2012

SUBSTANCE ABUSE
TRAINING MANUAL
Information Guide for Peer Educators

NCDA Field Department

1/1/2012

FIELD SERVICES DEPARTMENT

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Table of Contents

Contents

Training Objectives: ............................................................................................................................... 4

Course Outline: ...................................................................................................................................... 5
Session 1 .......................................................................................................... 5
The National Council on Drug Abuse- Structure, Objectives, and Operations. ............................ 5

Categories of drugs ......................................................................................................................... 5
Session 2 .......................................................................................................... 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
Session 3 .......................................................................................................... 5
Understanding Addiction ............................................................................................................... 5

Tolerance ........................................................................................................................................ 5

Dependence .................................................................................................................................... 5

Addiction ........................................................................................................................................ 5

Programmes for Treatment and Rehabilitation .............................................................................. 5
 Available Centres ........................................................................................................................... 5
Session 4 .......................................................................................................... 5
Life skills ........................................................................................................................................ 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

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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
and abuse

 To build a cadre of persons who will be able to address substance abuse related
issues in their field of work

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Course Outline:
Session 1
The National Council on Drug Abuse- Structure, Objectives, and
Operations.

Definition of drugs

Categories of drugs

Reasons for use and abuse of drugs

Session 2
Commonly abused substances – alcohol, tobacco, marijuana, crack
cocaine, amphetamines, steroids.

History

Characteristics

Effects of these substances on the person

Signs and Symptoms of Usage

Session 3
Understanding Addiction

Tolerance

Dependence

Addiction

Programmes for Treatment and Rehabilitation
 Available Centres

Session 4
Life skills

Coping Skills

Resistance Skills

Decision Making Skills

Positive Self Esteem/Self Worth/Values

Healthy Lifestyle/Physical Condition

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FIELD SERVICE DIVISION

NATIONAL COUNCIL ON DRUG ABUSE

M.O.H.
Board Members

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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
processes.
• The uncontrolled or unprescribed use/misuse/abuse of any such substance is defined as
Drug/Substance Abuse

Factors Contributing to Drug Use

THE PERSON THE DRUG\SUBSTANCE THE ENVIRONMENT
Heredity Availability Social

Psychological problems Accessibility Cultural

Economic

Historical Conditions

 The Person-
 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
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 Mental Disturbance
 Poor Physical Health/Illnesses

 Economic
 Unemployment
 Lack of Business Opportunities
 Lack of skills/educational qualifications

 Cultural
 Cultural Acceptance of certain Drugs
 Traditional & Adopted/Imported Cultural/Religious practices

 Social
 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)

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Categories of Drugs

DRUG CLASS EXAMPLES ACTION

Stimulants Cocaine, Amphetamine, MDMA, Stimulate mood, stimulate

Caffeine, and Nicotine processes of the body

Depressants Alcohol, Benzodiazepines, Slows down the function of

Rohypnol the Central Nervous System

Marijuana (THC) Ganja, Weed Impairment of attention

processes and brain
function.

Inhalants Glue, Solvents, Gases, etc. Depress CNS function and/ or

block the passage of oxygen
to the brain.

Opiates Heroin Elevate mood, cause

indifference, analgesia

Hallucinogens 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),

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• 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,
e.g.
 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
 Street Names
 Ganja, Grass, Spliff
 Weed, Weed of Wisdom
 Sensimila, Sensi
 Joint,
 Herb, Callie, Callie Weed
 Derivative
 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

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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

Short Term
• 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

Long Term
• 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
Short Term
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• 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

Long Term
• 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)

Tobacco
• 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.
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• 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

Short Term:
 Faster heart beat
 High blood pressure
 Dizziness
 Relieves tension & tiredness

Long Term:
 Lung & Heart damage
 Lung, mouth, & throat cancer
 Stomach ulcers
 Reduces sense of taste & smell

Alcohol
• 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
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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
• Swaggering walk

Effects of Alcohol Use

Short Term:
 Faster & weaker heart beat
 Confusion & lack of concentration
 Sick stomach & vomiting
 Mood changes quickly to violence & depression

Long Term:
 Permanent liver, heart & brain damage
 Liver cancer
 Stomach ulcers
 High blood pressure
 Alcoholism
 Death from overdose
 Death from road and other accidents

Seasoned Spliff
 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
addition to:

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Restlessness

Anxiety

Short term high followed by depression

Cocaine & Crack

 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

Short term:

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

Long term:

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)
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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

Signs of Use:
• Excessive activity
• Irritability
• Nervousness
• Mood swings
• Needle marks

Effects of Amphetamines
Short Term
 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

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 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

Long term:
 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
behaviour
 Continued abuse leads to tolerance or the need for higher

Terms to Understand

 Neuron
Nerve cells in the Brain
 Neurotransmitters
Special chemicals released by Neurons which transmit or carry “messages” from one
neuron to another, e.g. Dopamine
 Receptors
 Key sites on neurons to which neurotransmitters attach themselves
 Synapse
 The space between neurons over which neurotransmitters travel by diffusion, as an
electrical impulse

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 Dopamine Transporter
 A pump that assists in the releasing or pumping of dopamine from one neuron to the
other
 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.

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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

Empathy

• Ability to listen and understand another's needs and circumstances and express that
understanding

Cooperation and Teamwork

 Expressing respect for others' contributions and different styles

 Assessing one's own abilities and contributing to the group

Advocacy Skills

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 Influencing skills & persuasion

 Networking and motivation skills

Decision Making

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
motivation

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
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 Relaxation techniques

Where to get Treatment Help

Help for substance abusers are available at:-

INSTITUTIONS ADDRESS TELEPHONE NUMBER

Detox. & Assessment Unit UWI, Mona, Kingston 7 977-0705
Richmond Fellowship 6 Upper Musgrave 978-1670/2324
Jamaica (Patricia House) Avenue, Kingston 6
William Chamberlin 174 Orange Street, 908-0389
Kingston
Ward 21 UWI, Mona, Kingston 7 927-2492
2-6 Melmac Avenue,
NCDA Counselling Services Kingston 5 926-9002-4
RADA Complex, Catherine
Hall, Mo-Bay 940-2240/971-1538
RISE Life Management 57 East Street, Kingston 967-3777-9
Services
10 Shaw Park Road,
Teen Challenge Ocho Rios, St. Ann 974-5818
Community Group Homes 163 Hope Road 977-1108

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