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SUBSTANCE ABUSE TRAINING MANUAL Information Guide for Peer Educators NCDA Field Department FIELD SERVICES DEPARTMENT Table of Contents Contents Training Objectives: . 4 Course Outline: . 5 The National Council on Drug Abuse- Structure, Objectives, and Operations. 5  Categories of drugs . 5 Commonly abused substances – alcohol, tobacco, marijuana, crack cocaine, amphetamines, steroids. 5  History . 5  Characteristics . 5  Effects of these substances on the person . 5  Signs and Symptoms of Usage . 5 Understanding Addiction . 5  Tolerance . 5  Dependence . 5  Addiction . 5  Programmes for Treatment and Rehabilitation . 5  Available Centres . 5  Coping Skills . 5
 Resistance Skills . 5
 Decision Making Skills . 5
 Positive Self Esteem/Self Worth/Values . 5
 Healthy Lifestyle/Physical Condition . 5
What is a Drug? . 7
Legal &Illegal Substances . 8
Legal Substances . 8 Illegal Drugs . 8 Understanding Drug Addiction . 17 How Drugs work in the brain . 17 Life Skills . 19 Coping and Self-Management Skills . 20 Where to get Treatment Help . 21 National Council on Drug Abuse Substance Abuse Prevention Training Manual for Peer Educators Training Objectives:  To educate Peer Educators about the effects, dangers and impact of substance use  To build a cadre of persons who will be able to address substance abuse related issues in their field of work Course Outline: Session 1 The National Council on Drug Abuse- Structure, Objectives, and  Definition of drugs  Categories of drugs  Reasons for use and abuse of drugs Commonly abused substances – alcohol, tobacco, marijuana, crack cocaine, amphetamines, steroids.  History  Characteristics  Effects of these substances on the person  Signs and Symptoms of Usage Understanding Addiction  Tolerance  Dependence  Addiction  Programmes for Treatment and Rehabilitation  Available Centres  Coping Skills  Resistance Skills  Decision Making Skills  Positive Self Esteem/Self Worth/Values  Healthy Lifestyle/Physical Condition FIELD SERVICE DIVISION NATIONAL COUNCIL ON DRUG ABUSE What is a Drug? Drugs: • Substances which affect, alter, or change the natural functions of the body. • The use of illicit drugs, prescription drugs or over the counter drugs for the purposes other than those for which they were indicated or in quantities other than directed. Substance Abuse: • Substance Abuse is defined as a pattern of harmful use of any substance for mood altering • The uncontrolled or unprescribed use/misuse/abuse of any such substance is defined as Drug/Substance Abuse Factors Contributing to Drug Use THE DRUG SUBSTANCE Psychological problems Historical Conditions  Curiosity  Boredom & Idleness  Inherited Tendencies  Early Influences/Following Examples  Dysfunctional Families  Lack of or Negative Parental Guidance  Inadequate Life Skills  Difficulty Coping with Depression & Stress  Poor Self Image/Self Esteem  Desire to feel good/high  Lack of Information  Misinformation/Myths  Feeling of Invincibility  Rebelliousness  Being deceived/tricked into using  Illiteracy  Mental Disturbance  Poor Physical Health/Illnesses  Unemployment  Lack of Business Opportunities  Lack of skills/educational qualifications  Cultural Acceptance of certain Drugs  Traditional & Adopted/Imported Cultural/Religious practices  Drugs used for socialisation/relaxation  Negative influences of Society/Societal Norms  Poor Physical Environment/Conditions of living etc Legal &Illegal Substances Legal Substances These are Drugs/Substances for which possession and use is legal and is not punishable by law e.g. • Alcohol • Tobacco • Prescribed & over the counter drugs Note: Driving under the influence of Alcohol is punishable by law Illegal Drugs These are Drugs/Substances whose use and/or possession is illegal and punishable by law e.g. • Marijuana(Ganja) • Crack/Cocaine • Heroin • The sale of Alcohol by to minors (persons under 18 yrs) Categories of Drugs Cocaine, Amphetamine, MDMA, Stimulate mood, stimulate Caffeine, and Nicotine processes of the body Alcohol, Benzodiazepines, Slows down the function of the Central Nervous System Impairment of attention processes and brain function. Glue, Solvents, Gases, etc. Depress CNS function and/ or block the passage of oxygen to the brain. Elevate mood, cause indifference, analgesia LSD, Datura (Joy Juice) Altered state of perception and feeling; user perceives things differently from reality. Drugs/substances are categorised based on how the drug affects the Central Nervous System. Stimulants These are substances that stimulate or speed up the brain and nervous system e.g. • Seasoned Spliff • Amphetamines • Nicotine (tobacco), • Caffeine (coffee, tea, Pepsi, etc), • Cocaine/Crack Depressants These are substances (sometimes used to treat mental or other illnesses) that depress or slow down the nervous system e.g. • Alcohol • Tranquilisers • Sleeping pills (e.g. valium) • Heroin. Marijuana It is the dried parts of the cannabis sativa plant and contains over 400 different chemicals. Probably brought to Jamaica in the 1840's by Indian migrants Grown & used in Jamaica for over 150 years Exported illegally for many years Illegal, although socially and culturally acceptable in some places Characteristics  Green, brown, or gray mixture of dried, shredded leaves of the hemp plant (cannabis sativa)  Contains over 400 chemicals, some unknown, some harmful, & some beneficial when extracted,  Canasol for glaucoma  Asmasol for asthma  Main ingredient-Tetrahydrocannabinol (THC)-causes some who use the drug to experience a calm euphoria (others react differently).  Scientific Names  Cannabis Sativa  Cannabis Indica  Ganja, Grass, Spliff  Weed, Weed of Wisdom  Sensimila, Sensi  Joint,  Herb, Callie, Callie Weed  Hash, Hash Oil Methods of Marijuana use • Dried, crushed, rolled in paper & smoked • Smoked in a chalice/pipe/chalwa • Can be swallowed in solid form • Eaten in/with food • Drunk as a tea/beverage Signs of Marijuana Use  Smell of ganja smoke on clothes/person  Burns on fingertips  Neglect of appearance  Loss of interest in most things  Loss of motivation  Possible weight loss/gain  Change in friends/peers  Change in sleep patterns Effects of Marijuana Use • Feel calm, relaxed & sleepy • Faster heartbeat • Reaction time slows down • Throat, mouth, and lips get dry • Eyes get bloodshot, eyesight blurs • Lose sense of time • Impaired perception • Heart & Lung damage • Lung cancer • Loss of memory • Lower ability to fight colds & flus • Lower sperm count & movement • Disrupts menstrual periods & ovulation Inhalants These are substances that when inhaled will cause mind altering effects. E.g. of these are normal household or office cleaners, glue, lighter fluid, white-out, gasoline. These are common household and other products/chemicals that give off mind altering fumes when sniffed or inhaled. e.g. normal household or office cleaners, glue, lighter fluid, white-out, gasoline. Easily available and accessible to the very young. Types  Volatile solvents: gasoline, paint thinners, glue, cleaning solutions.  Aerosols: spray paints etc.  Anesthetic agents: chloroform, ether, oil and grease dissolvers.  Amyl, butyl and isobutyl nitrites: room and car fresheners. Effects of Inhalants • Double vision, feel dizzy, get bad headaches, • Sick stomach, nausea, loss of appetite • Tired feeling, fatigue, hand tremors • Slows down body functions • Bad breath, Chemical odor • Aggressiveness • Careless about appearance • Red or runny eyes or nose • Speech gets slurred, lack of coordination • Sneeze, cough, get bloody noses • Vomiting, diarrhea, urinate & defecate without control • Moody, restlessness • Lack of concentration • Muscle loss, weak muscles • Liver, blood and bone marrow damage • Spots or sores around mouth • Permanent brain, lung, & kidney damage • Deadly when used with alcohol or other depressants • Death by suffocation Heroin This is an addictive substance made from Opium that goes to the brain and alters how the body works. It can be inhaled or injected. Heroin affects the part of the brain that controls emotions, pain and automatic body functions such as breathing and heart rate. Hallucinogens These are substances which cause the brain and the nervous system to produce images and/or sounds which are not real; these include • LSD (lysergic acid diethyl amide) • PCP (phencyclidine) • Marijuana/Ganja. (Note: Marijuana-Cannabis Sativa- may also stimulate or depress, and is often placed in a category of its own) • Comes from the plant Nicotiana Tabacum • Has been used for centuries • Contains thousands of chemicals • The main addictive substance is Nicotine • The addiction produced by Nicotine is as strong as that produced by Cocaine or Heroin • Is one of the Legal/Social Drugs • Is not widely thought of as a Drug. • Is very widely used and socially accepted. • Its manufacturing is a big industry and provides employment for many. • The manufacturers target Adolescents in their marketing strategies. Methods of Tobacco Use • Smoked in cigarettes, as cigars or in pipes • Chewed as tobacco • Sniffed Signs of Tobacco Use • Tobacco smell/bad breath • Stained teeth • Stained fingers-over the long term Effects of Tobacco Use Faster heart beat High blood pressure Relieves tension & tiredness  Lung & Heart damage  Lung, mouth, & throat cancer  Stomach ulcers  Reduces sense of taste & smell • Was an integral part of the slave system and the sugar economy • Is a byproduct of sugar cane • Was given to Slaves frequently as part of their "diet" • Is interwoven with the history, culture and social system • Is a socially & legally accepted drug (except for those under 18 yrs) • Scientific name is ethyl alcohol • Street names are:  Booze  Juice  Brew  Liquor  Waters  John Crow Batty Method of Alcohol Use • Liquid form only • Presented in varying strengths to encourage use, especially among the young people, e.g.  Wine coolers  Light beers  Tonic/stout Signs of Alcohol Use- Smell of Alcohol on the person Impaired muscle/limbs coordination Impaired judgment Slurred, slow speech Effects of Alcohol Use  Faster & weaker heart beat  Confusion & lack of concentration  Sick stomach & vomiting  Mood changes quickly to violence & depression  Permanent liver, heart & brain damage  Liver cancer  Stomach ulcers  High blood pressure  Alcoholism  Death from overdose  Death from road and other accidents  A combination of crack and ganja  Crack sprinkled on and rolled in ganja spliff Method of Use  Smoked Signs & Effects of Use:  Signs & Effects similar to those of Marijuana and Cocaine usage, in  Restlessness  Anxiety  Short term high followed by depression  White powdery substance  Not indigenous to Jamaica  Obtained from the Coca Plant which is found mainly in Bolivia & Peru  Importation may have started during the first quarter of the twentieth century  Not grown (although crack is produced) in Jamaica Crack  Crack is produced by "cooking' cocaine with baking soda  It is a more potent and addictive form of cocaine  It is cut up in small pieces (rocks) resembling small lumps of soap with the texture of porcelain Street Names  Coke  Crack  White lady Methods of Use o Snorted or inhaled in its pure form o Smoked as crack Effects of Cocaine/Crack Use  Faster heart beat  Blood pressure rises  Body temperature rises  Breathe faster  Can't sit still or sleep/Restlessness  Become more alert  Short term high followed by depression  Changes in sleeping/eating habits  Permanent lung damage  Holes & ulcers inside of the nose  Personality changes & violent behaviour  Fear of people & things (paranoia)  See things that aren't real (hallucinate)  Death from overdose Amphetamines These are chemically manufactured drugs which stimulate the Central Nervous System, e.g. Dexedrine, Biphetamine, Preludin, and Methedrine. Amphetamines are usually in the form of capsules, pills, and tablets. Scientific Names:  Amphetamines  Dextroamphetamine  Methamphetamine Street Names:  Speeds, uppers  Pep pills  Bennies  Crank  Dexies  Moth  Ice  Crystal  Black Beauties Methods of Use: • Swallowed as pills or as capsules • Inhaled into the nose • Injected into the veins • Excessive activity • Irritability • Nervousness • Mood swings • Needle marks Effects of Amphetamines  Loss of appetite  Hallucinations, paranoia, feelings of Alertness and Euphoria  Dizziness, headaches, blurred vision, and sweating  Dilation of pupils of the eyes  Loss of coordination, tremors, convulsions, and physical collapse  Sudden increases heart rate & blood pressure from injections resulting in fever, stroke, or heart failure  Nervousness, irritability and drastic mood swings  User can go without sleep for long periods  Causes distorted thinking  Anorexia and malnutrition resulting from decreased appetite  Coma  Brain damage  Death from overdose Understanding Drug Addiction Addiction is defined as a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. It is considered a brain disease because drugs change the brain – they change its structure and how it works. These brain changes can be long lasting, and can lead to the harmful behaviours as seen in people who abuse drugs How Drugs work in the brain  Drugs are chemicals  Drugs interfere with the way nerve cells normally send, receive and process information  Some drugs can activate neurons because their chemical structure mimics a natural neurotransmitter  Other drugs cause the nerve cells to release abnormally large amounts of natural neurotransmitters or prevent the normal recycling of these brain chemicals  The disruption causes a greatly amplified message  Drugs directly or indirectly target the brain's reward system  Excessive use of drugs of abuse disrupts the way critical brain structures interact to control  Continued abuse leads to tolerance or the need for higher Terms to Understand Nerve cells in the Brain  Neurotransmitters Special chemicals released by Neurons which transmit or carry "messages" from one neuron to another, e.g. Dopamine  Key sites on neurons to which neurotransmitters attach themselves  The space between neurons over which neurotransmitters travel by diffusion, as an electrical impulse  Dopamine Transporter  A pump that assists in the releasing or pumping of dopamine from one neuron to the  The Limbic System  The section of the brain that controls emotions, such as fear, anger, and feelings of pleasure related to survival, such as those experienced from eating and sex Communication Process Neurons communicate by sending messages to each other. This is done by an electrical impulse and the release of neurotransmitters, which diffuse across the synapse, and attach themselves to receptors on the receiving neurons. Neurons receive messages and carry out the appropriate action, after which the neurotransmitter is pumped back to the sending neuron to complete the Communication Process. This is how the brain functions or communicates normally. Changes in the Brain: Some drugs, such as heroin & LSD, mimic or act like natural neurotransmitters. Others, such as PCP, prevent messages from getting through. Other drugs, such as methamphetamines, act by causing neurotransmitters to be released in greater amounts than normal. Cocaine and crack, blocks the dopamine transporter, and prevents the neurotransmitter (dopamine) from being pumped back to the "sending" neuron. The result is that dopamine, which was blocked from returning to the neuron that sent it, builds up in the synapse or space between the neurons. This allows the dopamine to continue to act on the receiving neuron long after it should have stopped. This causes a sustained "high" or a prolonged feeling of pleasure in a drug user, which only stops after the drug, has worn out. Although cocaine may make someone feel pleasure for a while, long term use will affect the ability to feel pleasure, and changes the way the brain functions. Long-term cocaine use reduces the amount of dopamine or the number of dopamine receptors in the brain. The neurons at this time must have cocaine to communicate properly, as without the drug, the brain cannot send enough dopamine into the receptors to create a feeling of pleasure. At this stage, if a cocaine user stops taking the drug, the person feels an extremely strong craving for it, because without it he or she cannot feel nearly as much pleasure, or even normal. These long-lasting changes result in addiction. It is as if there is a "switch" in the brain that "flips" at some point during an individual's drug use. The point at which this "flip" occurs varies from person to person, but the effect of this change is the transformation of a drug abuser to a drug addict. Other drugs act on the brain in different ways, or act on other sections of the brain. However, all drugs alter the normal or natural functions of the brain, and addiction occurs when the person is no longer able to feel normal or feel pleasure without the Drug. Life Skills UNICEF defines life skills as psychological and interpersonal skills that are generally considered important. The interplay between the skills is what produces powerful behavioural outcomes, especially where this approach is supported by other strategies. Life skills encompasses of four pillars of learning:  Learning to know  Learning to do  Learning to be  Learning to live together These skills can be classified as; 1. Communication and Interpersonal skills Interpersonal communication skills  Verbal/Nonverbal communication  Active listening  Expressing feelings; giving feedback (without blaming) and receiving feedback Negotiation/refusal skills  Negotiation and conflict management  Assertiveness skills  Refusal skills • Ability to listen and understand another's needs and circumstances and express that Cooperation and Teamwork  Expressing respect for others' contributions and different styles  Assessing one's own abilities and contributing to the group Advocacy Skills  Influencing skills & persuasion  Networking and motivation skills Decision making implies action, and that action carries consequences. If one refuses to make the decision, then it is made for you. As the leader, you need to be responsible for making important decisions regarding the group. It is a good idea to make the decision- making process a participatory one. The process in cooperates:- Problem solving skills  Information gathering skills  Evaluating future consequences of present actions for self and others  Determining alternative solutions to problems  Analysis skills regarding the influence of values and attitudes of self and others on Critical thinking skills  Analyzing peer and media influences  Analyzing attitudes, values, social norms and beliefs and factors affecting these  Identifying relevant information and information sources Coping and Self-Management Skills Skills for increasing internal locus of control  Self esteem/confidence building skills  Self awareness skills including awareness of rights, influences, values, attitudes, rights, strengths and weaknesses  Goal setting skills  Self evaluation / Self assessment / Self-monitoring skills Skills for managing feelings  Anger management  Dealing with grief and anxiety  Coping skills for dealing with loss, abuse, trauma Skills for managing stress  Time management  Positive thinking  Relaxation techniques Where to get Treatment Help Help for substance abusers are available at:- TELEPHONE NUMBER Detox. & Assessment Unit UWI, Mona, Kingston 7 Richmond Fellowship 6 Upper Musgrave Jamaica (Patricia House) Avenue, Kingston 6 William Chamberlin 174 Orange Street, UWI, Mona, Kingston 7 2-6 Melmac Avenue, NCDA Counselling Services RADA Complex, Catherine Hall, Mo-Bay 940-2240/971-1538 RISE Life Management 57 East Street, Kingston 10 Shaw Park Road, Ocho Rios, St. Ann Community Group Homes


4.4 Welche Krankheitsstadien gibt es? Stadium 1: Die Krankheit entwickelt sich aus einem normalen Leistungsniveau. Stadium 2: In der Folge nimmt die/der Betroffene leichte Störungen wahr. Die Merkfähigkeit und das Gedächtnis sind beeinträchtigt. Namen und Termine werden vergessen. Bei manchen Situationen fehlt die Erinnerung und öfters werden Dinge verlegt.

Identifying, recruiting and retaining top talent

Course Syllabus Page 1 Marketing Strategy and Planning Management 352 (4 units) Professor Bernard Jaworski Peter F. Drucker Chair Phone: (909) 607-3647 Email: Office hours: by appointment, always available by email Faculty support: Bernadette Lambeth, Burkle Upper Level East End Phone: 909-607-7008,