chest, muscles, joints, heart trouble, severe |
| Important social, | | | | depression, fatigue, |
| occupational, or recreational activities are given up or | | | | loss of appetite, bronchial spasm, sores on nose or |
| reduced | | | | mouth, nosebleeds, |
| because of substance use (continuation despite | | | | diarrhea, bizarre or reckless behavior, sudden death, |
| adverse | | | | suffocation.LSD/Hallucinogens: Extremely dilated pupils, |
| consequences).(7) The substance use is continued | | | | (see note below). Warm |
| despite | | | | skin, excessive perspiration and body odor. Distorted |
| knowledge of having a persistent or recurrent physical | | | | sense of sight, hearing, |
| or | | | | touch; distorted image of self and time perception. |
| psychological problem that is likely to have been | | | | Mood and behavior changes, |
| caused or | | | | the extent depending on emotional state of the user |
| exacerbated by the substance (adverse | | | | and environmental conditions |
| consequences).III. Specific: Pupil DilationBefore you do | | | | Unpredictable flashback episodes even long after |
| anything, consider | | | | withdrawal |
| this. There are two trains of thought prior to detection | | | | (although these are rare). Hallucinogenic drugs, which |
| and | | | | occur both |
| intervention. One thought is to catch and punish, and | | | | naturally and in synthetic form, distort or disturb |
| the | | | | sensory input, |
| other is to identify and help- remember why you are | | | | sometimes to a great degree. Hallucinogens occur |
| doing | | | | naturally in |
| this, and the intervention will turn out much better.Note: | | | | primarily two forms, (peyote) cactus and psilocybin |
| A 6mm, 7mm, or 8mm pupil size could indicate that a | | | | mushrooms. |
| person is | | | | Several chemical varieties have been synthesized, |
| under the influence of cocaine, crack, meth., | | | | most notably |
| hallucinogens, crystal, | | | | LSD, MDA , STP, and PCP. Hallucinogen usage |
| ecstasy, or other stimulant. A 1mm or 2mm pupil size | | | | reached a peak |
| could | | | | in the United States in the late 1960's, but declined |
| indicate a person under the influence of heroin, | | | | shortly |
| opiates, or other | | | | thereafter due to a broader awareness of the |
| depressant. A pupil close to pinpoint could indicate use. | | | | detrimental effects |
| A pupil completely dilated could indicate use. | | | | of usage. However, a disturbing trend indicating a |
| Blown out wide pupils are indicative of crack, | | | | resurgence in |
| methamphetamine, cocaine, stimulant use. Pinpoint | | | | hallucinogen usage by high-school and college age |
| pupils are indicative of heroin, opiate, depressant use. | | | | persons |
| (Click this link for pictures)Other causes of pupil | | | | nationwide has been acknowledged by law |
| dilationIV. Specific: Signs and SymptomsAlcohol: Odor | | | | enforcement. With the |
| on the breath. Intoxication. Difficulty focusing: glazed | | | | exception of PCP, all hallucinogens seem to share |
| appearance of the eyes. Uncharacteristically passive | | | | common effects |
| behavior; or combative | | | | of use. Any portion of sensory perceptions may be |
| and argumentative behavior. Gradual (or sudden in | | | | altered to varying |
| adolescents) deterioration | | | | degrees. Synesthesia, or the "seeing" of sounds, and |
| in personal appearance and hygiene. Gradual | | | | the "hearing" of |
| development of dysfunction, | | | | colors, is a common side effect of hallucinogen use. |
| especially in job performance or school work. | | | | Depersonalization, |
| Absenteeism (particularly on | | | | acute anxiety, and acute depression resulting in suicide |
| Monday). Unexplained bruises and accidents. Irritability. | | | | have also been |
| Flushed skin. | | | | noted as a result of hallucinogen use. Note: there are |
| Loss of memory (blackouts). Availability and | | | | some forms of |
| consumption of alcohol | | | | hallucinogens that are considered downers and |
| becomes the focus of social or professional activities. | | | | constrict pupil diameters.PCP: Unpredictable behavior; |
| Changes in | | | | mood may swing from passiveness to |
| peer-group associations and friendships. Impaired | | | | violence for no apparent reason. Symptoms of |
| interpersonal | | | | intoxication. Disorientation; |
| relationships (troubled marriage, unexplainable | | | | agitation and violence if exposed to excessive |
| termination of | | | | sensory stimulation. Fear, |
| deep relationships, alienation from close family | | | | terror. Rigid muscles. Strange gait. Deadened sensory |
| members).Marijuana/Pot: Rapid, loud talking and bursts | | | | perception |
| of laughter in | | | | (may experience severe injuries while appearing not |
| early stages of intoxication. Sleepy or stuporous in the | | | | to notice). |
| later stages. | | | | Pupils may appear dilated. Mask like facial |
| Forgetfulness in conversation. Inflammation in whites | | | | appearance. Floating |
| of eyes; pupils | | | | pupils, appear to follow a moving object. Comatose |
| unlikely to be dilated. Odor similar to burnt rope on | | | | (unresponsive) |
| clothing or breath. | | | | if large amount consumed. Eyes may be open or |
| Tendency to drive slowly - below speed limit. | | | | closed.Ecstasy: Confusion, depression, headaches, |
| Distorted sense of time passage - tendency to | | | | dizziness (from |
| overestimate time intervals. Use or possession of | | | | hangover/after effects), muscle tension, panic attacks, |
| paraphernalia including roach clip, packs of rolling | | | | paranoia, |
| papers,pipes or bongs. Marijuana users are difficult to | | | | possession of pacifiers (used to stop jaw clenching), |
| recognize unless they are | | | | lollipops, |
| under the influence of the drug at the time of | | | | candy necklaces, mentholated vapor rub, severe |
| observation. Casual users | | | | anxiety, sore |
| may show none of the general symptoms. Marijuana | | | | jaw (from clenching teeth after effects), vomiting or |
| does have a distinct | | | | nausea |
| odor and may be the same color or a bit greener | | | | (from hangover/after effects) |
| than tobacco.Cocaine/Crack/Methamphetamines | | | | Signs that your teen could be high on Ecstasy: Blurred |
| Stimulants: Extremely dilated | | | | vision, |
| pupils. Dry mouth and nose, bad breath, frequent lip | | | | rapid eye movement, pupil dilation, chills or sweating, |
| licking. Excessive | | | | high body |
| activity, difficulty sitting still, lack of interest in food or | | | | temperature, sweating profusely, dehydrated, |
| sleep. Irritable, | | | | confusion, faintness, |
| argumentative, nervous. Talkative, but conversation | | | | paranoia or severe anxiety, trance-like state, |
| often lacks | | | | transfixed on sites and |
| continuity; changes subjects rapidly. Runny nose, cold | | | | sounds, unconscious clenching of the jaw, grinding |
| or chronic | | | | teeth, very |
| sinus/nasal problems, nose bleeds. Use or possession | | | | affectionate.V. |