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CHW 103: Health Across the Lifespan
103.8 Tobacco, Alcohol and Drugs; Oral Health
Substance effects, harm reduction, stigma-free language and healthy mouths
Your materials
Slides (PowerPoint) Handout (Word)
For instructors
Facilitator guide Printable pre and post tests Quiz (LMS import)
What you will learn
- Describe how common substances affect the body and the brain
- Explain harm reduction tools, including naloxone and test strips
- Use stigma-free language when talking about substance use
- Teach basic oral health care from baby teeth to older age
Start here
What words have you heard people use about someone who uses drugs? How might those words feel to that person?
Lesson
How substances affect the body
Every substance changes the brain. Some also harm the heart, lungs and liver.
- Tobacco and vaping: Nicotine is highly addictive. Smoking harms nearly every organ. Vapes still carry nicotine, which harms the growing teen brain.
- Alcohol: Heavy drinking harms the liver, heart and brain, and raises risk of injury, violence and several cancers.
- Opioids: Pain pills, heroin and fentanyl slow breathing. Too much can stop breathing and cause death.
- Stimulants: Cocaine and meth speed up the heart and raise blood pressure. They can cause stroke, heart problems or psychosis.
Cannabis in Ohio: legal is not harmless
What Ohio law allows
- Adults 21 and older may buy and use cannabis
- Legal since December 7, 2023 (Issue 2)
- Possession limits apply, such as 2.5 ounces of plant
- Smoking or vaping it in public places is banned
Where it still causes harm
- Teens: can affect memory, attention and learning
- Pregnancy and breastfeeding: can affect the baby
- Driving: slows reaction time; never drive high
- Edibles: can poison children who find them
Responding to a possible overdose
Signs: will not wake up, slow or no breathing, blue or gray lips or nails, pinpoint pupils.
- Call 911: Say the person is not breathing or will not wake up. Give the address.
- Give naloxone: Spray it into one nostril. It is safe even if opioids are not the cause.
- Support breathing: Give rescue breaths if trained. When breathing returns, roll the person onto their side.
- Stay with them: Give a second dose if there is no response in 2 to 3 minutes. Naloxone can wear off.
- Tell your supervisor: Document what happened and get support for yourself afterward.
Harm reduction: meeting people where they are
Harm reduction keeps people alive and connected until they are ready for more.
- Naloxone: Free kits and training from MetroHealth Project DAWN in Cleveland, call 216-387-6290.
- Test strips: Fentanyl and xylazine test strips are no longer drug paraphernalia under Ohio rules since October 2025.
- Never use alone: Someone nearby can call 911 and give naloxone if something goes wrong.
- Treatment referral: SAMHSA National Helpline: 1-800-662-4357, free, confidential, 24/7, English and Spanish.
Words matter
| Instead of | Say |
|---|---|
| Addict, junkie, user | Person with a substance use disorder |
| Alcoholic | Person with alcohol use disorder |
| Clean | Testing negative; in recovery |
| Former addict | Person in recovery or long-term recovery |
| Drug abuse | Drug use, or misuse of a prescription |
| Addicted baby | Baby with neonatal abstinence syndrome |
Why substance use clusters
- What we see: Darnell, 34, in Fairfax, uses pain pills he buys on the street. He has had two close calls with overdose.
- Why it happens (upstream): A work injury with no paid leave, untreated trauma, few jobs nearby, and long waits for treatment that takes his insurance.
- What we can build on (assets): Project DAWN naloxone, his barbershop, a recovery group at his church, peer recovery supporters, and the ADAMHS Board of Cuyahoga County.
Healthy mouths across the lifespan
- Babies and children: Baby teeth matter for eating, talking and saving space. No bottles of milk or juice in bed.
- Everyone, every day: Brush twice a day with fluoride toothpaste. Floss between teeth daily. See a dentist at least once a year.
- Gum disease and diabetes: Diabetes raises the risk of gum disease, and gum disease can make blood sugar harder to control.
- Tobacco and the mouth: Smoking and chewing tobacco cause gum disease, mouth cancer and other mouth problems.
Situation: the worried grandmother
Situation: Ms. Pauline Carter in Hough tells you her grandson, 22, lives with her and uses pills. She is scared he will die. She also says her own gums bleed, but she has not seen a dentist in years.
What do you say and do?
- Listen without judgment and thank her for trusting you
- Offer naloxone training and a free kit through Project DAWN
- Share the SAMHSA Helpline for treatment options when her grandson is ready
- Help her find a dentist who takes her insurance and set a visit
Talk it over
- How has stigma about drug use shown up in your family, church or neighborhood?
- Where could naloxone be kept in your community so anyone could reach it?
- What keeps people in your neighborhood from getting dental care?
Study sheet
The big idea: We keep people alive, speak without stigma, and connect them to care, from overdose response to a healthy mouth.
Key points
- Nicotine, alcohol, opioids and stimulants all change the brain; opioids can stop breathing.
- Cannabis is legal for Ohio adults 21 and older, but still harms teens, pregnancy and driving.
- For a possible overdose: call 911, give naloxone, support breathing and stay with the person.
- Harm reduction tools include naloxone, test strips and never using alone.
- Person-first language reduces stigma and helps people ask for help.
- Brush twice a day with fluoride toothpaste; children see a dentist by age 1.
- Diabetes and gum disease make each other worse.
Remember
- Overdose: 911, naloxone, breathing, stay; second dose after 2 to 3 minutes
- Project DAWN (MetroHealth): 216-387-6290, free naloxone
- SAMHSA National Helpline: 1-800-662-4357, free, 24/7
- Ohio adult-use cannabis: 21 and older since December 7, 2023
- Crisis: call or text 988
Ask yourself
- What words do I use about substance use without thinking, and what will I say instead?
- Am I ready to give naloxone if I see an overdose tomorrow?
Vocabulary
| Word | What it means |
|---|---|
| Substance use disorder | A health condition where a person keeps using alcohol or drugs even when it causes harm. |
| Harm reduction | Practical ways to lower the dangers of drug use and keep people alive and connected to care. |
| Naloxone | A medicine, often a nasal spray called Narcan, that reverses an opioid overdose. |
| Fentanyl | A very strong opioid often mixed into street drugs and into fake pills made to look like prescriptions. |
| Fentanyl test strip | A small paper test that shows if fentanyl is in a drug before someone uses it. |
| Opioid | A type of drug, such as oxycodone, heroin or fentanyl, that relieves pain and slows breathing. |
| Stimulant | A drug, such as cocaine or methamphetamine, that speeds up the heart and brain. |
| Stigma | Negative beliefs and labels that make people feel shame and keep them from seeking help. |
| Person-first language | Words that name the person before the condition, such as person with a substance use disorder. |
| Fluoride | A mineral in toothpaste and many water supplies that makes teeth stronger and prevents cavities. |
| Gum disease | Infection of the gums that can cause bleeding, loose teeth and tooth loss. |
Real-life situations
Unresponsive at the bus stop
On your way to a home visit near East 105th Street, you find a young man slumped on a bench. He will not wake up, and his lips look gray.
What to do
- Call 911 and say he is not breathing well and will not wake up
- Give naloxone from your outreach bag
- Give rescue breaths if trained; when he breathes again, put him on his side
- Give a second dose if he does not respond in 2 to 3 minutes, and stay until help arrives
- Tell your supervisor and document the event
Why: Opioid overdose stops breathing. Naloxone and fast action save lives, and in Ohio anyone can get and give naloxone.
The teen who vapes
At an after-school program in Lorain, Aaliyah, 15, says she vapes every day and feels jittery when she cannot. She thinks vapes are just flavored water.
What to do
- Thank her for being honest and do not lecture
- Explain that most vapes contain nicotine, which is addictive and affects the growing brain
- Ask what she would like to do, and respect her answer
- Share teen quit supports and help her talk with a trusted adult or her doctor
Why: Feeling jittery without it is a sign of nicotine dependence. Respectful education keeps the door open.
Bleeding gums and diabetes
Mr. Hector Morales in Clark-Fulton has type 2 diabetes. He mentions his gums bleed when he brushes, and he has not seen a dentist since he was a child.
What to do
- Explain that diabetes raises the risk of gum disease, and gum disease can make blood sugar harder to control
- Check his insurance and help him find a dentist who accepts it
- Help him schedule a visit and plan a ride
- Encourage him to tell his doctor about his gums too
Why: The mouth and the body are connected. Getting dental care supports his diabetes care.
Activity: Asset map: naloxone, recovery and dental care
About 25 minutes.
- Pick one Cleveland or Ohio neighborhood you know well.
- Find two places where people can get naloxone or harm reduction supplies.
- Find two recovery supports, such as peer groups, faith-based groups or treatment programs.
- Find one dental clinic that accepts Medicaid.
- Write each on a card with address, phone and hours, and share it in the course discussion.
Post-test
Ten questions. You need 75% to pass, with one retake. Your result is saved in this browser.
Sources
- Ohio State Moritz College of Law, Ohio reforms: SB 56 and Issue 2 (January 2026)
- Cleveland Metropolitan Bar Association, SB 56 presentation (July 15, 2026)
- WYSO, Ohio effort to repeal hemp ban falls short on signatures (March 18, 2026)
- Health Policy Ohio, Ohio decriminalizes fentanyl test strips (October 2025)
- NIDA, Words Matter: Terms to Use and Avoid When Talking About Addiction
- MetroHealth, Project DAWN
- SAMHSA, National Helpline
- Signal Cleveland, Free overdose reversal medication in public emergency boxes (2024)
- Ohio Department of Health, Carry Naloxone
- CDC, Cigarette Smoking
- CDC, E-Cigarette Use Among Youth
- CDC, Cannabis Health Effects
- CDC, Cannabis and Teens
- CDC, Cannabis and Pregnancy
- CDC, What to Do If You Think Someone Is Overdosing
- CDC, Reversing Opioid Overdoses with Lifesaving Naloxone (fact sheet)
- SAMHSA, Overdose Prevention and Response Toolkit
- NIDA, Methamphetamine
- NIDA, Cocaine
- CDC, Oral Health Tips for Adults
- CDC, Oral Health Tips for Children
- MedlinePlus, Tooth decay: early childhood
- NIDCR, Diabetes and Oral Health
- CDC, Tobacco Use and Oral Health Facts
- NIDCR, Oral Cancer
- CDC, Dental Care Is Safe and Important During Pregnancy
- Humana Healthy Horizons in Ohio (Ohio Medicaid plan), Dental coverage
- CDC, Alcohol Use and Your Health
- CDC, Fentanyl Facts
- FDA, FDA approves first over-the-counter naloxone nasal spray