Training Module on the Right to Mental Health for the Security Sector 35 with crime victims can expect to have to deal with substance abuse issues in some or many of their clients. • Signs of alcohol intoxication are familiar to anyone who has ever been to a New Year’s Eve party: slurred speech, unbalanced posture, impaired coordination, and so on. • Alcohol has varying effects, depending on the user, with some inebriated drinkers becoming more mellow and tractable, others becoming angry and agitated. • In general, alcohol and most other drugs lower inhibitions and self-control, so any intoxicated person must be approached with caution in any clinical or law enforcement encounter. • Less common, but potentially more serious, are signs and symptoms of alcohol withdrawal in subjects who are physiologically addicted to alcohol. This usually presents as an agitated state with tremors (the shakes). • In severe cases, this can be accompanied by hallucinations and/or seizures. An acute state of agitated delirium, characterized by intense fear and tactile and visual hallucinations of vermin crawling on the skin, is called delirium tremens. • Typically, such individuals will be so clearly impaired that the need for transport to a medical facility is obvious. • Other substances of abuse have different effects on behavior, depending on their biochemical action. • Stimulants (uppers), such as cocaine and methamphetamine, produce a racing kind of high, with rapid thought and speech, erratic and impulsive behavior, and a turbo-charged energy level. • Danger may arise when their overconfidence and impulsivity lead to confrontations that may get them beat up, shot, stabbed, or arrested. • Downers like benzodiazepines (e.g., Valium, Xanax), have effects similar to alcohol, which include a calming effect, but this tranquilization can be accompanied by a loosening of inhibitions, which may lead to impulsive and dangerous actions. • Most encounters with medical or law enforcement services for these users tend to be due to their passing out unconscious in a public place, in which case they may be robbed or beaten, but they may become combative if they are still confused and disoriented when aroused from their stupor. • The effects of hallucinogens, such as marijuana, LSD, or angel dust, may range from mellow loopiness to violent delirium.