Alcohol, Tobacco and Other Drugs (ATOD)

The depressant class of drugs, also known as “downers,” works by increasing the brain’s amount of the neurotransmitter GABA. This slows brain function and depresses the central nervous system. The most commonly known depressant drug is alcohol, which is consumed in liquid form. There are also many prescription pills classed as depressants. Prescription depressants include: Benzodiazepines a.k.a. “benzos” (e.g. Valium, Xanax), Sedatives a.k.a. sleeping pills (e.g. Ambien, Lunesta), Barbiturates (e.g. Seconal, Nembutal).

People who use depressants report benefits like:

• feelings of calm and relaxation
• prescription depressants can help them treat anxiety, muscle spasms, sleeplessness and other conditions 

Someone experiencing the effects of a depressant drug: 

• at low doses, may be more talkative or bold
• at higher doses, may be confused or uncoordinated
• at very high doses, their breathing may slow or stop

Potential risks and harms of depressants:

• Depressants can affect decision-making, causing people to say or do things they normally wouldn’t.
• Because depressants slow bodily functions, too much can cause someone to stop breathing and possibly die.
• Long term use can lead to physical dependence and addiction.

Alcohol

Low to moderate amounts of alcohol can produce feelings of relaxation, lowered inhibitions, and increased sociability. Larger amounts can cause dizziness, nausea, slurred speech, slow reflexes, impaired judgement and dehydration. Overdoses and drinking too much in one sitting can cause blackouts (having no memory of what took place), passing out, coma, and death.

Alcohol poisoning is when someone drinks so much alcohol that its depressant effects begin to shut down basic life support functions such as breathing, heart rate and temperature control. One of the reasons it occurs is that many people don’t actually know how much alcohol is in what they’re drinking—the dose.

We can refer to standard drink for dosage of alcohol. A standard drink is defined as 12 oz. of beer at 5% alcohol, 5 oz. of wine around 12% alcohol, or 1.5 oz. of liquor at 40% alcohol. It takes about 60-90 minutes for someone to metabolize one standard drink of alcohol.

It’s possible to overdose on any depressant drug on its own, so combining two—like “benzos” and alcohol drastically increases the risk of overdose and death.

Here are some signs that could indicate that someone has alcohol poisoning:

C – Cold, clammy skin

U – Unconsciousness

P – Puking, particularly while passed out

S – Slowed or irregular breathing

If someone shows signs of alcohol poisoning call 911 and place the person in the recovery position.

Here are some strategies to reduce alcohol related harms:

• Abstaining from alcohol.
• Avoid driving after drinking or riding in cars with people who drink and drive — instead have a designated driver or use rideshare. 
• Avoid going places where underage drinking is occurring.
• Decide or set a limit on number of drinks.
• Pace and space out drinking.
• Avoid mixing substances.
• Make sure that no one is driving if they were drinking.
• See that people are getting home safely and leaving with someone they know and trust.
• Know drug policy.

Please complete this form if you would like to talk with a health educator about alcohol and other drugs: https://forms.office.com/r/twb9DLN4iW 
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Less is More Fact Sheet (pdf)
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Cannabis, also known as marijuana, is a plant. It can also be made into concentrated forms put into oils, butter, and a sticky substance called “wax” or “shatter.”

It first grew in Asia and has thousands of years of history of human use. It is the most commonly used illicit drug.

Cannabis is most commonly smoked or vaped but it can also be consumed in products called “edibles.”

Cannabis has over 400 identified chemical compounds. THC is the main psychoactive ingredient in cannabis: this chemical affects the mind and gets people ‘high.’ THC and other chemical compounds that do not cause psychoactive effects, like CBD, are all referred to as cannabinoids.

These mimic chemicals that are produced naturally in the brain as part of our endocannabinoid system.

The Effects of Cannabis

People who use cannabis report short-term benefits like:

• Relaxation and calm
• Stimulation or increased creativity
• Helping treat pain and anxiety, or encouraging appetite in cancer patients

Someone experiencing the short-term effects of cannabis:

• may laugh more easily
• may take a longer time to respond or seem distracted
• may feel nauseated, have mild hallucinations, or become paranoid at higher doses

Potential risks and harms of cannabis

• The effects of cannabis are sometimes hard to predict, and depend very heavily on the dose, the way it’s consumed and even the strain (type of cannabis plant).
• People can take too much cannabis and experience very uncomfortable highs and/or panic.
• Prolonged or habitual cannabis use can make mental health problems worse. Researchers are particularly concerned about the ways in which cannabis use could impact teenage brains, especially in people who start using it before age 18.
• Sometimes synthetic cannabinoids—which can cause shortness of breath, rapid heart rate, and sometimes death—are sold as cannabis.

Examples of opioids include heroin, oxycodone (OxyContin/Percocet), Fentanyl, Morphine, Codeine, and Hydrocodone(Vicodin). 

Fentanyl is a synthetic opioid. It is one of the most potent opioids approved for medical use. Recently fentanyl is often produced illicitly—outside of the legal regulatory system—and many related compounds (analogues) have been appearing that have no prior use in medicine. Fentanyl’s effects are generally the same as other opioids like heroin, but because of the drug’s potency, they often appear faster and can last longer. Recent reports have found fentanyl mixed with other drugs like cocaine, meth, heroin, MDMA(Molly), and counterfeit pills posing as Xanax, Oxycodone, Adderall, and more.

The way an opioid is taken may increase harm. Opioids may be taken orally, snorted, smoked, or injected with a syringe (needle).

People who use opioids may report benefits like pain relief, sedation, and feelings of euphoria. Someone experiencing the effects of an opioid drug may have small contracted pupils, loose muscles, slurred speech, fall asleep unexpectedly, may have erratic or slow breathing, or in the case of an overdose, stop breathing entirely.

Overdose is common with any form of opioid, and can be fatal. The risk of overdose increases when opioids are mixed with other drugs.

If someone is overdosing, they will be:

• Unresponsive to touch or voice
• Not breathing or breathing will be slow and uneven
• Gasping or gurgling sounds
• Skin, fingernails, or lips are blue or purple

Follow these steps when responding to an overdose

STEP 1. Identify opioid overdose and check for a response. Stimulate them awake by yelling their name and administering a hard sternum rub to the chest plate.

STEP 2. If you have naloxone/Narcan, use it. Administer one dose every two minutes.

• Nasal: Stick the device up one nostril and click the plunger

STEP 3. Call 911, explain someone is not responsive and not breathing

STEP 4. Provide rescue breathing

• Get the person on their back, tip their head back to straighten the airway, pinch their nose, put your mouth over theirs, and form a seal, one breath every five seconds

STEP 5. When the person starts to breathe regularly on their own, roll them into a recovery position on their side

STEP 6. Stay with the person until help arrives. Be gentle with them and yourself afterwards!

Reducing Overdose Risk

Don’t use alone. Have someone check on you if you like using alone. That way, if you do overdose, someone can intervene.

Have an overdose response plan. Having a plan to assist people helps to ensure that an overdose is not fatal.

Don’t mix drugs (including alcohol). Fentanyl is a dangerous drug but in combination with other drugs, the risk of overdose is much greater.

Learn how to use fentanyl test strips. Knowing what’s in your drugs can help you decide how much and how best to use them.

Always carry Narcan/naloxone. Be familiar with the signs of an overdose and be prepared to respond with naloxone, no matter what drug you’re using.

Get Naloxone Now is a free online resource to train people to respond effectively to an opioid overdose emergency. Access the training here https://www.getnaloxonenow.org/#gettraining

Recovering from Opioid Overdose Resources

Substance Abuse and Mental Health Services Administration (SAMHSA)

• National Helpline: 1-800-662-HELP (4357) or 1-800-487-4889 (TDD, for hearing impaired)
• Behavioral Health Treatment Services Locator (search by address, city, or ZIP Code):

https://findtreatment.samhsa.gov/

• Buprenorphine Treatment Practitioner Locator (search by address, city, or ZIP Code):

https://www.samhsa.gov/medication-assisted-treatment/physician-program-data/treatment-physicianlocator

• Single State Agencies for Substance Abuse Services: https://www.samhsa.gov/sites/default/files/ssadirectory.pdf
• State Opioid Treatment Authorities: https://dpt2.samhsa.gov/regulations/smalist.aspx

If you or someone you know uses recreational drugs or prescription drugs for reasons other than what they were prescribed for, the following tips and resources can be helpful to reduce harm and unintended outcomes.

1. Know how to refuse if you don’t feel like using drugs. Its ok to say “no”, or to give a reason like “I don’t like how it makes me feel” or “I have to get up early tomorrow”.
2. If you do use a drug, keep in mind that it might make you less likely to remember to drink water, eat, and/or get enough sleep.
3. Drugs vary in their potency, effects, and how long they take to work, so never drive after taking drugs. The motto “go low and start slow” is good to remember and means start with a low dose and wait for a while before using more of a substance.
4. Mixing different types of drugs, or mixing drugs with alcohol can increase negative outcomes and should be avoided.
5. When using a recreational drug or a prescription drug given to you by someone other than a medical provider, you never know for sure what is actually in that drug. The only way to be sure is by using a drug testing kit from places like dancesafe.org.
6. Using drugs can impair your decision making abilities and can increase chances for unprotected or unwanted sexual activity.
7. Always use the “buddy system” if you or someone you know chooses to use drugs. This means that you stay with a person and they stay with you, and that you look out for one another to avoid overdose and other unintended consequences.

Below are more resources to reduce harm from drug use:

• Recognize the signs of overdose [pdf]
• Safer Partying Checklist [pdf]
• Helping someone who is using drugs [pdf]

Although there are many types of stimulant drugs, what they have in common is their ability to excite or stimulate the body’s central nervous system through a release of neurotransmitters like dopamine and norepinephrine, a neurotransmitter related to adrenaline.

Stimulants may be taken orally, as in the case of prescription pills, or snorted, smoked or injected.

Examples of stimulants include:

• Nicotine
• Cocaine/Crack cocaine
• Amphetamines: brand names include Benzedrine
• aka bennies, Adderall, and Vyvanse
• Methamphetamines: aka crystal meth/ice/speed
• Caffeine
• Methylphenidate: brand names include Ritalin and Concerta

People who use stimulants report effects like:

• increasing energy
• increasing alertness and focus
• suppressing appetite
• improving mood

Someone experiencing the effects of a stimulant drug:

• May feel euphoric and experience a rush of confidence.
• May display signs such as dilated pupils, sweating, increased heart rate and elevated temperature.
• Using stimulants can also increase mental acuity, making people feel like their thoughts are sharper and faster. They may have a lot of different ideas that they need to share, and they may act giddy or restless.

Potential risks and harms of stimulants

• Stimulants can actually decrease focus by making people feel jittery, anxious and irritable, and can impair judgement and contribute to poor impulse control. 
• Stimulants can make it difficult to sleep and increase urination, leading to dehydration. 
• They can also dangerously raise blood pressure and cause heart palpitations. 
• Using stimulants in excess can result in physical and/or psychological dependence. 

Harm reduction strategies for using stimulants

• One of the biggest risks of stimulant and cocaine use is “over-amping.” “Over-amping” is the term used to describe what is considered an overdose but for stimulants such as cocaine. The effects of this can be physical or psychological, and can include extreme anxiety, paranoia and hallucinations.
• People who have used cocaine try to reduce harm by using the smallest amount possible and waiting between doses.
• The effects of over-amping can be reduced by hydrating, eating food, getting sleep, breathing, exercise, walking, taking a warm shower and getting fresh air.

• Cocaine alone adversely affects the heart, and drinking alcohol with it adds to that risk. The combination of cocaine and alcohol together or even within a few hours of one another can be extremely risky because it increases heart rate and blood pressure, which further heightens the risk of a heart attack. 

• Prescription stimulants like Adderall are powerful substances that are actually chemically similar to illegal drugs like amphetamine and methamphetamine.
• If you are prescribed Adderall or another prescription stimulant, it is important that you adhere to your proper dose and dosage.

Education, workshops and groups can help to reduce or eliminate negative outcomes associated with drug and alcohol use. We integrate motivational interviewing and harm reduction strategies in our services.

Motivational interviewing is a person-centered approach that addresses someone’s mixed feelings to change an aspect of their substance use. Harm reduction is helpful for those who do not wish to abstain from substances, but prefer to reduce frequency and any harms associated with use.

Here are some examples of the services provided at the Wellness Center.

One-on One session with a health educator, where students can learn more about drugs or talk about their own drug use expectations, behaviors, triggers and stress. You can request a one-on-one session here  

Group workshops or lectures, where students can learn about drugs with classmates or friends. You can request a workshop here  

SMART Recovery on-line group meetings for those who want to abstain from or stop using alcohol or drugs. SMART Recovery meetings can be found on Mybar.

Narcan Distribution Program complete this form to request Narcan Nasal Spray 

Nicotine Replacement Therapy 

Screen U for alcohol, prescription medication and cannabis is a resource that can help you identify if you are experiencing negative consequences because of your alcohol or drug use. Based on your responses, you will receive non-judgmental feedback encouraging you to think about your choices that may be putting you at risk for harmful consequences. It can also provide ways for you to keep yourself and your friends safer.

Screen U for Alcohol 

Screen U for Prescription Medication  

Harm reduction is a set of strategies that encourages the safest and healthiest choice based on someone’s circumstances. Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. It incorporates a spectrum of strategies that includes safer use, managed use, and/or abstinence.

Drug Checking

Drug checking, also known as pill checking or adulterant screening, is a harm reduction service that allows people to get more information about what is in their drugs.

The best way involves a precise, high- level testing method called gas chromatography / mass spectrometry (GC/MS). Individuals can send a sample in to drugsdata.org for testing at a lab and wait 2 to 3 weeks for the lab results to be posted online.

Personal drug checking kits, which use liquid chemical reagents to help potential users get a better understanding of what’s in their substance. These kits come with a color chart that helps people determine what drug is mostly present in the substance they’ve tested. Drug checking kits are available through Dance Safe 

Fentanyl testing strips , originally designed for urine drug tests, are now being used off label to test for the presence or absence of fentanyl and fentanyl analogs in the illicit drug supply. Fentanyl testing strips work by dissolving a small sample of a drug into water, insert a test strip, and look for an indicator line alerting the user to the presence of fentanyl. Dance Safe provides specific instructions on how to check drugs for fentanyl https://dancesafe.org/product/fentanyl-testing-strips-instruction-sheets/

Additional Harm Reduction Strategies:

• Abstinence
• Develop drug knowledge
• Learn dose and dosage
• Start low and go slow
• Consider moderation
• Consider mindset and setting before using drugs
• Avoid mixing substances
• Know how to respond to an emergency
• Know drug policy

Please complete this form if you would like to talk with a health educator about harm reduction strategies 

Harm Reduction Resources

Erowid 

Dance Safe 

Drugs Data 

• Blood Alcohol Content: Virtual Bar
• EROWID: Psychoactive Plants and Drugs
• Quit Smoking Services
  • 1-800-NO-BUTTS
    1-800-844-CHEW
  • 1-800-QUIT-NOW
  • Cessation Support by Text
    Free Virtual Recovery Support
    Smart Recovery
    QuitGuide
    QuitSTART app