Drugs and Society

FIVE HISTORICAL THEMES OF DRUG USE

1. Human beings have a basic need to find ways to cope with their environment and enhance their existence. 2. Human brain chemistry can be affected by psychoactive drugs, behavioral addictions and mental illness to induce an altered state of consciousness or mood. 3. Governments and businesses have been involved in cultivating, manufacturing, distributing, taxing, and prohibiting drugs. 4. Technological advances in refining and synthesizing drugs have increased the potency of these substances. 5. The development of more efficient and faster methods of putting drugs in the body has intensified the effects

- Tolerance and Addiction:

Because prolonged use of stimulants forces the release of extra neurotransmitters, tolerance develops rapidly. Tolerance and dependence can also develop with amphetamine congeners, caffeine, nicotine, and other milder stimulants - (In chemistry, congeners are related chemicals, e.g., elements in the same group of the periodic table, or derivatives thereof.

Tobacco

Between 1962 and 2001, per capita tobacco use declined more than 20% in the U.S....BUT, smoking increased among women to the point that lung cancer kills more women than breast, uterine, or ovarian cancers combined.

TOBACCO CROSSES THE OCEANS-

Conquistadors noted the native peoples' use of tobacco as a medicine. Spanish explorers carry it back to Europe and the Portuguese introduce it to Japan and China.

In 1524, ______, a Swiss-German alchemist, returned from Constantinople to Western Europe with a concoction of alcohol and opium which he called _______.

In 1524, Paracelcus, a Swiss-German alchemist, returned from Constantinople to Western Europe with a concoction of alcohol and opium which he called laudanum.

COCA TO COCAINE-

In 1859, Dr. Albert Nieman isolated the alkaloid cocaine from the coca leaf. It was much more potent. Used as a topical anesthetic and also popularized as a medication by Sigmund Freud. It was considered a "wonder" drug, useful for treating morphine addiction as well as tuberculosis and many other ailments.

Of the estimated ____ plants that yield psychoactive substances, only about ___ have been in continuous use throughout history.

Of the estimated 4,000 plants that yield psychoactive substances, only about 60 have been in continuous use throughout history.

The Enlightenment and Early Industrial Revolution (1700-1900)

The development of refined forms of psychoactive drugs, new methods of use, and improved production techniques along with governments' (taxes) and merchants' (sales) economic motives led to greater use and rising levels of addiction and social problems.

Prescription Drug Abuse

There has been a recent decline in abuse of street drugs but a huge increase in abuse of prescription (and OTC) medications, especially among adolescents. Why? - Increased border security has slowed the cocaine trade from Mexico, Central, and South America. - There's been a 150% increase in prescriptions written to adults in the last decade. - Tremendous availability of these drugs via the Internet.

AMPHETAMINES

Used by all sides in WWII in order to fight fatigue and increase aggression. The appetite suppression qualities led to it being used as a diet drug in the 50's and 60's. • HIV and Hepatitis C is spread through contaminated needles and high-risk sexual practices that are more common among users than other groups.

Sources

We should always take into consideration the source of the information we're considering. Accounts of high levels of drug use, new kinds of drug use, or new problems being associated with drug use are not always provided by objective, reliable, and credible sources. "Agendas" are often in play and it is important to consider what a particular group or organization might be trying to accomplish by presenting their information. • One way to tell if a "problem" is really a problem is to look for more than one type of evidence coming from different kinds of sources, all pointing to the same conclusion.

When ____, cocaine ____ the heart rate and ____ blood vessels. This leads to _____ changes including damage to _____ muscles, coronary arteries, and other blood vessels The raised blood pressure can also weaken the walls of blood vessels and cause a ____, usually within 3 hours of use.

When injected, cocaine raises the heart rate and constricts blood vessels. This leads to cellular changes including damage to heart muscles, coronary arteries, and other blood vessels The raised blood pressure can also weaken the walls of blood vessels and cause a stroke, usually within 3 hours of use.

• ISLAM

Wine was not used as a sacrament in Islamic countries and consumption was generally frowned upon. Instead, opium, tobacco, hashish, and coffee were the drugs of choice in Islamic countries during the Middle Ages.

MOST POPULAR PSYCHOACTIVE DRUG OF THE MILLENEIUM

alcohol

PRESCRIPTION MEDICATIONS

many over-the- counter (prescribed) medications of the 1800-1900's contained amounts of opium, cocaine or Cannabis, usually in a mixture of alcohol

Unwanted psychological effects of chronic use include:

paranoia, intense craving, irritability, drug dreams, hyperexcitability, cocaine psychosis, and certain social problems such as high-risk activity.

Formication is the term for

sensations that feel like hundreds of tiny bugs ("coke bugs," "meth bugs," "snow bugs") are crawling under one's skin.

Physical side effects of smokable cocaine include:

slurred speech, thirst, coughing, dry skin, blurred vision, and tremors.

Withdrawal

the "body's attempt to rebalance itself after cessation of prolonged use of a psychoactive drug."

• RITALIN/ADDERALL (two PDF articles posted on Smartsite) • Know their prescribed uses and what motivates people to use illicitly. • Have a sense of these two drugs' effects.. • What are the potential downsides to using these drugs?

weight loss or performance enhancement. increases dopamine levels in the brain. Stimulants can increase blood pressure, heart rate, and body temperature and decrease sleep and appetite. When they are abused, they can lead to malnutrition and its consequences. Repeated abuse of stimulants can lead to feelings of hostility and paranoia. At high doses, they can lead to serious cardiovascular complications, including stroke.

• Cocaine at the street level is almost always _____. When the drug is used _____, not only are diluents put into the bloodstream but so are ______ and ______ from contaminated drugs or needles that can transmit diseases, including blood and heart _____, _____, hepatitis B, and especially hepatitis C.

• Cocaine at the street level is almost always adulterated. When the drug is used intravenously, not only are diluents put into the bloodstream but so are bacteria and viruses from contaminated drugs or needles that can transmit diseases, including blood and heart infections, AIDS, hepatitis B, and especially hepatitis C.

Crack is not _____ than cocaine hydrochloride (powder); it is just sold in _____ units

• Crack is not cheaper than cocaine hydrochloride (powder); it is just sold in smaller units

• The effects and side effects of ______ cocaine are more _____ than the effects of snorting. • More cocaine has to be smoked than ______ for the same effects. Smoking crack gives a rush that lasts as little as _____ seconds. Thus crack is almost always used in a _____ pattern whether smoked, injected, or even snorted.

• The effects and side effects of smoking cocaine are more intense than the effects of snorting. • More cocaine has to be smoked than injected for the same effects. Smoking crack gives a rush that lasts as little as 5-10 seconds. Thus crack is almost always used in a binge pattern whether smoked, injected, or even snorted.

STREET FACTS (Cocaine)

• Two-thirds of the smuggling into the United States is handled by drug gangs and cartels centered in Mexico. • North America consumes 40-50 % of the world's cocaine. • At the street level, prices avg. about $60 to per gram with an average purity of 57%. • "Rocks" of crack cocaine, varying in size from one- tenth to one-half of a gram, sell for $10 to $20 each. • The Drug Use Forecasting (DUF) program, which questions arrestees in city jails, estimates there are over 3 million hardcore users in the U.S. • Concerning aggression, there is indication that cocaethylene (an active metabolite when cocaine and alcohol are taken together) induces greater agitation, euphoria, and violence than just cocaine alone. Cocaethylene also seems more likely to induce cardiac conduction abnormalities compared to cocaine.

Middle Ages

"Hexing Herbs" were used, so named for their use in applying spells as well as being valued for their medicinal qualities (at low doses). These herbs in the nightshade family contain the psychoactive chemicals atropine and scopolamine.

● STIMULANTS/UPPERS (cocaine)

- All stimulants increase the chemical and electrical activity in the central nervous system. - ↑HR, ↑BP, ↑sweating, ↓appetite -Emotional/Mental Side Effects: initially, stronger stimulants increase self-confidence and induce euphoria. With prolonged use, neurotransmitter imbalance causes talkativeness, restlessness, irritability, insomnia, and eventually paranoia, psychosis, aggressiveness, and violence.

● FROM EXPERIMENTATION TO ADDICTION

- Drugs are used out of curiosity, availability, to get high, to self-medicate, to increase confidence and energy, for psychological pain relief, to control anxiety, because of peer pressure, or for boredom relief -Levels of Use: to judge a person's level of use it is necessary to know the amount, frequency, and duration of psychoactive drug use. [abstinence, experimentation, social/recreational, habituation, abuse, addiction) -Abuse is "the continued use of a drug despite adverse consequences. -Addiction comprises the "4 Cs" of loss of control, compulsive drug use, craving, and continued use despite negative consequences.

● PHYSIOLOGICAL RESPONSES TO DRUGS

- Factors such as tolerance, tissue dependence, psychological dependence, withdrawal , and drug metabolism can moderate or intensify the effects of drugs. - Tolerance: continued use forces the body to change and adapt, so the user has to take larger and larger amounts to achieve the same effect.

●DRUG METABOLISM

- Some factors that affect drug metabolism are age, race, gender, heredity, health, emotional state, weight of user, etc. -The liver is the key metabolic organ. -The kidneys are the key excretory organs because they filter waste from the blood into urine

● ROUTES OF ADMINISTRATION & DRUG ABSORPTION

- There are five common ways that drugs enter the body: inhaling (7-10 seconds), injecting (15-30 seconds, 3-5 minutes), mucous membrane absorption (3-5 minutes), ingestion (20-30 minutes), and contact absorption (slowest). -FASTEST: when inhaled (it takes 7-10 seconds before an inhaled drug reaches the brain.) - Drugs can be injected directly into the body with a hypodermic syringe intravenously (15-30 seconds), intramuscularly, and subcutaneously (3-5 minutes). - Injecting is the most dangerous method of use because it bypasses most of the body's natural defenses.

Three main forms of withdrawal

- Three main forms of withdrawal: 1. Non-purposive withdrawal- those signs and symptoms that are directly observable- seizures, sweating, diarrhea, etc. Note that these signs a symptoms may occur even with placebo- stressing the impact of psychic dependence. 2. Purposive withdrawal- this is not true withdrawal. Although it may be intentional (conscious) or unintentional (unconscious) on the part of the patient, it is a "faking" of withdrawal in order to get sympathy, support, or more drug. 3. Protracted withdrawal- This is often referred to as "flashbacks". Again, this is not a true withdrawal. After a long period of abstinence, the former user may experience an unpleasant sensation upon some stimulus that is associated with the drug use. An appropriate analogy would be "post- traumatic stress" for addicts.

-COCAINE:

-Cocaine forces the release of the neurotransmitters, norepinephrine, epinephrine, and dopamine and then blocks their reabsorption, so more are available for intense stimulation. -By blocking the reuptake ports, cocaine leaves those neurotransmitters vulnerable to metabolism by enzymes that live between the brain cells, resulting in their depletion. The neurotransmitter dopamine coordinates fine motor skills, signals the reward/reinforcement pathway, and regulates thoughts. The neurotransmitter dopamine can also over stimulate the brain's fright center causing paranoia. -Withdrawal: Besides anhedonia and anergia, the major symptoms of cocaine withdrawals are loss of motivation or initiative, emotional depression, vivid and unpleasant dreams, insomnia, increased appetite, psychomotor agitation, and an intense craving for the drug.

● INCREASED POTENCY OF PSYCHOACTIVE DRUGS

-The refinement of opium to morphine and morphine to heroin, and the invention of the hypodermic needle encouraged abuse and addiction. -Smoking put greater amounts of opium into the blood (via the lungs) more quickly and therefore into the brain sooner. -Morphine is about 10 times more powerful than opium and therefore a more effective pain reliever. The use of morphine led to more rapid development of tolerance to the drug and therefore greater dependence. -Drugs could easily be put directly into the bloodstream by intravenous (IV) use causing more intense effects. -In 1874 diacetyl morphine, better known as "heroin," was refined from morphine as a remedy for coughs, chest pains, and tuberculosis. The greater intensity of the heroin high caused a more rapid progression to abuse and addiction.

3 types of tolerance

1) Dispositional tolerance is when the body speeds up metabolism of the drug. 2) With pharmacodynamic tolerance, nerve cells become less sensitive to the effects of the drug. 3) With behavioral tolerance, the brain learns to compensate for the effects of the drug.

• FOUR PRINCIPLES OF PSYCHOACTIVE DRUGS

1) Drugs, per se, are not good or bad: There are no "bad" drugs. 2) Each drug has multiple effects. 3) Both the impact and the nature of the drug's effect depend on the amount the individual has taken. 4) The effect of any psychoactive drug depends on the individual's history and expectations: For example, both alcohol and marijuana impair performance in a driving simulator, but several studies have shown that experienced users are generally less impaired, at least in part because they had learned to compensate for some of the alterations in perception caused by the substances.

● WHY PSYCHOACTIVE DRUGS ARE USED

1. Alter consciousness, medicinal (pain relief, cough suppression, diarrhea, etc), stress- induced, religion.