REPUBLIC OF THE PHILIPPINES National Disaster Risk Reduction and Management Center, Camp Gen. Emilio Aguinaldo, Quezon City, Philippines NDRRMC UPDATE Progress Report on Diarrhea Outbreak in Bataraza, Palawan (Region IV-B) March 01 – April 13, 2011 Releasing Officer USEC BENITO T RAMOS Administrator, OCD DATE: 14 April 2011, 6:00 PM Source: DOH-HEMS,
Microsoft word - newmod12olMARYLAND CORRECTIONAL TRAINING ACADEMY
CORRECTIONAL ENTRANCE LEVEL TRAINING PROGRAM
INMATES WITH SPECIAL PROBLEMS
Objective: #028. Describe the four major categories of drugs & identify by name at lease three examples in each category. #029. Describe the various ways drugs can be taken & identify the drug paraphernalia available within the #030. Distinguish between a drug addict & a drug offender. #031. Describe the reasons an individual would become involved in the use of drugs, to include a low/inadequate #032. Describe the characteristics of a person under the influence of drugs &/or experiencing drug withdrawal. #033. Select the proper action(s) to be taken by the correctional employee if he/she identifies an inmate under the influence of/or in the possession of drugs or drug paraphernalia. MODULE #12
INMATES WITH SPECIAL PROBLEMS
D. Drug addict-a person who is physically and psychologically dependent upon the habitual use of drugs. E. Drug offender-a person who is arrested and convicted for violating a drug law or laws, Maryland or Federal. FOUR MAJOR DRUG CATEGORIES
CHARACTERISTICS/SYMPTOMS OF DRUGS
4. Infected, sore spots on hands, feet, etc. 3. Immune to pain (chemical agents and O.C. spray) WITHDRAWAL SYMPTOMS
HOW DRUGS ARE TAKEN INTO THE BODY/DRUG
4. Jagged glass (having sharp, projecting points) ACTIONS TO BE TAKEN BY CORRECTIONAL EMPLOYEES
IF AN INMATE IS UNDER THE INFLUENCE &/OR IN
POSSESSION OF DRUGS
A. Follow your institutional policy (Most important action) B. All the above are actions which could be taken depending upon the circumstances and condition of the inmate. WHY DO PERSONS BECOME INVOLVED IN DRUG ABUSE?
A. Everyone is eligible B. Medical treatment C. Recreational use D. Peer pressure E. Low self esteem, inadequate ego structure F. Kicks H. Escapism from boredom, danger, problems or just reality CONCLUSION
A. Instructor review of Module objectives
I. INTRODUCTORY SET
Ask the class, “Why are we studying drugs”? Continue to ask questions until they respond that the use of and
addiction to illicit drugs are major factors in the commission of crime and that illicit drug use causes many
serious problems in our prisons and detention center.
II. PERFORMANCE OBJECTIVES
III. INSTRUCTIONAL INPUT (CONTENT)
A drug is a substance other than food intended to affect the structure or function of the body of man or other
A prescription drug is any drug intended for use by man which because of its toxicity or other potential for
harmful effects, or the methods of its use, or the collateral measures necessary for its use, bears a warning
against dispensing without a prescription under Federal Law or is designated by the Maryland State Department
of Health and Mental Hygiene as not safe for use except under the supervision of a practitioner licensed by law
to administer such drugs.
In order to define drug abuse, it might be useful to first consider how a person takes a drug in a non abusive
manner. If a medical practitioner tells you to take a drug in order to prevent or treat a valid medical condition
and you take the drug exactly as prescribed, is that drug abuse? Of course not. Suppose you are sick or have a
medical problem and go to the drug store and buy over the counter medicine. If you follow the directions on the
label are you abusing the drug? Of course not. However, if a person takes a drug apart from valid medical
practice, that is drug abuse. So, we can define drug abuse as taking any drug in a way that is not medically
Drug addition means a physical and psychological dependency upon the habitual use of a drug.
A drug addict is a person who is addicted to one or more drugs.
Many people must take drugs on a daily basis to restore a chemical balance that their body is no longer able to
maintain. For example, many people must take insulin every day because their pancreas no longer produces
insulin. That is not drug addition. Other people take heart or blood pressure medication every day. That is not
addiction. They are replacing a chemical or restoring a chemical balance that should naturally occur in their
However, some people put chemicals (drugs) in their body that are not naturally found there. Nicotine, heroin,
caffeine, and alcohol are a few examples of addicting drugs. Many people find the effects of these drugs
enjoyable so they take them again. Then the person tells him/herself that he/she needs the drug and can=t
function without it. This is the stage of psychological addiction.
Eventually, the person=s body gets used to having these foreign chemicals (drugs) and then needs to have them
on a regular basis. If these drugs are abruptly removed from the body the person experiences physical
symptoms of withdrawal, such as convulsions, tremors, hallucinations, etc. That is addiction.
A drug offender is a person who has been arrested and convicted of violating a federal or local drug law.
Remember, an arrest is only a formal accusation. A person is legally innocent until found guilty in a court of
One category of drugs is Depressants:
Depressants slow down, (depress) the central nervous system. The person under the influence of this type of
drug has shallow breathing, slowed pulse, and falling blood pressure. Many, but not all Depressants are
addictive. If a person takes an overdose of Depressants death can result.
Narcotics/Opiates are a form of depressant drugs.
The word Narcotic comes from the Greek work ANarcs@ which mean Adeep sleep@. Not all narcotics are opiates
but all opiates are directly derived from raw opium, which is processed from the poppy plant. It looks like a
large tulip plant. Its name is Papaver Somniferum, which means Asleep bearing@. Remember, the movie AThe
Wizard of Oz? When Dorothy and her friends walked through the poppy field, they all fell asleep. That was
symbolic of the narcotic properties of the Poppy.
Narcotics have been used to control severe pain since the Revolutionary war. This category of drugs is highly
addictive therefore many addicts become addicted to narcotics during medical treatment.
Heroin is a narcotic, which causes many problems for law enforcement and corrections. On the street is called
“H”, “Big H”, “junk”, “Shit”, “Mexican Mud” and other names.
When a person takes heroin for the first time, after about 10-12 minutes he or she will experience nausea and
may even vomit. Immediately after that an incredible high (euphoria) is obtained which does not seem possible
with any other substance. The user goes into a twilight state, a state of non-reality. He or she feels no pain, no
stress, no worry or anxiety, just perfect balance with nothingness-Nirvana.
Some addicts say that their first “high” was 10 times more pleasurable than their best sexual experience. So they
try it again. The problem is, the user never again experiences the “high” he or she originally experience because
tolerance sets in. That is, the more a person takes, the more he needs to experience the drug=s effect. Before long
the person discovers that he must continue taking heroin on a regular basis or suffer very unpleasant physical
symptoms of withdrawal.
Since heroin is illegal it must be smuggled into the country and cannot be sold openly. This causes the price of
heroin to be very high. The Johns Hopkins Hospital studied 237 heroin addicts and found that they committed
over 500,00 crimes in 11 years to buy heroin.
In order to maximize profits, each dealer “cuts” or dilutes the heroin with another substance until the user on the
street is usually buying about 5%-10% heroin. The rest can be anything from powder sugar to rat poisons. These
cutting agents and dirty needles are what frequently kills heroin addicts.
Sometimes the heroin has not passed through enough hands and instead of the usual 5% purity it may be 50%
pure. The addict dies from a massive overdose with the needle still in the arm. Addicts call that “the big one”.
Methadone (Dolophine) is a synthetic narcotic, which is available through prescription. When a person is on
Methadone he or she does not crave heroin. Another advantage is that unlike heroin, methadone does not
produce drowsiness so the person can hold a job. Since it is available by prescription he/she does not have to
steal to buy it. The disadvantage is that it is just as addictive as heroin.
Many drugs used to relieve pain are narcotics. Dilaudid and Codeine are 2 other narcotic pain relievers.
Another type of Depressant is Hypnotic/Barbiturates, better known as sleeping medications and sedatives.
Seconal, Nembutal and Phenobarbital are examples of this type of drug. Most hypnotic and barbiturates are
very addictive and an overdose can easily cause death.
Another type of depressant is tranquilizer.
Some tranquilizers are used to reduce psychotic (crazy) symptoms; others are used to reduce anxiety.
Thorazine is the oldest anti-psychotic tranquilizer. Prior to it=s invention, one had to go through 2 locked steel
doors in order to enter a psychiatric hospital. When Thorazine was introduced in the late 1950's, 2/3 of the
patients went home. Most of the remaining 1/3 are able to be housed in unlocked wards. Although many people
take anti-psychotic medications daily for decades they are not addictive. Deaths due to overdoses of these
medications are rare.
Anti-Anxiety tranquilizers include Valium, Librium, Atarax and Miltown. Many of these drugs are addictive
and are easy to overdose on, especially when combined with alcohol or other drugs.
Alcohol is an important, addictive Depressant drug covered separately in another class.
“Barbiturates and Narcotics” of the movie: “What did you take”?
The second category of drugs are central nervous system Stimulants. These drugs act the opposite of
Depressants. Stimulants speed up the central nervous system. They raise the blood pressure and pulse,
inhibit sleep, and increase the rate of breathing.
Stimulants are prescribed by physicians, to treat a disorder called narcolepsy. Recurrent attacks of
uncontrollable desire for sleep. Another medical use for stimulants is weight reduction. Stimulants cause a
person to loose weight in 2 ways. They trick the brain into not feeling hungry. At the same time they speed up
the metabolism, causing the person to burn calories at an increased rate. Dexedrine and Benzedrine are 2
examples of these drugs.
Another stimulant is Ritilan.
When given to children who have not yet gone through puberty, it calms them and increases their ability to
Cocaine is a stimulant, which is causing many problems for law enforcement and corrections. About 100
years ago, there was a cocaine epidemic in the United States. Back then cocaine was legal; therefore it was
cheap. At first the public thought cocaine was wonderful. It cured a headache instantly and filled the user with
pep. However, the public soon realized that for every up there was a down; for every high a low. Public opinion
turned against it and laws were passed to enforce public opinion. Cocaine became illegal. It became dangerous
to smuggle it into the country, dangerous to buy or sell it. That made the price go way up. Many people commit
serious crimes to buy cocaine. Cocaine stimulates so many of the pleasure centers in the brain that once it
has been tried, many cannot resist trying it again and again. It is very habit forming. Being a powerful
stimulant, Cocaine raises the blood pressure and pulse rate so high that many people, even young people in their
20's have died of heart attacks and strokes.
When people take stimulants they often experience irritability, sleeplessness, nervousness and paranoid
thinking, (being frightened and suspicious when there is not reason to be frightened or suspicious).
“Stimulants/Amphetamines” portion of video called “What did you take?”
The third category of drugs is Hallucinogens. These drugs do not sped up or slow down the central nervous
system, however, they cause users to hallucinate, that is, they cause a person to experience an event which
does not exist in reality. Most Hallucinogens cause visual hallucinations. The person sees something that is
not there; no one is able to see it but him or her. LSD, DMT, PCP and THC are examples of these drugs. LSD
became popular during the 1960's. It mainly causes the user to visually hallucinate.
Sometimes the hallucinations are frightening to the user. MDT is similar to LSD. PCP was invented to be an
animal tranquilizer. It=s use was discontinued because of the bizarre and aggressive behavior of the animals.
When people take PCP, their behavior can become bizarre, very aggressive, and since they cannot feel pain,
they can be very dangerous to themselves and others. THC is the active ingredient in marijuana and hashish.
In low doses it causes distortions in the perception of time and space. In higher doses it causes visual
“Hallucinogens” of the movie “What did you take?”
The forth and final category of drugs is a Miscellaneous category. These drugs affect the mind but do not
speed up or slow down the central nervous system nor do they cause hallucinations. Lithium Carbonate is a
drug used to control severe mood swings. It=s dosage is very critical, too little and it does not work. A little too
much causes brain damage, heart damage and death. The newer anti-depressive medications such as Paxil and
Prozac are in this category since they neither, speed up, or slow down the central nervous system nor do they
cause hallucinations. They help to correct a chemical imbalance in the brain, which helps to relieve depression.
Some symptoms of Heroin use are:
Pinpoint pupils of the eyes. The eyes are sensitive to light.
“On the nod” The user has trouble staying awake.he/she is not energetic and talkative.
Needle marks or tracks. Permanent scaring of the arms or legs from using dirty needles.
Inflammation, sores, cysts on the hands or legs. These are infections from using dirty syringes.
Chronic unemployment. Since the user is so sleepy and must engage in crime in order to afford the heroin, it is
hard to hold a job.
Withdrawal usually begins within 8-16 hours after their last dose and reaches it=s maximum intensity about 3
days later. Withdrawal can last up to 10 days.
Every drug causes different effects when it is taken. To further complicate things, each person reacts somewhat
differently to the same drug. Different drugs also cause different symptoms when people withdraw from their
use. However, some general symptoms of drug usage and drug withdrawal you can look for in your
A sleepy, fatigued, “dopey” appearance.
An agitated, restless, insomnia, nervous, shaky appearance or muscle spasms.
Perspiring heavily in the absence of heat, exercise or a fever.
Pupils of the eyes either abnormally small or abnormally large.
Not alert and realistically concerned about his or her surroundings, severe depression or impairment of
Some symptoms of Heroin withdrawal are:
Hot and cold flashes
Diarrhea and vomiting
Muscle spasm, shaking and twitching
Muscle aches and pains
WAYS DRUGS ARE TAKEN INTO THE BODY
There are several ways that drugs can be taken into the body.
Intra-venous injection-a hypodermic needle is used to put the drug directly into the blood stream. Heroin is
often taken this way.
Intra-muscular injection-the drug is injected into the muscle. It gets into the blood stream and the brain a
little more slowly than an IV injection. Vaccinations and tranquilizers are often given this way.
Sub-cutaneous injection-the drug is injected in the fatty layer between the skin and the muscle. This is a
slower way to get the drug into the blood stream. Insulin and allergy shots are often given this way.
Trans-dermal-some drugs can go through the skin into the blood stream. Nicotine, nitroglycerine and some
hormones are drugs, which can be given transdermal.
Oral-the drug is swallowed and passes through the gastrointestinal tract into the blood stream. We take most
medicines this way.
Suppository action-Some drugs can be placed in the other end of the gastrointestinal tract and absorbed into
the blood stream through the large intestine.
Sub-lingual-the drug is placed under the tongue and absorbed through the gums and cheeks into the blood
stream. Nicotine and nitroglycerin can be taken this way.
Smoking-many drugs can be burned and the smoke inhaled into the lungs. This is a very fast way to get the
drug into the blood stream and to the brain.
Snorting-the drug is ground into a powder and snorted into the nasal passages where it passes into the blood
vessels. Tobacco and cocaine are taken this way.
Inhaling-the vapors of a substance such as gasoline, paint thinner or glue are inhaled into the lungs. It is
like smoking only the substance is not burned. This causes rapid and severe brain and liver damage.
Some drug paraphernalia you might find in a correctional facility are:
Medical syringes which have been stolen from the medical department or smuggled into the facility.
Homemade fabricated syringes. Ballpoint pens and sharp glass can be used to inject the drugs into the body.
Cookers-metal bottle caps or metal spoons, on which heroin can been melted from a powder into a liquid.
Pipes and screens-these are used to smoke drugs.
Nutmeg and mace-these spices, when ingested in large quantities act as hallucinogens.
People abuse drugs and become addicted to drugs for many reasons. Some of these reasons are:
Escapism-some people do not like themselves or the situation they are in. Often it is easier to change the
perception of reality with drugs than it is to change themselves or their situation. This is frequently a reason
that inmates abuse drugs.
For kicks-people sometimes take drugs because they are bored; they want to add excitement to their lives.
Peer pressure/cultural reasons-virtually every social group has a drug the group members are obligated to
use. Affluent neighborhoods have coffee, and cocktail parties, (remember, caffeine and alcohol are addicting
drugs), poorer neighborhoods have beer parties and heroin shooting galleries.
Death wish-with some people drug abuse may be a gamble with death; they may be flirting with suicide.
Low/inadequate ego structure-this means that the person lacks coping skills and has trouble dealing with the
demands of life. This reason is similar to escapism.
Prescribed drugs-many people become addicted to drugs without ever abusing drugs. Many people take
prescription pain killers, tranquilizers and sleeping pills exactly as the doctor prescribed them. However,
because of the addicting nature of these drugs, people can become addicted to them.
Many organized religions require their followers to use a very small amount of wine during religious
ceremonies. Some people use a considerable amount of hallucinogens in order to have a spiritual
Drug abusers and drug addicts come from all walks of life, no one is immune. People such as yourselves, co-
workers, clergy, teachers, firemen, business men and women, inmates and a vast array of others.
What action is to be taken by correctional employees if an inmate is on drugs or suffering from drug
Follow your institutional policy
Render first aid and CPR
Notify a supervisor
Summon medical assistance
Search the inmate
Search the inmate=s cell
Secure the area
Call for help
Write a report
Read the objectives to the class and ask if they have been satisfied.
To close this module, re-read the objectives to the class and ask if the objectives have been satisfied. Ask the
students if there are any questions on the material that was covered in class for this module.
We will review for Test 7. The test has a total of 64 questions. Questions are multiple choice with 4 or 5
possible selections. You have to select the one that is right, or the one that does not belong to the answer set.
Identifying potential adverse effects using the web: a new approach to medical Adrian Benton, BAa,*, Lyle Ungar, PhDc, Shawndra Hill, PhDb, Sean Hennessy, PharmD, PhDa, Jun Mao, MD, MSCEa, Annie Chung, BAa, Charles E. Leonard, PharmDa, John H. Holmes, a University of Pennsylvania School of Medicine, Philadelphia, PA b University of Pennsylvania, The Wharton School, Philadelphia, PA c Universi