Lecture 19: substance use

Question 1

According to the Canadian Centre on Substance Use and Addictions, the main addictions in Canada are:

Answer 1

alcohol (most commonly used)
cannabis
cocaine
gambling
methamphetamines
opioids / prescriptions drugs

Question 2

Factors that play a role in substance use and addiction include:
homelessness

Answer 2

socioeconomic status – those who live in lower income areas are the heaviest impacted
pre-existing mental health condition
race and ethnicity (there is an SDL on opioid crisis within First Nations community)
gender (males are impacted more than females)
personal history of trauma and abuse

Question 3

One of the most effective strategies for reducing alcohol harm

Answer 3

alcohol pricing policies and creening for heavy drinking

Question 4

Canadians wth lowest incomes report

Answer 4

less heavy drinking
>< more likely to be hospitalized for conditions entirely caused by alcohol

possible reasons:
higher stress levels
limited social supports
poor diet and physical inactivitity

Question 5

low-risk alcohol drinking guidelines in Canadanewly released guidelines (January 2023) - ALCOHOL INTAKE: standard drinks

Answer 5

• no risk: 0
• low 1-2
• moderate 3-6
• high 7+

Question 6

low-risk alcohol drinking guidelines in Canadanewly released guidelines (January 2023) - health consequences of drinking

Answer 6

cancer (especially breast cancer in women); heart disease; stroke

Question 7

What do cancer specialists want to add to liquor labels?

Answer 7

add warning labels, similar to what is on cigarette packaging

Question 8

Potential benefits of cannabis

Answer 8

may help those with an alcohol or opioid addiction
might help to relieve symptoms of depression, PTSD and anxiety
might help alleviate side effect in chemotherapy treatment of cancer
might help with certain medical conditions (MS, epilepsy)

Question 9

Health risks of cannabis

Answer 9

exacerbate mental health issues (e.g. bipolar disorder, schizophrenia)
cyclic vomiting syndrome (severe vomiting and abdominal pain)
2-3x increases risk of vehicular accidents caused by impaired driving
accidental use by children (e.g. gummies)
decrease in size of hippocampus; decrease in attention, planning, decision-making; frequent use in youth is related to reduction in IQ
low growth hormone, thyroid hormone (related to metabolism, brain function)

brain changes specifically related the THC, the psychoactive component of cannabis
hypotension = low blood pressure
copd = chronic obstructive pulmonary disorders (classification of lung disease)
teratogenesis = changes DNA expression and/or mutates DNA

Question 10

CBD OIL

Answer 10

non-psychoactive ingredient from cannabis (contains less than 1% THC

Question 11

Reasons to take CBD

Answer 11

reducing stress, anxiety, nervousness
reduce inflammation related to autoimmune disease
minor join and muscle pain
helping to promote sleep

Question 12

Side effects of CBD use

Answer 12

cotton mouth
dwosiness
may interfere with other medication
diarrhea or liver problems
nausea

Question 13

What is an opioid?

Answer 13

A substance that is a pain-reliever, and can induce euphoria (feeling high)
* codeine
* fentanyl
* morphine
* oxycodone
* hydromorphone
* medical heroin

Question 14

Opioid use data

Answer 14

is a Canadian health concern. Quebec has the 4th highest rate of opioid-related deaths in Canada.

Question 15

Opioid overdose

Answer 15

take too much of an opioid.
=> affect the part of your brains that controls your breathing => breathing slows => unconsciousness and even death

Question 16

The opioid drug supply is tainted by several drugs that are increasing risk of death. These include:

Answer 16

Cocaine
methamphetamines (meth, crystal meth)
***Benzodiazepines – a depressant drug to aid with sleeping.

Question 17

Can administration of nalozone treats benzodiazepine overdoze

Answer 17

no

Question 18

The most common method of opioid use that contributed to death was

Answer 18

smoking

Question 19

Naloxone

Answer 19

is a fast-acting drug used to temporarily reverse the effects of opioid overdoses.

restore breathing within 2-5 minutes

works by kicking opioids off the receptors in your brain => binding those receptors => reversing/blocks the effect

Question 20

Naloxone only works if you have opioids in your system, such as:

Answer 20

fentanyl
heroin
morphine
codeine

Question 21

Signs of opioid overdose

Answer 21

blue lips or nails
dizziness and confusion
can’t be woken up
chocking, gurgling or snorling sounds
slow, weak or no breathing
drowsiness or difficulty staying awake

Question 22

suspect an overdose, do

Answer 22

call 911
administer naloxone
stay

Question 23

The four pillars in reducing drug and alcohol addiction

Answer 23

prevention
treatment
harm reduction
justice & community safety

Question 24

services that are important in support of drug and alcohol use:

Answer 24

community support
harm reduction support
case management
advocating for participants
medication delivery
crisis support
housing supports
income supports and drug coverage
legal support
cultural programming
referrals to other services

Question 25

Positive impact on participants having access to safer supply of drugs

Answer 25

improved health, wellbeing and quality of life
decreased overdose risk
addressed mental health and chronic diseases
more energy and more active
eat and sleep better
becoming housed and employed
increased stability
no longer engaged in survival sex work
improved relationship
hopeful

Question 26

Why is there disproportional substance use amongst the First Nations population?

Answer 26

• they come from other places and have been blighted by colonialism and sexual abuse
  and physical abuse (by church authorities)

Question 27

Why is the gap getting bigger? (First Nation and substance use)

Answer 27

racial stigma
access to treatment
social deteminants
intergenerational trauma

Question 28

What are the 4 pillars of framework in people with substance use?

Answer 28

1. PREVENT PEOPLE
   WHO OVERDOSE
   FROM DYING
2. harm reduction: keep people safe when using
3. CREATE AN
   ACCESSIBLE RANGE
   OF TREATMENT
   OPTIONS
4. SUPPORT PEOPLE
   ON THEIR
   HEALING JOURNEY

Question 29

During Covid, Quebec population gambled online

Answer 29

increased
because there’s no access to onsite gambling, to have fun or pass time, isolation and loneliness

Question 30

serotonin and dopamine influence behaviour and substance addiction

Answer 30

The act of gambling releases serotonin, increasing feelings of relaxation (mood stabilizer) therefore reinforcing the behavior.

In risk-taking behaviours (e.g. gambling) dopamine is released, and this neurological feeling of pleasure/reward reinforces the addiction
that some gamblers have low serotonin levels.

This low serotonin level can be genetic or due to environment (e.g. traumatic event).

Question 31

Reasons for gambling

Answer 31

Financial issues, recent life trauma or loss, experiencing loneliness
Some medications may render some individuals more susceptible, e.g. medications given for Parkinson’s disease
Some conditions such as schizophrenia, bipolar disease, alcohol or cocaine addiction may increase likelihood
genetic/neurological (e.g. serotonin deficiency)
gender: most serious gamblers are male
easy accessibility: phone apps, online, terminals, casinos…

Question 32

GA

Answer 32

Gamblers anonymous, to
help someone that might be affected by gambling

Question 33

. Are the recovery steps written in any particular order? Why?

Answer 33

Yes, they need to be
done in order so that if someone tells you to get lost you can handle it emotionally.

Question 34

Is my issue a financial issue or something else?

Answer 34

Gambling was never a financial
problem, it was an emotional problem

Question 35

What is sponsorship? What’s its importance?

Answer 35

A sponsor is someone who’s been in that
position before abd they are there to help the gambler overcome their addiction

Question 36

Will I ever gamble normally again?

Answer 36

NO, but have to think of it as a day by day process.