Module 12: working with intoxicated young people: learner's workbook

6.3 Drug-related factors that influence the experience of intoxication

Page last updated: 2004

As well as individual and environmental factors, the Interaction model takes into account drug-related factors. Particular aspects of the drug itself can influence the drug-using and intoxication experience.

Question - What drug-related factors might influence a young person's experience of intoxication?

Drug-related factors
Intoxication
Summary

Drug-related factors

Some of the factors related to the drug that may affect the experience of intoxication include:

Type of drug

A useful way of understanding how a drug affects an individual is to look at its psycho-active effect on a person's central nervous system (CNS). Our brain forms the major part of the central nervous system and this is where psycho-active drugs trigger their main effect. The table on the following page indicates the effect on the central nervous system of each type of drug.

Amount and purity

The amount of the drug taken and the purity of strength of the dose will have a huge influence on the drug use experience.

Classifying drugs by their effect on CNS

  • Stimulants

    • Effect on CNS: Tend to speed up the activity of a person's central nervous system (CNS) including the brain. These drugs often result in the user feeling more alert and more energetic.
    • Examples:
      • Amphetamines
      • Cocaine
      • Pseudoephidrine (found in medications such as Sudafed, Codral Cold and Flu)
      • Nicotine
      • Caffeine

  • Hallucinogens Top of page

    • Effect on CNS: Have the ability to alter a user's sensory perceptions by distorting the messages carried in the CNS. A common example is LSD (trips). Hallucinogens alter one's perceptions and states of consciousness.
    • Examples:
      • LSD
      • Psilocybin (magic mushrooms)
      • Mescaline (peyote cactus)
      • Kava

  • Depressants (also known as relaxants)

    • Effect on CNS: Tend to slow down the activity of the CNS, which often results in the user feeling less pain, more relaxed, and sleepy. These symptoms may be noticeable when a drug is taken in large amounts. It is important to note that the term 'depressant' is used to describe the effect on the CNS, not mood. CNS depressants are more likely to result in euphoria than depression, especially in moderate use.
    • Examples:
      • Alcohol
      • Major tranquillisers
      • Benzodiazepines (e.g. Valium, Temazepam)
      • Opioids (heroin, morphine)
      • Volatile substances (can also be classified as other). These include glue, petrol, and paint.

  • Others

    • Effect on CNS: Includes psychoactive drugs that do not fit neatly into one of the other categories, but which are clearly psychoactive, such as antidepressants (e.g. Zoloft) and mood stabilisers (e.g. Lithium).
    • Examples:
      • MDMA (ecstasy)
      • Cannabis
      • Volatile substances

Mode of administration

The following modes of administration also influence the drug use experience (from fastest to slowest):
  • Injecting or intravenous drug use is the quickest way of achieving a psychoactive drug effect. The amount of time for the drug effect to be experienced is less than one minute.

  • Inhaling or breathing a volatile substance such as petrol or nitrous oxide (also known as laughing gas) is almost as fast as IV drug use, because the gaseous molecules travel easily and quickly through the cell walls from the lungs into the bloodstream.

  • Snorting or sniffing a powdered drug such as cocaine or amphetamine (speed) also results in rapid drug effect. The drug is absorbed quickly through the mucous membranes inside the nose into the bloodstream and the effects can be felt in two minutes.

  • Smoking a burnt substance such as cannabis or tobacco also results in a rapid onset of a drug effect. However it is not as fast-acting as volatile substances (petrol), as the tiny particles in the smoke do not pass from the lungs into the bloodstream with the ease of inhalants.

  • Swallowing a drug is a relatively slow method. After the drug is swallowed, it is dissolved in the stomach and then absorbed into the bloodstream through the stomach lining and later, the small intestine. Alcohol passes from the stomach into the bloodstream and produces drug effects in five to ten minutes. Drugs in tablet form can take over an hour to have an effect.

  • Rectal absorption of a drug involves the insertion of the drug into the rectum, where it can dissolve and be absorbed into the bloodstream via the linings of the rectum. In medical use, drugs are sometimes administered in this way to patients who cannot swallow. Recreational use of this type of administration is not widespread. Absorption is usually relatively slow.
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Time taken to consume the drug

The time taken to consume the drug (10 minutes vs 10 hours) will have a major impact on the drug-use experience of the individual.

Poly-drug use

Young people will often use two or three types of drugs at the same time. This is known as poly-drug use. According to the 1998 National Drug Strategy Household Survey, young people are more likely to be poly-drug users than older illicit drug users, who seem to develop a preference for one drug later in their twenties. Mixing drugs is an increasingly important issue in the youth scene, with pre-packaged 'drug cocktails' now available for sale. The reasoning behind 'cocktails' is that stimulants like cocaine and ecstasy (and possibly hallucinogens) are used for an energetic good time, followed by depressants like Rohypnol to help wind down and get off to sleep many hours later.

If the young person has been mixing various drugs, the resulting intoxication is far less predictable. If stimulants have been mixed with a depressant or hallucinogenic drugs, (speed mixed with alcohol or heroin) then the impact on the central nervous system, and resulting intoxication, will be very unpredictable.

Some drug combinations will result in a greater effect than one or both of the substances would produce when used in isolation. This is known as potentiation. For example, when depressant drugs are mixed (e.g. alcohol and tranquillisers or heroin), then you can expect extreme intoxication to occur. In fact death by heroin overdose is more likely when a person has also been drinking heavily and/or using benzodiazepines, creating a potentiation effect. All three types are central nervous system depressants, putting a greater strain on the CNS.

The National Drug Household Survey (1998) states there is much evidence to suggest that alcohol is frequently used in combination with illicit drugs or pharmaceutical drugs. In fact, the average number of substances used by young people aged 14–19 years who had used at least one illicit substance was 1.8 in the 12 months preceding the survey. Another important finding was that of those people interviewed who used ecstasy, 93 percent said that they had used other drugs in conjunction with ecstasy. (These statistics included the broader population.)

These indicators signal a growing trend amongst some population groups and are an increasing cause for concern. For example, combining drugs can lead to potential health complications, such as dehydration which is associated with combined alcohol and ecstasy use (National Drug Household Survey, 1998).

You should be aware of the potential risks involved when various drugs are combined and consult with a medical practitioner whenever poly-drug use is apparent.

Intoxication

Task

Consider the low and high risk factors contained in the two different drug intoxication scenarios that follow.

Analyse the following cases using the drug, individual and environmental factors based on the adapted youth-focused systems approach which takes into account the environment, the individual and drug-related factors.
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Case study - Nick and Heather

Nick has been drinking and smoking marijuana with friends at his flat while having a jam session on guitars. He is generally pretty relaxed about things and chooses friends who also like to chill-out, with no dramas. Nick is a 21-year-old university student with little cash, so he has limited supplies of alcohol and other drugs on hand. He prefers to take his time using drugs, spacing his supplies out over many hours, so that he doesn't totally lose control. He has an assignment to complete the next day and is determined to graduate this year. However, some of his best mates, who are employed, like to get drunk/stoned quickly and bring ample supplies, which they insist Nick share with them. His friends will crash at his place for the evening. A neighbour, who has repeatedly complained about the noise from the jam sessions, has threatened to 'take the law into his own hands'.

Nick's younger sister Heather, aged 17, is in Year 12. She is a far more extroverted, risk-taking person than her brother and likes nothing better than to 'rave', always in the presence of two of her best friends. She has had a cocktail of drugs having swallowed pills, injected speed and drunk some alcohol. (She is not even too sure what, and how much she has had.) She is now roaming the streets with her friends looking for further action in the early hours of the morning.

Heather hates 'mindless authority' interfering with her good times and an argument with a bouncer is ensuing. Heather always carries a mobile phone with her parents' and Nick's phone numbers on 'speed dial'. Her parents also stress that she take a taxi (with a friend) whenever there is a problem and they will pick up the tab on the night. She does understand the reasons for their concern.

Complete the following by allocating to either the low-risk or high-risk group the various environmental, individual and drug-related factors affecting Nick and Heather. There may be overlap between each group or category. Feel free to speculate on any other factors that might be relevant that weren't mentioned in the scenarios. You do not have to have both low-risk and high-risk factors for each category.

Nick's experience of intoxication

Factors relating to the:
  • Environment
    • Local community issues
    • Peer and school influence
    • Family
    • Societal and political factors
  • Individual (Nick)
    • Personality
    • Physical and mental health
    • Social skills
    • Expectations
    • Gender
    • Age
    • Weight
  • Drug(s)
    • Amount
    • Type
    • Mode of administration
    • Where
    • When
    • Poly-drug use
An example of a low-risk factor under environment is 'at home (no driving, machinery, water-sports, crowds)'Top of page

Heather's experience of intoxication

Factors relating to the:
  • Environment
    • Local community issues
    • Peer and school influence
    • Family
    • Societal and political factors
  • Individual (Heather)
    • Personality
    • Physical and mental health
    • Social skills
    • Expectations
    • Gender
    • Age
    • Weight
  • Drug(s)
    • Amount
    • Type
    • Mode of administration
    • Where
    • When
    • Poly-drug use
An example of a low-risk factor in environment is 'Sticks with her close friends'

Answers

(Check your answer on the possible answers page.)

Risk outcomes

It is not hard to determine who is at greater risk of experiencing intoxication-related problems. We can perhaps predict what problems might occur for Heather and her friends as the night unfolds. Despite the differences in temperament and drug use, a switch of drug-taking environments could make a large difference. If Nick and his mates were 'jamming' at the beach and someone got the idea to have a moonlight swim, a tragedy might happen. Conversely, if Heather and her friends had gone straight to Nick's place in a taxi from the rave, the risks for her may have been greatly diminished. Top of page

Summary

  • Intoxicated behaviour can vary greatly in a person from one episode to another

  • Intoxicated behaviour is influenced by:

    • the setting or environment in which the drug is consumed

    • individual factors related to the user

    • factors specific to the drug

  • Many young people use more than one drug at a time which can increase the risk of health harms and complications

  • Medical advice should always be sought if a young person has been using a combination of drugs.