Hall Staff: Rector/AR/RA's

Referring a student

How to Deal with an Intoxicated Student

Acute Alcohol Poisoning

OADE Brochures

As hall staff you may have more contact with a student than any other staff or faculty member. You also have contact with student peer groups who may share concerns about a student.

Overview of Services OADE

The Office of Alcohol and Drug Education (OADE) coordinates the alcohol and drug education and prevention efforts on campus. Referring a student to the office can be related to themselves, a family member or friend.

Student Assistance Programming
Students are referred to the educational programs for various reasons:

• General concern without an incident
• Public intoxication
• High-risk behavior involving alcohol and/or drugs
• Alcohol-related behavior that violates the rights or safety of others
• Personal concern about use of alcohol or other drugs
• Personal concern about a friend or family member who is abusing alcohol or drugs

All students referred to OADE may receive the following services:

• Individual Education Screening or Consultation – This initial appointment is to understand the appropriate education or information a student needs based on the reason they are referred.
• Personalized Feedback and Recommendations – Results of the Education Screening are discussed with the student with recommendations into the appropriate education topic.

Students who can benefit from education will be referred to the most appropriate session/s to meet their individual needs. This could include:

• College Drinking Culture (Level 1): 11/2 hour session with a focus on harm reduction.
• College Drinking Culture (Level 2): Three sessions with a focus on higher risk drinking behavior.
• Women’s Alcohol Education: Two sessions with a focus on women’s issues and use of alcohol.
• Abstinence Skill Building Education: Six sessions to support non-drinking whether temporary or longer.
• Individualized Education: Includes books, articles, DVD’s, Reflection Journaling.
• Check-in Appointments: Designed to help monitor and assist with changing drinking behaviors.

Prevention Programming

OADE coordinates prevention services to reduce harm and assist students in making healthier decisions in regard to alcohol and takes an active role in sponsoring alcohol/drug-free activities on campus.

Office resources include:

• Walk-in Information Center
• Consulting services to faculty, staff and campus organizations
• Classroom support programs
• In-hall prevention programs
• Blood Alcohol Concentration (BAC) cards personalized for weight and gender
• Designated Driver cards

Student Organizations

• PILLARS – Peers Inspiring Listening Learning and Responsible Socializing

OADE Staff

Director	Chris Nowak, M.Ed., LMHC	Christine.E.Nowak.2@nd.edu
Assistant Director	Kelly Lawrence, MS.Ed.	Kelly.R.Lawrence.30@nd.edu
Assistant Director	Annie Eaton MS.Ed., LMHC	Annette.Eaton.15@nd.edu
Assessment Counselor	Jim Lewis, LCSW	James.B.Lewis.70@nd.edu
Research Associate	Jenna Gehl MA	jgehl@nd.edu
Assessment/Prevention Counselor	Mara Trionfero MSW	mtrionfe@nd.edu
Senior Staff Assistant	Arleen Davis	Arleen.A.Davis.14@nd.edu

Referring a Student for an Educational Screening

Anyone can refer a student for an education or consultation. As hall staff if you refer a student please inform the rector you have done so.

• Inform the student you would like them to make an appointment.

• Give the student a deadline of when you would like the call made.

• Please either send an incident report or call OADE about the referral.

• Confirm with the student that they made the call by the deadline.

What do I need to tell students when I refer them to OADE?

• Let the student know the screening is to determine the education session/s they will attend.

• Share with the student that the screening is an opportunity for them to minimize their risk for any future incidences. or if it is a consultation for an alcohol related topic to provide information to help them resolve whatever it is they are encountering.

The student should call our office or stop by 204 Saint Liam Hall, to set up an appointment. A screening/consultation will take approximately 30 minutes.
Screenings/consultations work best if the appointment is scheduled soon after the incident.

How can I verify that the student followed through on the referral?

You can call the office and verify that the student has scheduled a screening. At the completion of services a letter will be provided to the student that confirms they attended the session/s.

How to Deal with an Intoxicated Student

Keep in mind that there are different levels of intoxication to deal with. The more intoxicated the person and the number of intoxicated people the situation may require back-up.

• Assess the situation and follow your gut, if any doubt, have assistance before you confront.

• The more intoxicated the person, do everything possible to first get rid of the audience. An audience can escalate the situation and the person.

• If a student starts to escalate NDSP may have to be called. Have who ever is assisting you make the call.

• Do as little as possible to confront the person’s behavior. If you do have to confront them stick strictly to short statements about behavior you just observed, ie… you are slurring your speech and seem to be unsteady.

• Work on isolating the student and getting them to their room.

• It is better to confront them the next day. If they seem to be highly intoxicated remember blood alcohol can continue to rise, although they may not be in distress, it can still pass out within the next hour. It is best to continue to check on the person or have a friend stay with them even if they fall asleep.

• Staying calm is important. The more intoxicated the higher the risk of them physically fighting or getting verbally abusive..

• The next day talk with the person about their behavior and inform them you have to write up the incident. Do not fall into any bargaining or promises they try to make in order to stay out of trouble.

Common Reactions to Confrontations Involving Alcohol Use and Effective Guidelines to Deal with Them

Anger or Defensiveness: A student may react angrily to your confrontation regarding their use of alcohol and /or drugs. They may tell you that it is none of your business.

• Rephrase what they are saying and identify their emotion. Example: “I understand that you are angry, but I have seen some behaviors which concern me.”
• Tell them that you are not willing to accept their behavior as it is disruptive to the dorm/others/themselves. Stick to the limits and recommendations that you set. If necessary get Help, (Rector, Security, University Counseling Center, etc.).

Denial/Minimization: A student may tell you that you don’t know what you are talking about and that alcohol is not an issue for them or they will downplay their drinking or drunk episodes.

• List specific behaviors observed. Use concrete examples. If the student continues to deny or minimize their drinking behaviors, seek rector support.
• If the student denies or minimizes their drinking behavior, but they are willing to follow through with recommendations, acknowledge that you appreciate their willingness to explore this further. Discuss appropriate options with the student.

Fear: A student might acknowledge having some issues involving alcohol, but is worried about someone finding out.

• Discuss confidentiality issues.
• Encourage the student to use rectors, OADE, or the University Counseling Center. Tell the student that it makes sense to seek out help now, rather than wait for a situation to arise when someone else needs to act.

Remorse: When confronted, a student may get upset and tell you that so many things are bothering them they don’t know what to do.

• Let them discuss their feelings and thoughts.
• Help them define their stresses. Encourage them to seek help in resolving some of their stresses.
• Tell them that alcohol will not help their problems disappear… it will only make it worse.
• Make an appropriate referral and check in on the student again later.

Remember: The Referral to OADE is an Educational Experience

The focus of the experience is to help students make healthier decisions. Depending on the education session/s attended students will be able to:

• Discuss the college culture and individual choices.
• Students will be able to understand more about the effects of alcohol at certain blood alcohol levels and their own personal tolerance to alcohol.
• Students will gain understanding of high-risk drinking behaviors and negative outcomes of high risk behavior.
• Students will be able to evaluate personal values and goals.
• Students will also receive specific recommendations and guidelines to help them lower their overall risk.

What should I focus on for programming in the hall?

When we ask students what they want to know in terms of alcohol and other drug education, they do not want shocking statistics, crash car displays or scare tactics. Instead, they want to know the following:

• Students want to know if they choose to drink, how to drink and be safer. They may also have questions about how to avoid a hangover. High-risk users of alcohol and other drugs want to know what resources are available to assess their use without getting in trouble. They want to learn to moderate their use or to reduce their level of risk.
• Non-drinkers want to know that they are not alone. A significant number of students do not consider alcohol to be an essential part of their social life. They want information on what activities they can do that are not focused on alcohol.
• Students want to know how to help a friend who might be in danger of alcohol poisoning. They want to understand when the individual needs to “sleep it off” versus when it might be a serious medical emergency.
• Students want to know how to avoid being hurt and how to avoid hurting others (including prevention of violence, verbal abuse, sexual assault, and unintentional sexual behavior).
• Students that come from family backgrounds where alcohol or other drug abuse was problematic may want to know what resources are available to help them understand this better.
• Smokers want to know what resources are available to help them quit smoking.

A Snapshot of Annual High-Risk College Drinking Consequences

The consequences of excessive and underage drinking affect virtually all college campuses, college communities, and college students, whether they choose to drink or not.

• Death: 1,700 college students between the ages of 18 and 24 die each year from alcohol-related unintentional injuries, including motor vehicle crashes (Hingson et al., 2005).
• Injury: 599,000 students between the ages of 18 and 24 are unintentionally injured under the influence of alcohol (Hingson et al., 2005).
• Assault: More than 696,000 students between the ages of 18 and 24 are assaulted by another student who has been drinking (Hingson et al., 2005)
• Sexual Abuse: More than 97,000 students between the ages of 18 and 24 are victims of alcohol-related sexual assault or date rape (Hingson et al., 2005).
• Unsafe Sex: 400,000 students between the ages of 18 and 24 had unprotected sex and more than 100,000 students between the ages of 18 and 24 report having been too intoxicated to know if they consented to having sex (Hingson et al., 2002).
• Academic Problems: About 25 percent of college students report academic consequences of their drinking including missing class, falling behind, doing poorly on exams or papers, and receiving lower grades overall (Engs et al., 1996; Presley et al., 1996a, 1996b; Wechsler et al., 2002).
• Health Problems/Suicide Attempts: More than 150,000 students develop an alcohol-related health problem (Hingson et al., 2002) and between 1.2 and 1.5 percent of students indicate that they tried to commit suicide within the past year due to drinking or drug use (Presley et al., 1998).
• Drunk Driving: 2.1 million students between the ages of 18 and 24 drove under the influence of alcohol last year (Hingson et al., 2002).
• Vandalism: About 11 percent of college student drinkers report that they have damaged property while under the influence of alcohol (Wechsler et al., 2002).
• Property Damage: More than 25 percent of administrators from schools with relatively low drinking levels and over 50 percent from schools with high drinking levels say their campuses have a “moderate” or “major” problem with alcohol-related property damage (Wechsler et al., 1995).
• Police Involvement: About 5 percent of 4-year college students are involved with the police or campus security as a result of their drinking (Wechsler et al., 2002) and an estimated 110,000 students between the ages of 18 and 24 are arrested for an alcohol-related violation such as public drunkenness or driving under the influence (Hingson et al., 2002).
• Alcohol Abuse and Dependence: 31 percent of college students met criteria for a diagnosis of alcohol abuse and 6 percent for a diagnosis of alcohol dependence in the past 12 months, according to questionnaire-based self-reports about their drinking (Knight et al., 2002).

Estimating Blood Alcohol Levels

BAC Level	Generalized Dose Specific Effects
0.020-0.039%	No loss of coordination, slight euphoria and loss of shyness. Relaxation, but depressant effects are not apparent.
0.040-0.059%	Feeling of well being, relaxation, lower inhibitions, and sensation of warmth. Euphoria. Some minor impairment of judgment and memory, lowering of caution.
0.06-0.099%	Slight impairment of balance, speech, vision, reaction time, and hearing. Euphoria. Reduced judgment and self-control. Impaired reasoning and memory.
0.100-0.129%	Significant impairment of motor coordination and loss of good judgment. Speech may be slurred; balance, peripheral vision, reaction time, and hearing will be impaired.
0.130-0.159%	Gross motor impairment and lack of physical control. Blurred vision and major loss of balance. Euphoria is reducing and beginning dysphoria (a state of feeling unwell)
0.160-0.199%	Dysphoria predominates, nausea may appear. The drinker has the appearance of a sloppy drunk.
0.200-0.249%	Needs assistance in walking; total mental confusion. Dysphoria with nausea and vomiting; possible blackout.
0.250-0.399%	Alcohol poisoning. Loss of consciousness.
0.40% +	Onset of coma, possible death due to respiratory arrest.

Estimating Blood Alcohol Level (Based on Weight)

Males

Weight	1 drink	2 drinks	3 drinks	4 drinks	5 drinks	6 drinks	7 drinks	8 drinks	9 drinks	10 drinks
100 lbs	.043	.087	.130	.174	.217	.261	.304	.348	.391	.435
125 lbs	.034	.069	.103	.139	.173	.209	.242	.278	.312	.346
150 lbs	.029	.058	.087	.116	.145	.174	.203	.232	.261	.290
175 lbs	.025	.050	.075	.100	.125	.150	.175	.200	.225	.250
200 lbs	.022	.043	.065	.087	.108	.130	.152	.174	.195	.217
225 lbs	.019	.039	.058	.078	.097	.117	.136	.156	.175	.195
250 lbs	.017	.035	.052	.070	.087	.105	.122	.139	.156	.173

Females

Weight	1drink	2 drinks	3 drinks	4 drinks	5 drinks	6 drinks	7 drinks	8 drinks	9 drinks	10 drinks
100 lbs	.050	.101	.152	.203	.253	.304	.355	.406	.456	.507
125 lbs	.040	.080	.120	.162	.202	.244	.282	.324	.364	.404
150 lbs	.034	.068	.101	.135	.169	.203	.237	.271	.304	.338
175 lbs	.029	.058	.087	.117	.146	.175	.204	.233	.262	.292
200 lbs	.026	.050	.076	.101	.126	.152	.177	.203	.227	.253
225 lbs	.022	.045	.068	.091	.113	.136	.159	.182	.204	.227
250 lbs	.020	.041	.061	.082	.101	.122	.142	.162	.182	.202

Time Factor Table

Hours since first drink	1 hr.	2 hrs.	3 hrs.	4 hrs.	5 hrs.	6hrs.
Subtract from blood alcohol level	.015	.030	.045	.060	.075	.090

Low-Risk Drinking Guidelines

Concepts such as moderate drinking, responsible drinking and social drinking are vague and mean different things to different people. More useful are numerical estimates of safe drinking limits.

According to the U.S. Department of Health and Human Services and the National Institute on Alcohol Abuse and Alcoholism, low-risk drinking guidelines are defined as:

No more than one drink per day for most women – and – No more than two drinks per day for most men

Low-Risk Guidelines	Women	Men
Abstinence	No risk	No risk
1 drink per day	Low risk	Low risk
2 drinks per day	Slight risk	Low risk
1 drink per hr. / 2 drink limit	Slight risk	Low risk
1 drink per hr. / 3 drink limit	Moderate risk	Slight risk

Determining Risk Level by Examining Several Issues Source – PRIME FOR LIFE, Prevention Research Institute

Level 1 – Low-Risk

Quantity/Frequency Choices-Consistently within low-risk drinking guidelines:

Characteristic	Symptom
Tolerance	No significant change from initial tolerance level
Attitude Toward Drinking	Take it or leave it
Enabling	Minimal, may tolerate high-risk use in others
Social Dependence	N/A
Psychological Dependence	N/A
Physical Dependence	N/A

Negative Outcomes-MIP, beer in hallway, etc. – not intoxicated at time of incident

Level 2 – At-Risk

Quantity/Frequency Choices-Occasional high-risk choices, typically drinks every weekend:

Characteristic	Symptom
Tolerance	Slight but noticeable increase, tolerance level is beginning to elevate
Attitude Toward Drinking	Drinking is a good way to have fun (anticipation)
Enabling	High-risk choices are acceptable and encouraged by peers
Social Dependence	More comfortable in social situations when drinking
Psychological Dependence	Elevated tolerance gives rise to excuse-making and rationalizations
Physical Dependence	N/A

Negative Outcomes-Symptoms of intoxication, more serious incidents are isolated events

Level 3 – Alcohol Abuse

Quantity/Frequency Choices-Frequent high-risk drinking pushed by high tolerance

Characteristic	Symptom
Tolerance	Tolerance is obvious to self and others, drinks others under the table
Attitude Toward Drinking	Drinking is the fun (anticipation becomes preoccupation)
Enabling	Problems related to high-risk drinking are covered-up by self and peers
Social Dependence	Relies on high-risk drinking to feel normal at social events and parties
Psychological Dependence	Defends inappropriate behavior, justifies continued high-risk use
Physical Dependence	N/A

Negative Outcomes-Various life problems – employment, legal, family, social, emotional

Level 4 – Alcohol Dependence

Quantity/Frequency Choices-Compulsive high-risk drinking pushed by tolerance and loss of control

Characteristic	Symptom
Tolerance	Markedly increased – changes in brain chemistry and liver metabolism
Attitude Toward Drinking	Got to have it (preoccupation becomes compulsion)
Enabling	Requires a sophisticated network of enablers
Social Dependence	Minimal – becoming socially isolated
Psychological Dependence	Requires a sophisticated denial system
Physical Dependence	Evidenced by withdrawal or compulsive drinking to stave-off withdrawal

Negative Outcomes-Chronic/Escalated life problems, health problems, premature death

Alcohol and Women: Critical Information

Source: APPLIED HEALTH RESEARCH, INC., Nebraska Council to Prevent Alcohol and Drug Abuse

Current research indicates that women are not as efficient “drinking machines” as males. In other words, men and women do not respond to alcohol in the same way. Multiple factors influence this difference.

The first factor is body size.

Equivalent doses of alcohol produce higher levels of concentration in smaller individuals. On the average, women are of smaller build than men are.

The second factor is body composition.

The average female carries more body fat and less muscle than the average male, and body fat contains little water. Alcohol, when consumed, dilutes uniformly into body water. Thus, given the same body size, the average female has lower total body water in which to dilute the alcohol. This results in a higher blood alcohol concentration for a female than for a male, even if both drink the same amount and are the same size. This is why BAC charts are different for males and females, because the charts are based on total body water.

The third factor is a metabolizing enzyme called alcohol dehydrogenase.

This enzyme helps the body to rid alcohol from the system. Women have less of this enzyme than men do. Thus, more of what they drink enters the bloodstream in the form of pure alcohol.

An additional factor is hormone differences.

Preliminary research suggests that the menstrual cycle and use of oral contraceptives (because of the change in hormones) may intensify a woman’s response to alcohol.

Because of these differences, women can expect substantially more impairment than men can at equivalent doses. If a man and a woman were the same body size, one drink for the woman is equivalent to 2 drinks for the man. In addition, research findings suggest that alcohol problems among women may develop more quickly and may result in severe health consequences.

For these reasons, to reduce the risk for experiencing alcohol-related problems, women should limit their consumption.
Standard health recommendations for pace and rate are:

• No more than 1 drink per two hours

Acute Alcohol Poisoning

Acute alcohol intoxication, or alcohol poisoning, can occur after the ingestion of a large amount of alcohol. Inexperienced drinkers, or individuals sensitive to alcohol, may become acutely intoxicated and suffer serious consequences after ingesting smaller amounts of alcohol.

When ingested in larger quantities, alcohol slows body functions, including heart rate, blood pressure, and breathing. When alcohol significantly depresses these vital centers, unconsciousness results, this is one step away from coma and possible death. If you are concerned for any reason, contact medical personnel.

Symptoms of Persons at Moderate-Risk

• Student is conscious, alert, and appears to understand the risks of the situation
• Student can state his or her name, class, and campus address.
• Student is able to stand or walk without assistance, although coordination may be impaired and speech may be slurred.
• Student is willing to cooperate and return to residence.
  
  If any of these conditions are present, the following steps are beneficial:

• Escort the person to bed.
• Place them on their side, with a pillow in the small of their back.
• Have someone check in on them every 10-15 minutes for the remainder of the night.

Symptoms of Persons at Significant-Risk

• Student is unable to stand or walk, or can only do so with difficulty.
• Student is only poorly aware of his or her surroundings.
• Student has fever or chills.
• Student has difficulty speaking or identifying him/herself to others.
• Student is obnoxious or unruly.
• Student is reported to have consumed a large quantity of alcohol, or ingested other sedating or tranquilizing drugs within the last 30 minutes.

If some of these conditions are present, hall staff, Security or a medical professional should evaluate the intoxicated student because blood alcohol levels can continue to rise and symptoms can intensify:

• Stay with the person while waiting for assistance.
• If unable to sit, place the intoxicated person on his/her side in case of vomiting.
• Assist hall staff or other professional as directed.

Symptoms of Alcohol Poisoning

• Unconsciousness or semi-consciousness.
• Slowed or irregular breathing. Slow respiration, eight or less breaths per minute or lapses of more than 10 seconds.
• Cold clammy or pale or bluish skin.
• Repeated episodes of vomiting.
• Vomiting while sleeping or passed out, and not waking up after vomiting. If you encounter a person who exhibits one or more of these symptoms, call 911 (Security). This is a medical emergency.

• Stay with the person until medical/emergency help arrives.

While waiting for medical transport, gently turn the intoxicated person on his/her side and maintain that position by placing a pillow, jacket, etc., at the small of the person’s back. This is important to prevent asphyxiation in case of vomiting.

Lifestyle Risk Reduction Model

Source – PRIME FOR LIFE, Prevention Research Institute

Alcoholism, like heart disease is a lifestyle-related health problem, and can best be understood using the lifestyle risk reduction model.

Risk Reduction for Alcoholism

• Estimate your individual level of biological risk. A person with a parent or grandparent with alcoholism is four times more likely to develop alcoholism. If the family history is more extensive, the risk for developing alcoholism is even greater. High tolerance is also a sign of increased biological risk.
• Determine the quantity and frequency of your alcohol consumption. Drinking to intoxication or impairment (high-risk drinking) advances tolerance and increases overall risk for alcoholism.
• Adjust low-risk guidelines according to your level of biological risk. The person with a family history of alcoholism requires different guidelines than the individual with no significant biological risk.
• Identify social and psychological factors that may influence the quantity and frequency of your alcohol consumption, and develop strategies to minimize high-risk drinking situations.
• Practice the skills and attitudes necessary to maintain low-risk drinking patterns that are right for you.

Alcohol – Drug Interactions

An interaction between alcohol and a drug is described as any change in the properties or effects of the drug in the presence of alcohol. Drug interactions may be:

• Additive: The net effect of the drug taken with alcohol is the sum of their effects.
• Synergistic: The effect of the drug when combined with alcohol is greater than the sum of their effects.
• Antagonistic: The effect of the drug is diminished in the presence of alcohol.

Since the liver is responsible for metabolizing drugs other than alcohol, potentially dangerous alcohol-drug interactions can occur in both light and heavy drinkers. If you take prescription or over-the-counter medications, ask your health care provider for advice about alcohol intake. Recognize that even herbal medicines and supplements can have adverse interactions with alcohol.

Drug Effects	Interactions With Alcohol
Marijuana	A 2-4 hour high indicated by bloodshot eyes, slowed motor skills and reaction time, impaired recall, distorted perceptions of time and space Exacerbates the sedative effect and increases the level of intoxication of both drugs.
Cocaine	Mood elevation, euphoria, increased energy, alertness, anxiety, irritability, insomnia, decreased appetite. Alcohol may be used to counteract anxiety and tweaking effects of cocaine. Potentially very dangerous because alcohol also elevates blood pressure, increasing risk for heart attack and stroke.
Hallucinogens	Altered perception of all senses, euphoria, anxiety, depersonalization increased body temperature, heart rate, blood pressure, loss of appetite, sleeplessness.
Sedatives &Tranquilizers	Effects are similar to alcohol, but aggression is less likely, lowered inhibitions, slowed pulse and breathing, lowered blood pressure, drowsiness Severe drowsiness, depressed cardiac and pulmonary functions which can be fatal.
Antidepressants	Severe drowsiness.
Opiates	Euphoria, constricted pupils, lowered blood pressure and heart rate Enhances sedative effect of both, increasing the risk of overdose.
Antibiotics	Nausea and abdominal pain are fairly common side effects. Most antibiotics are less effective when taken with alcohol, may exacerbate nausea.
Antihistamines	Drowsiness, dry mouth. Severe drowsiness
Aspirin & Ibuprofen	Minor side effects include nausea, heartburn, nervousness. Increases the risk for gastrointestinal bleeding.

Other Drugs:

Marijuana

Marijuana is a mind and mood-altering drug with variable effects. It has been described as both a sedative and a stimulant. It also acts as a tranquilizer and produces mild hallucinogenic effects by enhancing perception and providing the user with a sense of euphoria.

Marijuana may also impair intellectual ability for months after use has been discontinued, and contribute to a variety of health problems. The main mind-altering chemical in marijuana is THC, (delta – 9 – tetrahydrocannabinol), but it is only one of about 420 chemicals released into the bloodstream when marijuana is smoked. By comparison, alcohol and cocaine are comprised of only one chemical.
Some findings show that marijuana is ten times more potent than it was 30 years ago, but this is not consistently true. High potency marijuana, sometimes known as sinsamilla or skunk weed may be more readily available, but THC concentrations can vary considerably, and many times the user does not know the potency of the drug before using it. To complicate things even more, marijuana is sometimes laced with crack cocaine or PCP, increasing the potential for adverse effects. Regardless, marijuana is a drug, and it poses serious risks for some people; especially teens, pregnant women and heavy users.

Psychological Effects

People smoke marijuana for many of the same reasons that others consume alcohol, i.e., to lower inhibitions, to gain acceptance, to relax, or to escape boredom, loneliness, stress, or emotional pain. In social doses, marijuana use causes mood changes, usually characterized as pleasant. Common experiences include laughter, dreaminess or introspection.

At higher doses, the effects become more intense. The individual may be easily distracted by irrelevant stimuli, or tend to remain relatively motionless, possibly staring at a TV. Sense of time and space become more distorted. Decision-response time is also affected. Some people find this exhilarating; others feel anxious, panicky, paranoid, disoriented and confused. When used with alcohol, impairment is much greater.

Social context, mood and previous experience can all affect the marijuana high. The person looking forward to getting high with a supportive group of friends tends to have a good time. On the other hand, the individual who feel pressured to get high, or feels depressed or anxious, is likely to have a negative experience

Physiological Effects

Problems related to marijuana have been both exaggerated and under-reported. Marijuana smoke is rapidly and completely absorbed into the bloodstream. Effects peak within 30 minutes and last 90 minutes to 3 hours.

(1) Marijuana is a psychoactive drug, which means it acts on the brain.
Marijuana affects the user’s ability to store short-term memories and transfer them to long-term memories. It may also affect the user’s ability to recall long-term memories.

In addition to memory deficits, marijuana use may interfere with other important brain activities:

• Learning ability
• Concentration
• Judgment
• Decision-making & response time
• Ability to carry out complex tasks
• Coordination
• Motivation & ambition

(2) Marijuana is smoked, so it affects the lungs.
Marijuana smoke is 50% more carcinogenic than tobacco. Marijuana smoke is also inhaled without a filter, and held in the lungs for a longer period of time which increases the amount of carbon monoxide and tar released into the lungs by 400 to 500%. Chronic marijuana smokers are more at risk for developing acute and chronic bronchitis, lung cancer, emphysema and cancer of the esophagus. Cancer risks are significantly greater for the individual who uses both marijuana and tobacco.

(3) Marijuana suppresses activity of the immune system and lowers the white blood cell count.
This not only puts regular users more at risk for infections and other diseases, but also makes it more difficult for them to fight off colds and flu symptoms.

(4) Marijuana use lowers hormone production.
Regular marijuana use in men causes a decrease in testosterone and a lower sperm count. The female reproductive system is especially sensitive to the effects of marijuana. THC readily crosses the placental barrier and disrupts the development of the fetus during pregnancy.

(5) Marijuana affects the heart.
In low doses it causes a temporary increase in heart rate and blood pressure. In higher doses, heart rate and blood pressure decline.

(6) Smoking marijuana dilates blood vessels in the whites of the eye causing the eyes to appear bloodshot.

(7) Blood glucose levels also drop, resulting in a craving for junk food.

Progression of Marijuana Use

• Experimentation
• Social – no pattern, minimal impact
• Habituation – established pattern of use
• Abuse – pattern of use and continued use despite negative consequences
• Addiction – continued use despite negative consequences, compulsion to use, loss of control, withdrawal, and desire to use again after withdrawal.

Ecstasy / XTC

What is Ecstasy?

MDMA, with street alias, Ecstasy, is a designer drug usually found at raves. MDMA is an amphetamine derivative and it is considered to be a strong stimulant. Its chemical structure is similar to two other synthetic drugs, methamphetamine and MDA. It is generally sold in the pill/tablet form for about $20 to $30 a pill.

What are the effects of Ecstasy?

MDMA stimulates the release of the serotonin from brain neurons, producing a high that lasts from several minutes to an hour. The drug’s rewarding effects vary with the individual taking it, the dose and purity, and the environment in which it is taken. MDMA can produce stimulant effects such as an enhanced sense of pleasure and self-confidence and increased energy. Its psychedelic effects include feelings of peacefulness, acceptance, and empathy. Users claim they experience feelings of closeness with others and a desire to touch them.

With regular and frequent use, tolerance builds to the effects of the drug, while dangerous results increase with continued use. The drug effects are unpredictable among different individuals even if given the same dosage.

Users experience confusion, depression, sleep problems, drug craving, severe anxiety, and paranoia-during and sometimes weeks after use (even psychotic episodes have been reported), muscle tension, involuntary teeth-clenching, nausea, blurred vision, rapid eye movements, faintness, and chills or sweating; increases in heart rate and blood pressure (a special risk for people with circulatory or heart disease).

MDMA appears to cause degeneration of neurons containing the neurotransmitter dopamine; the underlying cause of the motor disturbances seen in Parkinson’s disease. Symptoms of this disease begin with lack of coordination and tremors and can eventually result in a form of paralysis.

Recent research findings also link MDMA use to long-term (possibly permanent) damage to those parts of the brain critical to thought and memory. It is thought that the drug causes long-term damage to the neurons that use the chemical, Serotonin, to communicate with other neurons.

Also, there is evidence that people who develop a rash that looks like acne after using MDMA may be risking severe side effects, including liver damage if they continue to use the drug.

FATAL RISKS

According to the Government and Drug Agencies, MDMA has become a nationwide problem as well as a serious health threat. It is known to be lethal. Combining MDMA with alcohol or depressants can increase the possibility of negative effects including sedation, dehydration, exhaustion, overheating, and heart failure. Combining MDMA with Rohypnol can lead to heart failure, coma, and death. Even in healthy young individuals, combined use of these drugs has caused coma and death.

Rohypnol

Description
The Rohypnol pill looks like aspirin. Rohypnol is usually sold in its original bubble packaging just as most prescription drugs are. This unfortunately assists in creating the misperception that this “medicine” is safe or legal. Generic and illegally manufactured versions exist. Cost ranges from $0.50 to $5 a pill.

Why “Date Rape Drug”?

Like alcohol, the drug is considered a date rape drug of choice; attackers slip the drug into victims’ drinks to promote disinhibition. The drug is given to unwary victims (male or female) without their consent. The victim is physically incapacitated and has impaired judgment. This makes victims more vulnerable to assault and rape. Because of the memory loss and confusion under the influence of this drug, rape cases are difficult to prosecute. Recently, screening for Rohypnol has improved.

Reducing Risks

Rohypnol is an odorless, colorless, tasteless drug. If you or someone you trust did not open the container, do not eat or drink its contents. Never leave an open drink unattended and avoid punch bowls which may be spiked. If you experience any of the symptoms associated with Rohypnol, have someone take you to the infirmary or hospital immediately.

Testing

If a student at University of Notre Dame requests screening for Rohypnol, the lab in the Student Health Center will send samples to Roche laboratories. Samples need to be collected within 24 hours of suspected intake. The test has a 14 day turnaround. The test will cost $50. They will conduct the tests between the hours of 8AM-5PM. After hours, students must go to St. Joseph Hospital, Emergency Services.

Drug Interactions

One trend is termed synthetic speedballing. This involves combining Ecstasy and Rohypnol to induce a stronger effect. To produce a “floating effect,” Rohypnol is also used in combination with marijuana, cocaine, or heroin. College students typically use alcohol in combination with Rohypnol to create an enhanced feeling of drunkenness. High school students use the drug as a “cheap drunk” without the smell of alcohol. In some areas, it is associated with gangs and is known as a club drug. It is also popular in raves. Warning – when used in combination with other drugs including alcohol, Rohypnol presents great risk of overdose. Results are fatal because breathing stops. Combining Rohypnol with MDMA (Ecstasy) can lead to heart failure, coma, and death.

Short-Term Effects:

Rohypnol produces sedative effects, amnesia, muscle relaxation, and the slowing of psychomotor performance. Sedation occurs within 15 to 30 minutes after ingestion of a 2-mg tablet, and lasts for approximately 8 hours. Peak effect takes place after approximately 2 hours causing most victims to lose consciousness. Those who ingest the Rohypnol become extremely relaxed, can lose bodily control. They are uninhibited and appear to be very drunk. Greatest physiological risk occurs when Rohypnol is used in with other drugs.

Rohypnol is 10 times more potent than Valium and enters the bloodstream as quickly as 15 minutes after ingestion. A single 2-milligram pill has the same potency as a 6-pack of beer, but the effects differ slightly. Users can experience extreme sedation, dizziness, and loss of bodily control. Rohypnol causes an intoxication where users don’t care about what they do or cannot stop what happens to them. Users have great difficulty remembering what happened while they were under the influence of the drug; it wipes the memory clean.

Long-Term Effects:

Continued use can lead to both physical and psychological dependence. Withdrawal symptoms range from headache, muscle pain, and confusion, to hallucinations and convulsions. Seizures may occur.

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