A Reading on

Substance Abuse

In Partial Fulfillment of the

Requirements in NCM 217-RLE

PSYCHIATRIC NURSING ROTATION

Submitted to:
Glenda Lynne T. Fronteras, RN, MN
Clinical Instructor

Submitted by:
Nicole Keesha J. Mata, St. N
BSN 3G – Group 4 Subgroup 3

March 23, 2021

Title: Substance Abuse
Bibliography: Edwards, R. D., M.D. (2019, October 02). Substance Abuse: Drug
Types, Symptoms, Treatment & Prevention. Retrieved March 20, 2021, from
https://www.emedicinehealth.com/substance_abuse/article_em.htm

Summary:

Substance abuse is the repeated harmful use of any substance, including drugs
and alcohol. The substances may be legal, prescription drugs or banned substances as
well some those aren’t even classified as drugs.

Commonly abused drugs are Marijuana, Cocaine, Heroin, Methamphetamine,

Anabolic Steroids and Club drugs. Marijuana is the most widely used illegal drug in the
United States, and it comes from the Cannabis sativa plant. Marijuana, as the first illegal
drug used by people, and is related to a higher risk of leading to the use of more strong
and addictive substances like cocaine and heroin. Cocaine is derived from the South
American coca plant. The strength and length of the drug's effects are determined by
how it is taken. Both short- and long-term use of cocaine have been associated with
damage to the heart, the brain, the lung, and the kidneys. Drowsiness, pleasure, and
sluggish breathing are all symptoms of heroin intoxication. Since heroin is commonly
injected, often with dirty needles, it may cause a variety of health problems, including
heart valve damage, tetanus, botulism, and infections including HIV/AIDS or hepatitis.
Methamphetamine is a potent stimulant that improves alertness, suppresses appetite,
and causes euphoria.

Party drugs have popularized a variety of other drugs in the club scene and rave
parties. Most young people feel that these drugs are safe or even helpful to their health.
Ecstasy is the most common club drug. It is a stimulant and hallucinogen that's
commonly used for all-night dance parties to boost mood and energy. Even a single use
can induce dangerously high fevers that can lead to seizures. Long-term use of GHB or
Gamma Hydroxybutyratecan affects the brain's ability to control sleep, pain, memory,
and emotions. Mild relief to coma or death is both potential consequences. Since it is
tasteless colorless, and acts as a powerful sedative. Rohypnol is a sedative that's been
used as a date-rape drug in the past. Ketamine has the ability to affect memory and
concentration. Lysergic acid diethylamide causes hallucinations, numbness, fatigue,
and an elevated heart rate. Phencyclidine is a potent anesthetic used in veterinary
medicine. It has effects that are similar to ketamine but are often stronger. The
anesthetic effects are so powerful that even if you break your bone, you won't feel much
pain.

A person's chances of abusing drugs can be increased by such risk factors.

Family background influences that affect a child's early life, such as a dysfunctional
home atmosphere, poor upbringing, lack of nurturing and parental attachment, and
parental substance use or addiction, have been linked to an elevated risk of drug abuse.
Male ethnicity, childhood attention deficit hyperactivity disorder (ADHD), history of
anxiety or other mood disturbances, behavior disorder, or antisocial personality disorder
is also risk factors for drug abuse. Factors related to a child's socialization outside the
family may also increase the risk of drug abuse, including inappropriately aggressive or
shy behavior in the classroom, poor social coping skills, poor school
performance, association with a deviant peer group or isolating oneself from peers
altogether, perception of approval of drug-use behavior.

Friends and family members can be the first to detect symptoms of substance
abuse. Early detection increases the chances of a successful treatment. If someone is
suspected for drug abuse disorder and needs to get help, a doctor can refer them to
community resources where they can get a formal diagnosis and treatment of a
substance-abuse problem. A doctor can also prescribe drugs to help treat medical
problems caused by drug abuse, such as cravings and withdrawal. While there is no
one test that will definitively diagnose a substance use disorder, there are screening
tools, such as internet testing, that can help detect individuals that are at risk of
developing one. As a result, health-care providers evaluate this category of diseases by
collecting comprehensive mental-health, physical, and family data. The physician would
almost certainly request that the person's primary-care doctor conduct a physical
assessment, including lab examinations, to ascertain the person's general conditions to
determine whether or not the person has a medical disorder that may cause the same
symptoms as a mental-health crisis.
 Most substance abusers say they can avoid using drugs of their own, but the
vast majority of those who attempt fail. Until therapy for the addictive addiction may
continue, the substance abuser may need assistance with the physical recovery from
the alcohol or other substances that they have been using. Detoxification, or "detox," is
the name given to the first stage of therapy. It always necessitates hospitalization. Long-
term drug use changes brain activity and increases compulsions to use medications,
according to research. And if you quit using drugs, you'll still get a craving. Treatment
for drug abuse also requires involvement in a rehabilitation program and is dependent
on both the client and the substance used. A counselor, such as a social worker,
psychologist, therapist, or clinical nurse, offers techniques to deal with substance
cravings and ways to prevent relapse in behavioral therapy. Person and group therapy
are often used in treatment. A doctor can prescribe medicines such as nicotine patches
and methadone to manage withdrawal symptoms and substance cravings after a
detailed examination of the patient's condition.

School-age groups are also the focus of abuse reduction programs in schools
and communities. Children's misperceptions regarding tobacco, alcohol, and narcotics,
as well as the effects of their use, are addressed by programs that aim to improve
contact between parents and their children, teach resistance skills, and provide
knowledge. Most notably, policymakers hope to create an atmosphere of social
rejection of substance use by children's peers and communities through schooling and
the media. Individuals who are highly motivated to be in treatment, are consistently
involved in their own rehabilitation, who access comprehensive treatment programs are
most likely to be successful in recovery. The ability to quickly access community-based
treatment supports increases the prognosis for drug abuse recovery.
Reaction:

This article helped me to broaden my understanding about Substance Abuse. I

have learned that Substance abuse is a term used to describe a category of disorders
connected to the use of mind- and behavior-altering substances that have harmful
behavioral and health implications. Substance abuse is a serious matter that should not
be taken lightly. Treatment for drug abuse also requires involvement in rehabilitation. A
counselor, such as a social worker, psychologist, therapist, or clinical nurse, offers
techniques to deal with substance cravings and ways to prevent relapse in behavioral
therapy.

Also, I have learned that Marijuana is the most widely abused drug, followed by
Cocaine, Heroin, Methamphetamine, Anabolic Steroids and Party drugs. Many
substances can bring on withdrawal effects caused by cessation or reduction in the
amount of the substance used. Withdrawal symptoms can range from mild anxiety to
seizures and hallucinations. Drug overdose may also cause death.

I agree that drug education and prevention programs aimed at children and
adolescents have the greatest chance at minimizing substance abuse. And early
detection increases the chances of a successful treatment

For nursing education, this will enable nursing students to have deeper
understanding about the disorder substance abuse, its causes and risk factors, signs
and symptoms, treatment and how it may affect the health of the patient.

For nursing practice, it will also enhance the skills of the nursing students in the
clinical area by knowing how to provide care and assistance whenever we can handle
patient who are diagnosed with substance abuse. Making sure that they may reduce the
suffering or the problem the patient is encountering through the help of information
about management, treatment and prevention provided by this article.

Lastly, for nursing research, this article will serve as a guide in conducting
research or paper analysis for the people who are interested to know more about
substance abuse. Information will be provided and will serve as a reference for future
research and to elevate the standards of nursing research and services.
Copy of the Article:
HOME MENTAL HEALTH CENTERTOPIC GUIDE
Substance Abuse

 Medical Author: Roxanne Dryden-Edwards, MD

 Medical Editor: Melissa Conrad Stöppler, MD

Reviewed on 10/2/2019
Privacy & Trust Info
Facts on Substance Abuse

Substance abuse without treatment takes a heavy toll on a person's health, family, and society.
People abuse substances such as alcohol, tobacco, and other drugs for varied and complicated reasons,
but it is clear that our society pays a significant cost. The toll for this abuse can be seen in our hospitals
and emergency departments both through direct damage to health by substance abuse and its link to
physical trauma. Jails and prisons tally daily the strong connection between crime and drug dependence
and abuse. Although use of some drugs such as cocaine has declined in recent years, use of other drugs
such as heroin, crystal methamphetamine, and "club drugs" has increased.

 Finding effective treatment for and prevention of substance abuse and substance dependence,
now both included under the diagnosis of substance use disorder, has been difficult. Through
research, we now have a better understanding of this behavior. Studies have made it clear that
drug education and prevention aimed at children and adolescents offers the best chance to
curb drug abuse nationally.

 The 2014 National Household Survey on Drug Abuse estimated that more than 16% of
respondents in the United States have used illicit drugs in the past year. Other statistics from the
survey include that more than 22% of Americans over 18 years of age have engaged in binge
drinking in the past year, and more than 20% of Americans have smoked cigarettes in the past
month. Same survey reveals that 21.5 million people over 12 years of age in the United States
have had some form of substance use disorder in the past year.
Abused substances produce some form of intoxication that alters judgment, perception, attention, or
physical control.
Many substances can bring on withdrawal effects caused by cessation or reduction in the amount of the
substance used. Withdrawal symptoms can range from mild anxiety to seizures and hallucinations. Drug
overdose may also cause death.
Nearly all drugs of abuse can also produce a phenomenon known as tolerance, in which one must use a
larger amount of the drug to produce the same level of intoxication. Commonly abused drugs include the
following:

 Inhalants: This group of substances includes solvents that emit vapors, causing intoxication when
breathed in (inhaled). Individuals who abuse inhalants intentionally breathe in the vapors, either
directly from a container, from a bag in which such a substance is in, or from a rag soaked with
 the substance and then placed over the mouth or nose. Inhalant intoxication happens quickly and
doesn't last long.
o Abuse of inhalants is also called "huffing." Approximately 58% of inhalant users report
first using it by the end of ninth grade. Teens who started using inhalants before 15 years
of age were up to six times more likely as those who had started later to develop
dependence on these substances.
o Symptoms of inhalant intoxication are very similar to those seen with intoxication with
alcohol, including dizziness, clumsiness, slurred speech, elation, tiredness, slowed
reflexes, thinking and movement, shaking, blurred vision, stupor or coma, and/or
weakness. It can also result in chemical and temperature burns, as well as withdrawal
symptoms, chronic mental illness, and even sudden death.
o Long-term damage associated with inhalant use includes brain and nerve damage as
well as heart, liver, or kidney failure.

 Tobacco: People cite many reasons for using tobacco, including pleasure, improved performance
and vigilance, relief of depression, curbing hunger, and weight control.
o The primary addicting substance in cigarettes is nicotine. But cigarette smoke contains
thousands of other chemicals that also damage health both to the smoker and to those
around them. Hazards include heart disease, lung cancer and emphysema, peptic
ulcer disease, and stroke. Withdrawal symptoms of smoking include anxiety,
hunger, sleep disturbances, and depression.
o Smoking is responsible for nearly a half million deaths each year. Tobacco use costs the
nation an estimated $100 billion a year, mainly in direct and indirect health-care costs.

 Alcohol: Although many people have a drink as a "pick me up," alcohol actually depresses the
brain. Alcohol lessens your inhibitions, slurs speech, and decreases muscle control and
coordination, and prolonged use may lead to alcoholism.
o Withdrawal from alcohol can cause anxiety, irregular heartbeat, tremor, seizures, and
hallucinations. In its severest form, withdrawal combined with malnutrition can lead to a
life-threatening condition called delirium tremens (DTs). Alcohol abuse is the most
common cause of liver failure in the U.S. The drug can cause heart enlargement
and cancer of the esophagus, pancreas, and stomach.
o In addition to its direct health effects, officials associate alcohol abuse with nearly half of
all fatal motor-vehicle accidents. In 1992, the total economic cost of alcohol abuse was
estimated at $150 billion.
What Are Commonly Abused Drugs?

 Marijuana (also known as grass, pot, weed, herb): Marijuana, which comes from the
plant Cannabis sativa, is the most commonly used illegal drug in the United States. The active
ingredient in the plant, delta-9-tetrahydrocannabinol (THC), is associated with intoxication.
Marijuana resin, called hashish, contains an even higher concentration of THC.
o The drug is usually smoked, but it can also be eaten. Its smoke irritates your lungs more
and contains more cancer-causing chemicals than tobacco smoke. Common effects of
marijuana use include pleasure, relaxation, and impaired coordination and memory.
o Often the first illegal drug people use, marijuana is associated with increased risk of
progressing to the use of more powerful and dangerous drugs such as cocaine and
heroin. The risk for progressing to cocaine use is 104 times higher if you have smoked
marijuana at least once than if you never smoked marijuana.
 o Synthetic (man-made) forms of marijuana (often called K2, Spice, Black Mamba, Blaze
and Red X) can be smoked or otherwise inhaled. It is an increasing health risk, in that it
can produce the same impairment in judgment, addiction, and inability to function as
marijuana and go undetected by conventional drug testing. Some preparations of
synthetic marijuana are much more potent than traditional marijuana, leading to a higher
occurrence of becoming delirious, having seizures, or a stroke.

 Cocaine (also known as crack, coke, snow, blow, rock): In 2010, an estimated 1.5 million people
over 12 years of age abused cocaine in the United States.
o Derived from the coca plant of South America, cocaine can be smoked, injected, snorted,
or swallowed. The intensity and duration of the drug's effects depend on how you take it.
Desired effects include pleasure and increased alertness.
o Short-term effects also include paranoia, constriction of blood vessels leading to heart
damage or stroke, irregular heartbeat, and death. Severe depression and reduced energy
often accompany withdrawal. Both short- and long-term use of cocaine have been
associated with damage to the heart, the brain, the lung, and the kidneys.

 Heroin (also known as dope, smack, horse): A 2010 National Household Survey on Drug Abuse
indicated that the average age when Americans use this drug for the first time is about 21 years
of age, including 140,000 who reported using it for the first time in the year prior to the time the
survey was taken.
o Effects of heroin intoxication include drowsiness, pleasure, and slowed breathing.
Withdrawal can be intense and can include vomiting, abdominal cramps, diarrhea,
confusion, aches, and sweating.
o Overdose may result in decreased breathing to the point of stopped breathing and death.
Because heroin is usually injected, often with dirty needles, use of the drug can trigger
other health complications including destruction of your heart valves, tetanus,
and botulism, and infections like HIV/AIDS or hepatitis.

 Methamphetamines (also known as meth, crank, ice, speed, crystal): Use of this drug also has
increased, especially in the West. Methamphetamine is a powerful stimulant that increases
alertness, decreases appetite, and gives a sensation of pleasure.
o The drug can be injected, snorted, smoked, or eaten. It shares many of the same toxic
effects as cocaine -- heart attacks, dangerously high blood pressure, and stroke.
o Withdrawal often causes depression, abdominal cramps, and increased appetite. Other
long-term effects include paranoia, hallucinations, weight loss, destruction of teeth, and
heart damage.

 Anabolic steroids:
o This group of drugs includes testosterone, which is the natural male hormone. It also
includes a number of other synthetic forms of testosterone. Steroids are often abused by
bodybuilders or other athletes to increase muscle mass or improve performance.
o These types of substances seem to be associated with a number of mental-health
effects, like dependence on the substance, mood problems, and developing other kinds
of drug abuse.

 Club drugs: The club scene and rave parties have popularized an assortment of other drugs.
Many young people believe these drugs are harmless or even healthy. The following are the most
popular club drugs:
o Ecstasy (also called MDMA, E, X, E pills, Adam, STP): This is a stimulant and
hallucinogen used to improve mood and to maintain energy, often for all-night dance
 parties. Even onetime use can cause high fevers to the point of inducing a seizure. Long-
term use may cause damage to the brain's ability to regulate sleep, pain, memory, and
emotions.
o GHB (also called Liquid XTC, G, blue nitro): Once sold at health-food stores, GHB's
effects are related to dose. Effects range from mild relaxation to coma or death. GHB is
often used as a date-rape drug because it is tasteless, colorless, and acts as a powerful
sedative.
o Rohypnol (also called roofies, roche): This is another sedative that has been used as a
date-rape drug. Effects include low blood pressure, dizziness, abdominal cramps,
confusion, and impaired memory.
o Ketamine (also called Special K, K): This is an anesthetic that can be taken orally or
injected. Ketamine (Ketalar) can impair memory and attention. Higher doses can cause
amnesia, paranoia and hallucinations, depression, and difficulty breathing.
o LSD (also called acid, microdot) and mushrooms (also called shrooms, magic
mushrooms, peyote, buttons): Popular in the 1960s, LSD has been revived in the club
scene. LSD and hallucinogenic mushrooms can cause hallucinations,
numbness, nausea, and increased heart rate. Long-term effects include unwanted
"flashbacks" and psychosis (hallucinations, delusions, paranoia, and mood disturbances).
o PCP (also known as angel dust, hog, lovie, love boat): PCP is a powerful anesthetic used
in veterinary medicine. Its effects are similar to those of ketamine but often stronger. The
anesthetic effects are so strong that you can break your arm but not feel any pain when
under its effects. Usually, tobacco or marijuana cigarettes are dipped into PCP and then
smoked.
What Are the Causes and Risk Factors of Substance Abuse?
Use and abuse of substances such as cigarettes, alcohol, and illegal drugs may begin in childhood or the
teen years. Certain risk factors may increase someone's likelihood of abusing substances.

 Family history factors that influence a child's early development have been shown to be related to
an increased risk of drug abuse, such as
o chaotic home environment,
o ineffective parenting,
o lack of nurturing and parental attachment,
o parental drug use or addiction.

 Other risk factors for substance abuse are related to the substance abuse sufferer him- or herself,
like
o male gender,
o childhood attention deficit hyperactivity disorder (ADHD),
o history of anxiety or other mood disorders,
o conduct disorder or antisocial personality disorder.

 Factors related to a child's socialization outside the family may also increase the risk of drug
abuse, including
o inappropriately aggressive or shy behavior in the classroom,
o poor social coping skills,
 o poor school performance,
o association with a deviant peer group or isolating oneself from peers altogether,
o perception of approval of drug-use behavior.
o
What Are the Symptoms and Signs of Substance Abuse?
Friends and family may be among the first to recognize the signs of substance abuse. Early recognition
increases the chances for successful treatment. Signs to watch for include the following:

 Giving up past activities such as sports, homework, or hanging out with new friends

 Declining grades

 Aggressiveness and irritability

 A significant change in mood or behavior

 Forgetfulness

 Disappearing money or valuables

 Feeling rundown, hopeless, depressed, or even suicidal

 Sounding selfish and not caring about others

 Use of room deodorizers and incense

 Paraphernalia such as baggies, small boxes, pipes, and rolling paper

 Physical problems with unclear cause (for example, red eyes and slurred speech)

 Getting drunk or high on drugs on a regular basis

 Lying, particularly about how much alcohol or other drugs he or she is using

 Avoiding friends or family in order to get drunk or high

 Planning drinking in advance, hiding alcohol, and drinking or using other drugs alone

 Having to drink more to get the same high

 Believing that in order to have fun you need to drink or use other drugs

 Frequent hangovers

 Pressuring others to drink or use other drugs

 Taking risks, including sexual risks

 Having "blackouts," forgetting what he or she did the night before

 Constantly talking about drinking or using other drugs

 Getting in trouble with the law

 Drinking and driving

 Suspension or other problems at school or in the workplace for an alcohol- or drug-related

incident
When to Seek Medical Care
If you recognize that someone has a substance abuse problem and wants to quit, a doctor can refer
him/her to community resources where he/she may receive formal diagnosis and treatment of a
substance-abuse problem. A doctor also may prescribe medications to control cravings and withdrawal or
help manage medical complications resulting from substance abuse. Let a doctor know what drugs are
being used and how they are taken. Any of the following symptoms warrant a call to the doctor:

 Mild tremors or an alcohol withdrawal seizure not accompanied by hallucinations or confusion

 Jaundice (yellow skin and eyes)

 Increasing abdominal girth

 Leg swelling

 A cough, congestion, or sniffles that won't go away

 Continuing feelings of sadness or depression

 Pain at an injection site

 Fever
If any of the following occur, call 911 or go to a hospital's emergency department immediately:

 Thoughts of harming yourself or others

 Chest pain, rapid heartbeat, difficulty breathing, or lightheadedness

 Severe abdominal pain

 Confusion or ongoing hallucinations

 Severe tremors or recurrent seizures

 Difficulty speaking, numbness, weakness, severe headache, visual changes, or trouble keeping
balance

 Severe pain at an injection site (may be accompanied by redness, swelling, discharge, and fever)

 Dark, cola-colored urine

 Any suspicion of being sexually assaulted while under the influence

Screening and Assessment for Substance Abuse
While there is no one test that establishes the diagnosis of a substance use disorder with certainty, there
are screening tools, including online tests, that may help identify people who are at risk for having a
substance use problem. Therefore, health-care professionals assess this group of illnesses by gathering
thorough mental-health, medical, and family information. The practitioner will also likely ask that the
individual's primary-care doctor perform a physical exam, including lab tests to assess the person's
medical health and to explore whether or not the individual has a medical condition that can produce the
same symptoms as a mental-health problem.
Exploring the presence of mental-health symptoms includes determining if the person has a substance
use disorder, a mood disorder like depression and/or mania or anxiety, or if he or she suffers from the
hallucinations or delusions associated with schizophrenia, schizoaffective disorder, or other psychotic
disorders. The possible presence of a personality or behavior disorders like attention deficit hyperactivity
disorder (ADHD) is also usually explored. Practitioners may use a quiz or self-test as a screening tool for
substance-use disorders.
What Is the Treatment for Substance Abuse?
Most substance abusers believe they can stop using drugs on their own, but the majority who try do not
succeed. Before treatment for the addictive behavior can be directly addressed, the substance abuse
sufferer might need help in lessening physical withdrawal from alcohol or other drugs they have been
using. That initial phase of treatment is called detoxification or "detox." It often requires inpatient hospital
treatment.
Research shows that long-term drug use alters brain function and strengthens compulsions to use drugs.
This craving continues even after drug use stops.
Because of these ongoing cravings, the most important component of treatment, also called recovery, is
preventing relapse. Treating substance abuse often requires treatment in a rehabilitation (rehab) program
and depends on both the person and the substance being used. In behavioral treatment, a counselor (like
a social worker, psychologist, psychiatrist, psychiatric nurse, or nurse practitioner) provides strategies to
cope with drug cravings and ways to avoid relapse. Treatment often includes individual and group
therapy.
Once they have performed a thorough assessment of someone's condition, a doctor or nurse practitioner
may prescribe medications, such as nicotine patches and methadone, to control withdrawal symptoms
and drug cravings. Random drug testing is often an integral part of encouraging the person with
substance abuse problems to refrain from further drug use. Drug-abuse hotlines can be an invaluable
resource for people to initiate treatment and prevent relapse.
Often, a drug user has an underlying behavioral disorder or other mental illness, one that increases the
risk of substance abuse. When an individual suffers from a substance use disorder in addition to another
mental-health disorder, he or she is referred to as having a dual diagnosis. Such disorders must be
treated medically and through counseling along with treatment of the drug abuse.

QUESTION
What are opioids used to treat?See Answer
How Can You Prevent Substance Abuse?
Substance abuse may start in childhood or adolescence. Abuse prevention efforts in schools and
community settings now focus on school-age groups. Programs seek to increase communication between
parents and their children, to teach resistance skills, and to provide information in order to correct
children's misperceptions about cigarettes, alcohol, and drugs and the consequences of their use. Most
importantly, officials seek to develop, through education and the media, an environment of social
disapproval of drug use from children's peers and families.
What Is the Prognosis for Substance Abuse?
Individuals who suffer from substance abuse tend to be more successful in recovery when they are highly
motivated to be in treatment, are actively engaged in their own recovery, and receive intensive treatment
services. Prognosis for substance abuse recovery is further improved by being able to easily access
community-based social supports.
Costs to society
As of 2006, officials estimated that alcohol and drug abuse in the U.S. cost more than $246 billion. Some
important facts about the negative impact of drug and alcohol use in the United States are as follows:
  Crime: More than half of the economic cost of alcohol and other drugs is due to crime. A
substance abuser is 18 times more likely to be involved in illegal activity than someone who does
not abuse alcohol or other drugs. Many violent crimes have been linked to the mind-altering
effects of drugs. Substance abusers often commit thefts to support their drug habits. Drugs and
alcohol have been linked to domestic violence and sexual assault. At colleges, 75% of date rapes
are alcohol-related. Among jailed sex offenders, 43% say they were under the influence of drugs
or alcohol at the time of their crime.

 Disease: Most abused substances have harmful health effects. For some substances, such as
tobacco, effects are caused by long-term use. For other drugs, a single use can cause death,
disability, or significant disease.

 Behavior: In addition to their direct effects on health, drugs produce other indirect effects. Many
drugs lessen inhibitions and increase the likelihood that a person will participate in risky behavior.
Studies show that the use of alcohol and drugs among teenagers increases chances for
teen pregnancy and contracting HIV/AIDS or other sexually transmitted diseases. Any injected
drug is associated with contracting HIV/AIDS and hepatitis B and C.

 Trauma: Up to 75% of injured people treated at emergency departments test positive for illicit or
prescription drugs. Alcohol is strongly associated with both intentional and unintentional injury.
Drug use also puts people at risk of violence. Nearly half of assault victims are cocaine users.
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