# **Employee Education Outline**

-   Objectives of training

-   Overview of Drug-Free Workplace Policy

-   Impact of substance abuse in the workplace

-   Ways that people use alcohol and other drugs

-   Understanding addiction

-   Signs and symptoms of substance abuse

-   Family and coworker impact

-   Assistance

-   Confidentiality

-   Specific drugs of abuse

# **Objectives of Training**

At the end of the training, employees should be familiar with the
Drug-Free Workplace Policy and aware of the dangers of alcohol and drug
abuse.

Employees should understand:

-   The requirements of the Drug-Free Workplace Policy.

-   The prevalence of alcohol and drug abuse and its impact on the
    workplace

-   How to recognize the link between poor performance and/or alcohol
    and drug abuse

-   The progression of the disease of addiction

-   What types of assistance may be available

Slides 1-3

Handout 1

# **Overview of Drug-Free Workplace Policy**

# 

# **The Drug-Free Workplace Policy accomplishes two major things:**

-   Sends a clear message that use of alcohol and drugs in the workplace
    is prohibited.

-   Encourages employees who have problems with alcohol and other drugs
    to voluntarily seek help

**The policy exists to**:

-   Protect the health and safety of all employees, customers and the
    public

-   Safeguard employer assets from theft and destruction

-   Protect trade secrets

-   Maintain product quality and company integrity and reputation

-   Comply with the Drug-Free Workplace Act of 1988 or any other
    applicable federal, state or local laws

**The Drug-Free Workplace Policy answers the following questions:**

-   What is the purpose of the policy and program?

-   Who is covered by the policy?

-   When does the policy apply?

-   What behavior is prohibited?

-   Are employees required to notify supervisors of drug-related
    convictions?

-   Does the policy include searches?

-   Does the program include drug testing?

-   What are the consequences for violating the policy?

-   Are there Return-to-Work Agreements?

-   What type of assistance is available to employees needing help?

-   How is employee confidentiality protected?

-   Who is responsible for enforcing the policy?

-   How is the policy communicated to employees?

Slides 4-7

Handout 2

####### **Impact of Substance Abuse in the Workplace**

**Employee Health** -- People who abuse alcohol or other drugs tend to
neglect nutrition, sleep and other basic health needs. Substance abuse
depresses the immune system.

Impact on the workplace:

-   Higher use of health benefits

-   Increased use of sick time

-   Higher absenteeism and tardiness

**Productivity** -- Employees who are substance abusers can be
physically and mentally impaired while on the job. Substance abuse
interferes with job satisfaction and the motivation to do a good job.

Impact on the workplace:

-   Reduced output

-   Increased errors

-   Lower quality of work

-   Reduced customer satisfaction

**Decision Making** -- Individuals who abuse alcohol and/or other drugs
often make poor decisions and have a distorted perception of their
ability.

Impact on the workplace:

-   Reduced innovation

-   Reduced creativity

-   Less competitiveness

-   Poor decisions, both daily and strategic

Slide 8

Handout 3

**Safety** -- Common effects of substance abuse include impaired vision,
hearing and muscle coordination and low levels of attention, alertness
and mental acuity.

Impact on the workplace:

-   Increased accidents

-   More workers' compensation claims

**Employee Morale** -- The presence of an employee with drug and/or
alcohol problems creates a strain on relationships between coworkers.
Organizations that appear to condone substance abuse create the
impression that they don't care.

Impact on the workplace:

-   Higher turnover

-   Lower quality

-   Reduced team effort

**Security** -- Employees with drug and/or alcohol problems often have
financial difficulties, and employees who use illegal drugs may be
engaging in illegal activities in the workplace.

Impact on the workplace:

-   Theft

-   Law enforcement involvement

###### **Organizational Image and Community Relations** -- Accidents, lawsuits and other incidents stemming from employee substance abuse problems may receive media attention and hurt an organization's reputation in the community.

Impact on the workplace:

-   Reduced trust and confidence

-   Reduced ability to attract high-quality employees

Slide 8

Handout 4

**Ways that People Use Alcohol and Other Drugs**

**Use:** Alcohol and other drugs may be used in a socially accepted or
medically authorized manner to modify or control mood or state of mind.
Examples include having a drink with friends or taking an anti-anxiety
agency as prescribed by a physician. Described below are different ways
that people use alcohol and other drugs without necessarily becoming
addicted.

> **Experimentation** -- Out of curiosity and/or at the urging of peers,
> individuals may try drinking or using drugs illegally. If the illegal
> drug use is not repeated, or discontinues after a short time, such
> experimentation may not be problematic. Likewise, deciding to drink
> alcoholic beverages after early experimentation is not problematic for
> most adults.
>
> **Social/Recreational** -- Drinking alcoholic beverages is permitted
> in American society, and some excessive use may even be condoned. If
> use doesn't cause problems for the user, or those around him/her, most
> people would consider such use to be social or recreational. Some use
> marijuana in a similar manner -- only in certain social or
> recreational situations and without immediate adverse consequences.
> However, marijuana use is illegal, except in a few states.
>
> **As a Stress Reliever** -- Many people use alcohol or other drugs to
> help them cope with pressure or stress. If this type of use is
> infrequent and doesn't create more stress or difficulties for the
> user, or those around him/her, it may not lead to addiction, but
> alcoholism and drug addiction often begin with relief drinking.

**Abuse**: The use of a substance to modify or control mood or state of
mind in a manner that is illegal or harmful to oneself or others is
considered problematic use, or abuse. Examples of potential consequences
of harmful use are:

-   Accidents or injuries

-   Blackouts

-   Legal problems

-   Poor job performance

-   Family problems

-   Sexual behavior that increases the risk of HIV infection

**Addiction:** A number of individuals occasionally use or abuse alcohol
or drugs without becoming addicted, but for many abuse continues despite
repeated attempts to return to more social or controlled use and leads
to addiction. Addiction is the irresistible compulsion to use alcohol
and drugs despite adverse consequences. It is characterized by repeated
failures to control use, increased tolerance and increased disruption in
the family.

Slides 9-11

Handout 5

**Understanding Addiction**

Unfortunately, it is not possible to tell early on whose use may lead to
abuse and/or addiction. For one in ten people, abuse leads to addiction.

**Addiction to alcohol and other drugs is:**

**Chronic** -- Once you have developed an addiction, you will always
have to deal with it. You may manage to stop using alcohol or other
drugs for significant periods of time, but for most the disease doesn't
disappear but rather goes into remission. Should you attempt to resume
'normal' use, you will rapidly return to addictive, out of control use
and abuse.

**Progressive** -- Addiction gets worse over time. With some drugs, the
decline is rapid; with others, like alcohol, it can be more gradual, but
it does get worse. Alcohol and other drugs cause a biochemical change in
the nervous system that can persist even after the substance leaves the
blood. Repeated use causes progressive damage.

**Primary** -- Addiction is not just a symptom of some underlying
psychological problem, a developmental stage or a reaction to stress.
Once your use of alcohol or drugs has become an addiction, the addiction
itself needs to be medically treated as a primary illness.

**Terminal** -- Addiction to alcohol and/or other drugs often leads to
disease and possibly death.

**Characterized by Denial** -- One of the most disturbing and confusing
aspects of addiction is that it is characterized by denial. The user
denies that his/her use is out of control or that it is causing any
problems at home or work. The user often seems to be the last to know
that his/her life is out of control. There are effective strategies
employed by professionals for helping to break through this denial,
which must be overcome before treatment can take place.

######## 

######## Slide 12

Handout 6

######## **Risk of Addiction:**

*Addiction is a family disease:*

Some people with a history of substance abuse in their family are more
susceptible to developing problems with addiction. Children of
alcoholics or addicts are three times as likely to develop problems. If
both parents are addicts or alcoholics, the risk increases to five times
as great. This is due to heredity as well as learned behavior. It is
important for parents to realize that children learn much more from
watching their behavior than listening to their advice.

Prior abuse of alcohol and other drugs has a great impact on developing
future problems:

A pattern of abuse develops and can lead to addiction and psychological
reliance on drugs and/or alcohol. This can be a slow progression for
some and a rapid decline for others. Research demonstrates that the
later in life an individual first drinks alcohol or uses other drugs,
the less likely he or she will be to progress to problem use.

Other contributing factors:

Some people abuse alcohol and drugs as part of a self-destructive
lifestyle. Other people start to use substances to seek relief from
depression or crisis in their lives. Although some fortunate individuals
never develop serious problems and use diminishes or ceases once the
precipitating events change, others develop a serious problem before
they even realize it.

Slide 13

Handout 7

# **Signs and Symptoms of Substance Abuse**

Abuse of alcohol and other drugs affects people emotionally,
behaviorally and physically.

**Emotional Effects**:

-   Aggression

-   Burnout

-   Anxiety

-   Depression

-   Paranoia

-   Denial

**Behavioral Effects**:

-   Slow reaction time

-   Impaired coordination

-   Slowed or slurred speech

-   Irritability

-   Excessive talking

-   Inability to sit still

-   Limited attention span

-   Poor motivation and lack of energy

**Physical Effects**:

-   Weight loss

-   Sweating

-   Chills

-   Smell of alcohol

Slides 14-17

Handout 8

# **Family and Coworker Impact**

**Enabling**: Action that someone takes to protect the person with the
problem from the consequences of his or her actions. Unfortunately,
enabling actually helps the person to NOT deal with his or her problem.

**[Examples of enabling include]{.underline}:**

**Covering Up** -- Providing alibis, making excuses or even doing an
impaired worker's work rather than confronting the issue that he/she is
not meeting his/her expectations.

**Rationalizing** -- Developing reasons why the person's continued
substance abuse or behavior is understandable or acceptable.

**Withdrawing/Avoiding** -- Avoiding contact with the person with the
problem.

**Blaming** -- Blaming yourself for the person's continued substance
abuse or getting angry at the individual for not trying hard enough to
control his/her use or to get help.

**Controlling** -- Trying to take responsibility for the person by
throwing out his/her drugs, cutting off the supply or trying to minimize
the impact by moving him/her to a less important job.

**Threatening** -- Saying that you will take action (ceasing to cover
up, taking formal disciplinary action) if the employee doesn't control
his/her use, but not following through.

Slides 18-19

Handout 9

**[Examples of traps that family members and coworkers may fall
into]{.underline}:**

**Sympathy** -- Trying to get you involved in his/her personal problems.

**Excuses** -- Having increasingly improbable explanations for
everything that happens.

**Apology** -- Being very sorry and promising to change. ("It won't
happen again.")

**Diversions** -- Trying to get you to talk about other issues in life
or in the workplace.

**Innocence** -- Claiming he/she is not the cause of the problems you
observe, but rather the

victim. ("It isn't true." "I didn't know." "Everyone is against me.")

**Anger** -- Showing physically intimidating behavior, blaming others.
("It's your fault.")

**Pity** -- Using emotional blackmail to elicit your sympathy and guilt.
("You know what I'm going through. How can you do this to me now?")

###### 

###### **Tears** -- Falling apart and expressing remorse upon confrontation.

## 

Slide 20

Handout 10

**Assistance**

**Things to remember:**

-   Difficulty performing on the job can sometimes be caused by
    unrecognized personal problems -- including addiction to alcohol and
    other drugs

-   Help is available

-   Although a supervisor may suspect that an employee's performance is
    poor because of underlying personal problems, it is up to employee
    to decide whether or not that is the case

-   It is an employee's responsibility to decide whether or not to seek
    help

-   Addiction is treatable and reversible

-   An employee's decision to seek help is a private one and will not be
    made public

**If EAP services are available:**

-   An EAP can help employees decide what to do if they have a problem
    with alcohol or other drugs

-   An EAP also can help an employee decide what to do if someone in
    his/her family or workgroup has a problem

-   Conversations with an EAP are confidential

***If EAP services are not available, help may be available from:***

-   Community hotlines

-   Self-help groups such as Alcoholics Anonymous, Narcotics Anonymous,
    Al-Anon, etc.

-   Community mental health centers

-   Private therapists or counselors

-   Addiction treatment centers

Slides 21-24

####### Handout 11 

####### **Confidentiality**

**Employees need to know that:**

-   Problems will not be made public

-   Conversations with an EAP professional -- or other referral agent --
    are private and will be protected

-   All information related to performance issues will be maintained in
    his/her personnel file

-   Information about any referral to treatment, however, will be kept
    separately

-   Information about treatment for addiction or mental illness is not a
    matter of public record and cannot be shared without a release
    signed by the employee

-   If an employee chooses to tell coworkers about his/her private
    concerns, that is his/her decision

-   When an employee tells his/her supervisor something in confidence,
    supervisors are obligated to protect that disclosure

***If EAP services are available, employees are also assured that:***

-   EAP records are separate from personnel records and can be accessed
    only with a signed release from the employee

```{=html}
<!-- -->
```
-   EAP professionals are bound by a code of ethics to protect the
    confidentiality of the employees and family members that they serve

```{=html}
<!-- -->
```
-   There are clear limits on when and what information an EAP
    professional can share and with whom

**However, there are some limits on confidentiality that may require:**

-   Disclosure of child abuse, elder abuse and serious threats of
    homicide or suicide as dictated by state law

-   Reporting participation in an EAP to the referring supervisor

-   Reporting the results of assessment and evaluation following a
    positive drug test

-   Verifying medical information to authorize release time or satisfy
    fitness-for-duty concerns as specified in company policy

-   Revealing medical information to the insurance company in order to
    qualify for coverage under a benefits plan

Slides 25-28

Handout 12

####### **Specific Drugs of Abuse**

**Alcohol**

In American society alcohol is a legal drug. Nonetheless, it is a
depressant and is the leading drug of abuse. Use of alcohol affects
judgment and decision-making abilities, slows down the central nervous
system and brain function, and reduces coordination and reflex actions.

###### [Signs and symptoms of abuse]{.underline}:

-   Dulled mental processes

-   Lack of coordination

-   Slowed reaction time

-   Poor judgement

-   Reduced inhibitions

[Health effects]{.underline}:

-   Decreased sexual functioning

-   Liver disease

-   Increased cancers of the mouth, tongue, pharynx, esophagus, rectum,
    breast and skin

-   Kidney disease

-   Ulcers

-   Spontaneous abortion

-   Birth defects -- leading cause of preventable retardation

[Workplace issues]{.underline}:

-   Many employers now test for the presence of alcohol along with other
    drug testing.

-   Consuming alcohol increases the likelihood that a driver or
    equipment operator will be involved in an accident.

-   Low doses of alcohol reduce inhibitions and affect decision making.

-   People who would not ordinarily behave in inappropriate ways can be
    persuaded to change their behavior when they are drinking.

-   Often employees are under the influence of alcohol when they make
    the decision to use drugs.

Slide 29

Handout 13

**Marijuana**

Marijuana is a derivative of the hemp plant and is illegally used for
its intoxicating effects and dreamy state of relaxation and euphoria.
All forms of marijuana have negative physical and mental effects. The
active ingredient in marijuana is Delta-9-Tetrahydrocannabinol, or THC,
and is present in all forms of the drug.

[Signs and symptoms of use]{.underline}:

###### Physical 

-   Substantial increase in heart rate

-   Bloodshot eyes

-   Dry mouth and throat

-   Increased appetite

-   Chronic sore throat

###### Mental 

-   Impaired or reduced short-term memory and comprehension

-   Altered sense of time

-   Changed sensory perception\--sight, smell, hearing, touch

-   Reduced ability to perform tasks requiring concentration and
    coordination, such as driving a car

[Health effects]{.underline}:

-   Emphysema-like symptoms

-   Respiratory track and sinus infections

-   Lowered immune system response

[Workplace issues]{.underline}:

-   Employees who fall under Federal guidelines such as the Department
    of Transportation's testing regulations are prohibited from using
    marijuana in any form.

-   THC is stored in the body fat and is slowly released over time.
    Since it is retained in the fat, an employee can test positive many
    days after use.

-   Many employers also have work rules requiring the employee to
    disclose if he or she is taking any sedating medications that could
    impact his or her ability to work safely. This rule would apply even
    in states that have approved the medicinal use of marijuana.

-   The use of marijuana definitely would cause fitness-for-duty
    concerns.

Slide 29

Handout 14

**Inhalants**

Inhalants are mood-altering substances that are voluntarily inhaled.
Most substances used are commercial and household products, such as
solvents and aerosols, which are easily obtained and not harmful, if
used for the purpose intended and as directed. Because they are common
products, inhalants often are a young person's first attempt at "getting
high."

[Signs and symptoms of abuse]{.underline}:

Inhaling solvents allows the substance to reach the bloodstream very
quickly. Immediate negative effects of include:

-   Nausea

-   Sneezing

-   Coughing

-   Nosebleeds

-   Fatigue

-   Poor coordination

-   Loss of appetite

[Health effects]{.underline}:

-   Hepatitis

-   Brain damage

-   Debilitating effects on the central nervous system

-   Weight loss

-   Fatigue

-   Electrolyte imbalance

-   Muscle fatigue

-   Permanent damage to the nervous system

[Workplace issues]{.underline}:

-   Inhalants can severely impair judgment and driving ability.

-   They also cause severe disorientation, visual distortion and
    confusion.

-   Some such products may be available in the workplace.

Slide 29

Handout 15

**Cocaine**

###### 

Cocaine is the most potent stimulant of organic origin and the most
widely used of the stimulants. Although cocaine has been used in the
past as a topical anesthetic, its therapeutic uses have almost been
eliminated due to the development of safer anesthetics. Cocaine is a
powerfully addictive drug leading to physical and psychological
dependence.

###### [Signs and symptoms of abuse]{.underline}:

-   Dilated pupils

-   Increased pulse rate

-   Elevated blood pressure

-   Insomnia

-   Loss of appetite

-   Tactile hallucinations

-   Paranoia

-   Seizures

-   Anxiety, agitation

-   Periods of increased activity followed by fatigue and depression

-   Wide mood swings

-   Difficulty in concentration

[Health effects]{.underline}:

-   Cocaine stimulates the central nervous system. Its immediate effects
    include dilated pupils and elevated blood pressure, heart rate,
    respiratory rate and body temperature. Cocaine use can lead to death
    by cardiac arrest or respiratory failure.

-   Cocaine powder is sniffed or snorted. The euphoric high lasts for
    approximately 30 minutes. Occasional use can cause a stuffy or runny
    nose, while chronic use can ulcerate the mucous membrane of the
    nose. Cocaine powder can also be injected into the bloodstream when
    it is mixed with water. Using contaminated equipment to inject
    cocaine, or any other substance, can transmit HIV and cause
    HIV/AIDS, hepatitis and other infection diseases.

-   Preparation of freebase, which involves the use of volatile
    solvents, can result in death or injury from fire or explosion.
    Inhalation of cocaine fumes from freebasing produces effects that
    are very fast in onset, very intense and momentary in duration.

Slide 29

Handout 16

-   Crack is cocaine that is processed into tiny chips having the
    appearance of slivers of soap. Crack has become a very popular form
    of cocaine, since it is inexpensive and relatively easy to use. It
    is smoked in a pipe or rolled with tobacco in a cigarette. Cocaine
    can produce psychological and physical dependency, a feeling that
    the user cannot function without the drug. Many users become
    extremely depressed when not using the drug, and the craving for the
    drug is intense. In addition, tolerance develops rapidly.

[Workplace issues]{.underline}:

-   Employees who fall under Federal guidelines such as the Department
    of Transportation's testing regulations are prohibited from using
    cocaine in any form.

-   The addictive nature and cost can lead to workplace theft and/or
    dealing.

-   Work performance is erratic with periods of high performance and
    periods characterized by forgetfulness, absenteeism and missed
    assignments.

Slide 29

Handout 17

**Stimulants**

Stimulants are drugs that stimulate the central nervous system and
excite bodily activity. Methamphetamine or crank is one of the fastest
growing drugs of abuse. These drugs create less intense and less
expensive cocaine-like effects in the body.

[Signs and symptoms of abuse]{.underline}:

-   Mood changes

-   Impaired concentration

-   Impaired mental functioning

-   Swings between apathy and alertness

[Health effects]{.underline}:

-   Increased heart and respiratory rates

-   Elevated blood pressure

-   Sweating

-   Headaches

-   Blurred vision

-   Dizziness

-   Sleeplessness and anxiety

-   Rapid or irregular heartbeat

-   Tremors

-   Poor coordination

-   Physical collapse

[Workplace issues]{.underline}:

-   Employees who fall under Federal guidelines such as the Department
    of Transportation's testing regulations are prohibited from using
    amphetamines without a current prescription.

-   The addictive nature and cost can lead to workplace theft and/or
    dealing.

-   Work performance is erratic with periods of high performance and
    periods characterized by forgetfulness, absenteeism and missed
    assignments.

Slide 29

Handout 18

**Depressants**

A depressant is a drug that depresses the central nervous system,
resulting in sedation and a decrease in bodily activity. Depressants,
taken as prescribed by physicians, can be beneficial for the relief of
anxiety, irritability, stress and tension.

[Signs and symptoms of use]{.underline}:

-   Slurred speech

-   Staggered walk

-   Altered perception

-   Respiratory depression

-   Coma and death

[Health effects]{.underline}:

-   The use of depressants can cause both physical and psychological
    dependence. Regular use over time may result in a tolerance to the
    drug, leading the user to increase the quantity consumed.

-   The main classes of medical depressants are barbiturates and
    benzodiazepines. When regular users suddenly stop taking large
    doses, they can develop withdrawal symptoms ranging from
    restlessness, insomnia and anxiety to convulsions and death.

-   Babies born to mothers who abuse depressants during pregnancy may be
    physically dependent on the drugs and show withdrawal symptoms
    shortly after they are born. Birth defects and behavioral problems
    also may result.

[Workplace issues]{.underline}:

-   Mental clouding and drowsiness pose a fitness-for-duty concern.

-   Many employers also have work rules requiring the employee to
    disclose if they are taking any sedating medications that could
    impact their ability to work safely.

Slide 29

Handout 19

**Hallucinogens**

Hallucinogenic drugs distort the senses and often produce
hallucinations\--experiences that depart from reality. Phencyclidine
(PCP) interrupts the function of the neurocortex, the section of the
brain that controls the intellect and keeps instincts in check, because
the drug blocks pain receptors. Violent PCP episodes may result in
self-inflicted injuries.

[Signs and symptoms of use]{.underline}:

-   Impaired concentration

-   Confusion and agitation

-   Muscle rigidity

-   Profuse sweating

[Health effects]{.underline}:

-   Chronic users of PCP report persistent memory problems and speech
    difficulties.

-   Some of these effects may last six months to a year following
    prolonged daily use.

-   Mood disorders, such as depression, anxiety and violent behavior,
    also occur.

-   In later stages of chronic use, users often exhibit paranoid and
    violent behavior and experience hallucinations.

-   Large doses may produce convulsions and coma, as well as heart and
    lung failure.

[Workplace issues]{.underline}:

-   Employees who fall under Federal guidelines such as the Department
    of Transportation's testing regulations are prohibited from using
    PCP.

-   Use causes severe disorientation.

Slide 29

Handout 20

**Narcotics**

Narcotic analgesics are the most effective compounds used for pain
relief. Narcotic analgesics include Opium, Opiates (morphine, codeine,
percodan, heroin and dilaudid) and Opioids (synthetic substitutes such
as vicodin, darvon, demerol and methadone).

[Signs and symptoms of use]{.underline}:

Narcotics initially produce a feeling of euphoria that is often followed
by:

-   Drowsiness

-   Nausea and vomiting

-   Constricted pupils

-   Watery eyes and itching

-   Low and shallow breathing

-   Clammy skin

-   Impaired respiration

-   Convulsions

-   Coma

-   Possible death

[Health effects]{.underline}:

-   Tolerance to narcotics develops rapidly and addiction is likely.

-   The use of contaminated syringes may result in diseases such as
    HIV/AIDS, endocarditis and hepatitis.

-   Addiction in pregnant women can lead to premature, stillborn or
    addicted infants who experience severe withdrawal symptoms.

[Workplace issues]{.underline}:

-   Employees who fall under Federal guidelines such as the Department
    of Transportation's testing regulations are prohibited from using
    opiates without a current medical prescription.

-   Many employers also have work rules requiring the employee to
    disclose if they are taking any sedating medications that could
    impact their ability to work safely.

-   The addictive nature and cost can lead to workplace theft and/or
    dealing.

-   Mental clouding and drowsiness pose a fitness-for-duty concern.

Slide 29

Handout 21

###### **Designer Drugs**

Illegal drugs are defined in terms of their chemical formulas, but
underground chemists can modify the molecular structure of certain
illegal drugs to produce analogs known as designer drugs, which do not
meet these definitions. These drugs can be several hundred times
stronger than the drugs they are designed to imitate.

Many of the so-called designer drugs are related to amphetamines and
have mild stimulant properties but are mostly euphoriants. They can
produce severe neurochemical damage to the brain. The narcotic analogs
can cause symptoms such as those seen in Parkinson's disease, including
uncontrollable tremors, drooling, impaired speech, paralysis and
irreversible brain damage. Analogs of amphetamines and methamphetamines
cause nausea, blurred vision, chills or sweating and faintness.

Psychological effects include anxiety, depression and paranoia. As
little as one dose can cause brain damage, and the designer drugs still
cause illusions, hallucinations and impaired perception.

Some designer drugs are: Synthetic Heroin White, MPTP (New Heroin),
analogs of MDMA (Ecstasy, XTC, Essence), hallucinogens (STP, PMA, EVE)
and analogs of PCP.

Slide 29

Handout 22