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Module 4: Drugs & Mental Health

“Date Rape” Drugs

Flunitrazepam, also known as Rohypnol (called “roofies”), is commonly associated with “date rape” in popular culture, in part due to its effect of inducing a partial amnesia, but the empirical evidence of widespread use is thin. Possible reasons for this are because the post-use symptoms replicate a hangover, most rapes go unreported, the victim has no memory of the event, and Rohypnol generally cycles out of a user’s system in a matter of hours. If you suspect someone has been provided Rohypnol, the test must be done as soon as possible to maximize the possibility of detection. 

 

However, the absence of significant numbers of reported Rohypnol-induced rapes likely is because a predator does not need to slip anyone a “roofie” when abundant numbers of young people willingly ingest copious quantities of alcohol on any given weekend.  Alcohol is the predator’s weapon of choice.

 

Unfortunately, some students will willingly ingest Rohypnol, often to enhance their “clubbing” experience, leaving them extremely vulnerable to assault and other crimes.  

Prescription Drugs

We assume you are generally familiar with illegal street drugs through other sources, and are so we therefore focusing the drug portion of this module on prescription opioids.  But first, watch this personal story from New Jersey Governor Chris Christie:

What are Opioids?

Prescription opioids are medications that are chemically similar to endorphins – opioids that our body makes naturally to relieve pain – and also similar to the illegal drug heroin.  In nature, opioids are found in the seed pod of the opium poppy plant. Opioid medications can be natural (made from the plant), semi-synthetic (modified in a lab from the plant), and fully synthetic (completely made by people).

Prescription opioids usually come in pill form and are given to treat severe pain—for example, pain from dental surgery, serious sports injuries, or cancer. Opioids are also commonly prescribed to treat other kinds of pain that lasts a long time (chronic pain), but it is unclear if they are effective for long term pain.

 

Dependence and addiction are potential risks when taking prescription opioids. Dependence means you feel withdrawal symptoms when not taking the drug. Continued use can lead to addiction, where you continue to use despite negative consequences. These risks increase when these medications are misused. Prescription medications are some of the most commonly misused drugs by teens, after tobacco, alcohol, and marijuana.

Common Opioid types include:
  • oxycodone (OxyContin, Percodan, Percocet)

  • hydrocodone (Vicodin, Lortab, Lorcet)          

  • diphenoxylate (Lomotil)                                 

  • morphine (Kadian, Avinza, MS Contin)       

  • codeine

  • fentanyl (Duragesic)

  • propoxyphene (Darvon)

  • hydromorphone (Dilaudid)

  • meperidine (Demerol)

  • methadone

Fentanyl has been in the news recently as associated with the death of the musician Prince.  It is a powerful opioid prescribed for extreme pain that is 50 to 100 times more potent than morphine. It is extremely dangerous if misused, and is sometimes added to illicit drugs sold by drug dealers. 

 

A mix of prescription drugs, including the opioid Demerol, almost certainly played a role in the decline and death of music legend Elvis Presley.

How Prescription Opioid Medications Are Misused:

People misuse prescription opioid medications by taking them in a way that is not intended, such as:

  • Taking someone else’s prescription, even if it is for a legitimate medical purpose like relieving pain.

  • Taking an opioid medication in a way other than prescribed—for instance, taking more than your prescribed dose or taking it more often, or crushing pills into powder to snort or inject the drug.

  • Taking the opioid prescription to get high.

  • Mixing them with alcohol or certain other drugs.

  • Sharing unused pain relievers, unaware of the dangers of nonmedical opioid use. Most adolescents who misuse prescription pain relievers are given them for free by a friend or relative.

 

The prescribing rates for opioids among adolescents and young adults nearly doubled from 1994 to 2007.

The Link Between Prescription Drugs and Heroin.

Prescription opioids are chemically closely related to heroin, and their effects, especially when misused, can be very similar. Prescription opioids and heroin have similar chemical properties and physiological impacts; when administered by the same method (i.e., ingested or injected), there is no real difference for the user.  Because heroin may be cheaper to get, people who have become addicted to prescription pain medications sometimes switch to using heroin. Nearly 80 percent of people addicted to heroin started first with prescription opioids. About 4 percent of people who misuse prescription opioids transition to heroin. But because millions of people are using prescription opioids, this adds up to hundreds of thousands of heroin users.

Prescription Drug Overdoses

People overdose and die from prescription opioid misuse. In fact, taking just one large dose could cause the body to stop breathing.

 

Deaths from overdoses of prescription drugs have been increasing since the early 1990s, largely due to the increase in misuse of prescription opioid pain relievers. Drug overdose is now the leading cause of accidental death in the United States, with 52,404 lethal drug overdoses in 2015. Nearly 23,000 people died from an overdose of a prescription pain medication in 2015, with alarming increases among young people ages 15 to 24. There were 12,990 overdose deaths related to heroin in 2015.

 

The risk of overdose and death increase if you combine opioids with alcohol or other medications that also slow breathing, such as Benzodiazepines (e.g. Xanax).

Signs of Overdose

 
Signs of a possible prescription opioid overdose are:
  • slow breathing

  • blue lips and fingernails

  • cold damp skin

  • shaking

  • vomiting or gurgling noise

 

People who are showing symptoms of overdose need urgent medical help (call 911 immediately). A drug called naloxone can be given to reverse the effects of an opioid overdose and prevent death—but only if it is given in time.

Mental Health

Mental illness is often but not always linked to drug and alcohol abuse. It is also a frequent motivator for active shooters and can both result from sexual abuse and contribute to or cause sexual abuse. Moreover, in 2016, suicide, which is almost always related to mental illness, became the second leading cause of death among teenagers and is the leading cause of death among college students. Please review the following two videos on mental health. 

At the conclusion of this module, invite the students to stand and work on ducking a punch and slap-aways.  Remember to tell the students to be very careful not to actually strike each other during this exercise.

For a video on slap-aways and fast running technique, watch the video below:

MODULES