Understand about different substances, their effects and how they might be used.

Understand about different substances, their effects and how they might be used.In my role as a social care worker i am coming into contact more and more with service users who have mental health problems who are also substance users. The reason for such dependency and their particular drug of choice is reliant to some extent on what their diagnoses is and what sort of effects they are looking for. If people are trying to block out negative thoughts and feelings they may be using a particular substance that can do this, such as for someone with depression they could be using a stimulant such as amphetamine which could give them a feeling of increased energy and euphoria that they may not have experienced for some time.
Such a drug as an amphetamine can be categorised as a psychoactive drug which basically means it affects brain functioning, changes behaviour, mood, perception and/or consciousness.
Psychoactive drugs can be categorised into three broad groups:
Stimulants: amphetamins, cocaine, crack, ecstasy, anabolic steroids
Depressants: cannabis, alcohol, benzodiazepines (such as diazepine), opiates (heroin and morphine), GHB;
Hallucinogens: LSD.magic mushrooms (psilocybin), skunk.
One example of a drug being both a stimulant and a hallucinogenic is ecstasy so the above headings can be on occasion unhelpful. Drugs also have street names and can vary from place to place so a good social care worker should familiarise themselves with drug names generic to their local area if at all possible.
The likely effects and risks of commonly used drugs are dependent on several factors such as the persons expectations of what will happen, their previous experience of using the drug, the dose of the drug and its purity, the route used to take it, such as orally, intravenously, snorted and so on, who they are with, where they are and their surroundings. Some drugs have predictable effects –for example, benzodiazepines will usually sedate. However, the effects of a drug such as LSD are unpredictable even if the dose and contextual factors remain the same. The same individual can have extremely different experiences, ranging from euphoria to extreme anxiety.
Some further risks and effects of commonly used drugs:
Effects-relaxant, less anxious, more sociable.
Risks-slurred speech, nausea, psychological and physical dependence.
Effects-euphoria, increased energy.
Risks-Anxiety, panic, paranoia.
Effects-sedation, relaxation.
Risks-Quickly develop dependence, drowsiness, and overdose
Effects-Relaxation, disinhibition, increased sensory awareness.
Risks-Red eyes, anxiety, confusion, psychosis.
Effects-exhilaration, alertness, excitement, high energy.
Risks-sweating, tremor, depression
Effects-increased energy, heightened perception of colour and sound.
Risks-Lack of sleep, dehydration, death.
Effects-Relaxation (induces sleep).
Risks-Memory loss, associated with rape.
Effects-Intense pleasure, warmth, detachment.
Risks-Nausea, drowsiness, overdoses.
Effects-time distortion, perceptual changes.
Risks-impaired judgement, disorientation, anxiety.
Illegal drugs are classified into three categories: A, B and C (misuse of drugs act 1971). Class A drugs are viewed as the most dangerous and have the greatest penalties for illegal supply and use. Although the original act was passed in 1971 it has been amended several times since. Drugs such as cannabis have been reclassified several times the current classification is as follows;
Class A
Ecstasy, LSD, herorin, crack, magic mushrooms, amphetamines.
Class B
Amphetamines, cannabis, Methylphenidate (Ritalin), Pholcodine.
Class C
Tranqulisers, some pain killers, GHB, Ketamine.
There are many associated health risks long and short term associated with drugs as they stimulate various parts of the human body and certain areas of the brain. The many different types and classifications produce a variety of short term effects but the most common ones include increased heart rate, high blood pressure, dizziness, tremors, mood changes and paranoia. In high dosages the risks are far more dangerous such as the potential for heart attack, stroke, respiratory failure and coma. In the long term substance abuse may also lead to mental and physical effects that will require treatment to resolve these effects can include paranoia, psychosis, immune deficiencies and organ damage.
Drug use often begins as something recreational or a way of “self medicating” but due to the addictive properties it can turn to a constant need. This compulsion is uncontrollable and may interfere eventually with all aspects of their daily life. Even when the effects begin damaging a person’s body, relationships with friends, family members or staff the constant need for a substance often overcomes any rational thinking. Long term use can also lead to tolerance build up due to continuous use and the body becoming less and less stimulated by the drug. This may lead to a person using higher dosages to obtain the same desired effect which could result in the body receiving a level of drugs it cannot tolerate this is what can lead to an overdose.
Other legislation as well as the misuse of drugs act 1971 which could be relevant in my role is as follows:
The misuse of drugs regulations (Misuse of drug regulations 2001), and the medicines act 1968, care standards act 2000.The misuse of drugs (safe custody) regulations 1974. The storage and handling of prescribed controlled drugs and other substances is not usually something i have to deal with on a day to day basis as the majority of service users i support presently are all self medicating. None of the service users i work with at the moment have been prescribed controlled drugs such as methadone.
Under section 5 (4) of the misuse of drugs act 1971 there is a statutory defence in regards to possession, destruction and disposal of a controlled drug which is
1: He knew or suspected the substance to be a controlled drug.
2: He took the possession for the purpose of:
A preventing another person from committing an offence, or
B continuing to commit an offence in connection with that drug. Or
C delivering it into the custody of a person lawfully entitled to take custody of it.
3: As soon as possible after taking possession he took all; steps reasonably open to him either to: destroy the drug or to deliver it into the custody of a person lawfully entitled to take custody.
If a decision is made to destroy a drug it needs to be done in a lawful manner which also protects the social care worker from allegations. The above only applies in a situation where a drug is held unlawfully (classes A&B) or has been found or handed in and is being passed on to staff to pass it on to an authorised body (clause c).
All substances believed to be controlled drugs in a medicinal form can be handed in to a pharmacy (this can also include abandoned or lost medication). Protocols should be agreed with a local pharmacy though willing to do this, such as which staff member will be coming to the pharmacy(usually if possible notified in advance) and a record of said notification. Staff should always ensure they get some form of receipt confirming all substances have been handed in.
Non medicinal products including controlled drugs should either be destroyed or handed into the police. The person finding the drug should not pass it on to another staff member but should destroy it or take it to the police themselves. The destruction should always take place in the presence of a senior worker who witnesses the process if done “in house”. Flushing the drug down the toilet is not lawful as it contravenes environmental protection legislation. A record should be kept of the incident and if the quantity of drugs founds suggests supply may be taking place the police should be involved immediately. If a decision is made to take the drugs to the police for destruction the police should be contacted and informed that a member of staff is coming to the police station prior to setting off and a record made recording the time of the call the number of the officer receiving the call and a police incident reference number.
People misuse alcohol and other drugs for a variety of reasons. For instance, they may simply want to see how far they can push their limits (e.g., young people experimenting with substances they really like). They may be celebrating something (e.g., a birthday or a promotion) and feel justified in overdoing it. Some people use excessive amounts of alcohol and other drugs in order to temporarily escape physical, mental and/or emotional problems (e.g., abuse, depression, anxiety, post-traumatic stress disorder, a recent break up, the death of a loved one. A variety of influences contribute to an individual’s decision to engage in a potentially unhealthy behaviour, or to avoid it. Among these is the degree of pleasure or value an individual obtains from the behaviour. This varies from individual to individual and is mediated or intensified by a range of other personal, social and environmental influences. An individual’s perception of short- or long-term health risk will also influence their decision. Short-term or more immediate risks often have a bigger impact than long-term risks. People need more than knowledge to change their behaviour. They may need practical tools to help them cut down or quit using substances. They may need supports in the form of medical services, mental health services, housing, etc.
Factors reducing or stopping their substance use are varied but can be due to their readiness to change, personality factors, and psychosocial circumstances, environmental and cultural contexts.
As a social care worker you must accept the role of becoming an “agent of change” this requires supporting, motivating, educating the service user throughout the process. You should employ good communication aiming to understand the service user’s views and needs and be able to respond to their behaviour and language and to recognise their often unspoken needs thus developing trust and genuineness. Service users should feel comfortable to discuss their history if the above is followed and can be enhanced further by the style of interaction which should be non-confrontational, empathectic and respectful of the clients subjective experiences of substance misuse. Advice on harm reduction is important if there is continued substance misuse at the start of their initial support this method focuses on “safer” drug use being usually a set of practical strategies that reduce negative consequences. Some harm reduction techniques could be supervised consumption of methadone, needle exchange schemes to reduce the risks associated with HIV and hepatitis. Service users should be encouraged not to take drugs alone or in isolated places, educating them to the dangers of injecting being more dangerous than swallowing, smoking or inhaling. If they are injecting to advise on hygiene and the importance of using clean or preferably new equipment and making sure hands and injection area are clean. Mixing drugs or combining drugs and alcohol should also be avoided. Those with substance misuse and psychiatric disorders are difficult because substance misuse can mask psychiatric symptoms or distort diagnosis. Many individuals with dual diagnosis remain unnoticed in both drug and alcohol services and mental health services. It is important to provide a comprehensive assessment of mental health history and current symptons,current and historical substance use and misuse, current physical health, assessment of social needs and the awareness of diversity amongst those individuals with dual diagnosis and how these major aspects impact on their current presentation or baseline behaviour.

Understand about different substances, their effects and how they might be used. 8.6 of 10 on the basis of 2122 Review.