Substance Use and Abuse: Exam 1

parasympathetic system

Acetylcholine

compulsive behavior

Increasing amount of time spent in substance-related activities, such as obtaining, using, etc.

Genetic Explanations

Inherited traits can predispose some individuals to drug addiction.

Endorphins

Inhibitory Mild euphoria, Block pain Narcotics

Anandomide

Inhibitory Relaxation, Increased sense of well-being Tetrahydro-cannabinol, (marijuana-like), "spice" active ingredient

GABA

Inhibitory Sedation, Relaxation, Drowsiness, Depression Alcohol, valium-type barbiturates

Seratonin

Inhibitory Sleep, Relaxation, Sedation LSD

Increased use

Involves taking greater quantities of the drug

Social , Cultural, Biological, Personality Related

Low Self Esteem Mood disorders PTSD Unresolved grief or rage Peer norms Parental model with drug use Alientation

Age related: adolescents

Peer Norms Teenage Risk Taking Use perceived as glamorous Right of passage into adulthood

insiders

People who approve of and/or use drugs

Who is at risk?

People who are at a high risk for drug use and addiction are often known as drug sensation-seeking individuals or, simply, sensation-seekers.

Antagonist

Substances or drugs that attach to receptors and prevent them from being activated

Autonomic Nervous System

Sympathetic and parasympathetic system These systems work in an antagonistic fashion to control unconscious, visceral functions such as breathing and cardiovascular activity

Illegal recreational use

Taking illicit drugs for fun or pleasure

Illegal instrumental use

Taking nonprescribed drugs to achieve a task or goal

Legal instrumental use

Taking prescribed drugs or OTC drugs to relieve or treat mental or physical symptoms

orphan drug law

Tax advantages for development of drugs to treat "rare diseases" since this can be otherwise unprofitable

substance abuse disorder

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) combines substance abuse and substance dependence into a single condition called

Legal recreational use

Using licit drugs such as tobacco, alcohol, and caffeine to achieve a certain mental state

drug legalization debate

Violence and crime would decrease/increase? Profits associated with illegal trade would decrease/increase? Law enforcement costs would decrease/increase? Addiction would decrease/increase? Societal/health costs would decrease/increase? Consumption would increase/decrease?

withdrawal

The experience of a characteristic _________ symptom for the specific substance

Tolerance and withdrawal

The individual needs increased amounts to achieve the diminishing effects of the drug Symptoms that can often leading to renewed substance dependence

Withdrawal

The physical and/or psychological effects from not using the drug

excites or inhibits

The receiving region of the neuron is affected by a chemical message that either ________ or _________ it

employment

Unemployed persons (18.7%) have a greater tendency to use more illicit-types of drugs than people gainfully employed (10.6% full-time and 13.2% part-time workers).

neurotransmitter

a substance that is released at a synapse by a neuron and that effects another cell, either a neuron or an effector organ, in a specialized manner

Pregnant women

are less likely to use drugs than similar age women who are not.

Structural analogs

drugs that result from altered chemical structures of current illicit drugs. It involves modifying the basic molecular skeleton of a compound to form a new molecular species.

OTC drugs

$30.8 billion

Recovery

getting out of drug use/abuse

Maintenance

optimistic belief that the drug fits in well with day-to-day goals and activities

Prescription OTC Recreational Illicit Herbal Commercial

6 Major Categories of Drug Use

body size

smaller or thinner persons experience the effects of drugs more intensely

Schedule I

substances have high-abuse potential and no currently approved medicinal uses. Schedule __ drugs, substances, or chemicals are defined as drugs with no currently accepted medical use and a high potential for abuse. Some examples are: heroin, lysergic acid diethylamide (LSD), marijuana (cannabis), 3,4-methylenedioxymethamphetamine (ecstasy), methaqualone, and peyote

Schedule II

substances have high-abuse potential but are approved for medical uses and can be prescribed. Schedule ___ drugs, substances, or chemicals are defined as drugs with a high potential for abuse, with use potentially leading to severe psychological or physical dependence. These drugs are also considered dangerous. Some examples are: Combination products with less than 15 milligrams of hydrocodone per dosage unit (Vicodin), cocaine, methamphetamine, methadone, hydromorphone (Dilaudid), meperidine (Demerol), oxycodone (OxyContin), fentanyl, Dexedrine, Adderall, and Ritalin

Schedule II-V

substances reflect the likelihood of abuse and clinical usefulness.

Ex-addict

successfully quitting

Other drugs (poly drug use)

taking multiple drugs can dramatically increase drug impairment

drug misuse

the unintentional or inappropriate use of prescribed or over-the-counter (OTC) types of drugs.

Gateway drugs

types of commonly used drugs that are believed to lead to the use of other more powerful mind-altering and addictive drugs, such as hallucinogens, cocaine, crack, and heroin. Alcohol, tobacco, and marijuana are the most commonly used

Mindset

uncontrollable or impulse drinking and/or use of drugs dramatically increases drug effects

Floaters or chippers

Focus more on using other people's drugs without maintaining as much of a personal supply.

Licit

Legal. Examples include coffee, tea, alcohol, tobacco, and over-the-counter drugs.

substance abuse

Maladaptive, leading to recurrent adverse consequences or impairment

Acetylcholine Catecholamines Serotonin GABA Endorphins Anandamide

Neurotransmitters frequently altered by drugs of abuse:

proteins

Neurotransmitters travel and attach to receiving _________ called receptors on target cells.

Risky use of the substance

despite physical and/or psychological problems encountered

Subculture theory

explains that peer pressure is a determining cause of drug experimentation, use, and/or abuse.

Social impairment

failure to meet goals and obligations

Priority Review Designation

"Will direct overall attention and resources to the evaluation of applications for drugs that, if approved, would be significant improvements in the safety or effectiveness of the treatment, diagnosis, or prevention of serious conditions when compared to standard applications" Goal: reduce the time it takes for the FDA to review a new drug application, with a goal of completion in 6 months (compared to 10 months under standard review)

Social drugs

$90 billion for alcohol $51.9 billion for cigarettes $2 billion for cigars, chewing tobacco, pipe tobacco, roll-your-own tobacco, and snuff $5.7 billion for coffee, teas, and cocoa

Prescription drugs

$950 billion worldwide in 2012. $237.5 billion in the United States

Strength

(alcohol proof) and how the amount of the drug affects one's reaction

Erich Goode's Four Types of Drug Use

1. Legal instrumental use 2. Legal recreational use 3. Illegal instrumental use 4. Illegal recreational use

6 examples of drug misuse

1. Taking more drugs than prescribed 2. Using OTC or psychoactive drugs in excess without medical supervision 3. Mixing drugs with alcohol or other types of drugs 4. Using old medicines to self-treat new symptoms of an illness 5. Discontinuing prescribed drugs at will and/or against physician's orders 6. Administering prescribed drugs to a family member without medical consultation and supervision

Drug Use Causes Three Major Simultaneous Changes in the User

1. The social and psychological rewards from the effects of the drug "high" result in the illusion of temporary satisfaction and postponement of social pressures and anxieties leading to a superficial belief that problems and/or concerns are nonproblematic. 2. Pharmacologically, the nonmedical use of most drugs alters body chemistry largely by interfering with (affecting) its proper (homeostatic) functioning. Drugs enhance, slow down, speed up, or distort the reception and transmission of reality. 3. Using a particular drug may satisfy an inborn or genetically programmed need or desire.

age patterns

18-25 age category reports the most illicit drug use

National Household Survey on Drug Abuse, 2014

82.1% (217.8 million) Americans used alcohol during their lifetime 61.0% (161.8 million) Americans used cigarettes 49.2% (130.3 million) Americans used any illicit drug(s) Most commonly used illicit drugs (Lifetime Use): 117.2 million (44.2%) used marijuana/hashish 54.4 million (20.5%) used nonmedical psychotherapeutics, such as pain relievers, tranquilizers, stimulants, or sedatives (does not include OTC drugs) 39.2 million (14.8%) used cocaine 39.6 million (15.0%) used hallucinogens 36.1 million (13.6%) used pain relievers

Disease model

A belief that addiction is both chronic and progressive and that the drug user does not have control over the use and abuse of the drug

summation

A receiving neuron or target cell may have many synapses. Final cellular activity is a ___________ of these many excitatory and inhibitory synaptic signals.

addiction

A state of periodic or chronic toxication detrimental to the individual and society, which is characterized by an overwhelming desire to continue taking the drug and to obtain it by any means. Compulsive Uncontrollable Seeking Craving

Dependancy

A synonym for addiction; when more of the drug is sought despite the presence of physical symptoms

Suggestions for Reducing Demand

A top priority of prevention is to reduce demand by youth. Education must be carefully designed for the target population. Attitudes toward drug abuse must be changed. Replacement therapy can be useful.

The Sherley Amendment in 1912

Accuracy of manufacturers' therapeutic claims was not controlled by the Pure Food and Drug Act. Was passed to strengthen existing laws and required that labels should not contain "any statement ... regarding the curative or therapeutic effect ... which is false and fraudulent."

target cell

Activation of receptors causes a change in the activity of the _________ _____; the _________ _____ can be other neurons or cells that make up organs, muscles, or glands.

disease

Addiction is a complex __________

Secure and Responsible Drug Disposal Act

Addresses the problem that patients were not allowed to return drugs to DEA registrants

Inoculation

Aims to protect drug users by teaching them responsibility and explaining the effects of drugs on bodily and mental functioning

demand reduction

Aims to reduce the actual demand for drugs

Major Types of Commonly Abused Drugs

Alcohol (ethanol) Nicotine (all forms of tobacco) Prescription drugs (many drugs that are prescribed by a physician) Stimulants Major stimulants: amphetamines, cocaine, and crack Minor stimulants: nicotine, caffeine, tea, and chocolate Hallucinogens/psychedelics: LSD, mescaline, peyote, and psilocybin ("magic mushrooms") Bath salts (a designer drug) Depressants: barbiturates, benzodiazepines, valium, and alcohol Cannabis: marijuana and hashish Anabolic steroids: a synthetic form of the male hormone testosterone Inhalants/organic solvents: inhalants like gasoline, model glue, paint thinner, certain foods, herbs, and vitamins Narcotics/opiates: opium, morphine, codeine, and heroin

Major risk factors for addiction

Alcohol and/or other drugs used alone Alcohol and/or other drugs used in order to reduce stress and/or anxiety Availability of drugs Abusive and/or neglectful parents; other dysfunctional family patterns Misperception of peer norms regarding the extent of alcohol and/or drug use (belief that many other people are using drugs) Alienation factors, like isolation and emptiness

The following drugs that are detectable differ in the length of time they are detectable

Alcohol: 1 oz. for 1.5 hours Amphetamines: 48 hours Barbiturates: 2 to 10 days Benzodiazepines: 2 to 3 weeks Cocaine: 2 to 10 days Heroin metabolites: Less than 1 day Morphine: 2 to 3 days LSD: 8 hours Marijuana: Casual use, 3 to 4 days; chronic use, several weeks Methamphetamine: 2 to 3 days Methadone: 2 to 3 days PCP: 1 week

neurons and glia

All nervous systems consist of specialized nerve cells called ______ and _____ (supporting cells)

drug abuse

Also known as chemical or substance abuse and is the willful misuse of either licit or illicit drugs for the purpose of recreation, perceived necessity, or convenience. Refers to a more intense misuse of drugs—often to the point of addiction. Also known as chemical or substance abuse.

touch

Although they are close, neurons never actually ______

Primary conditions determining drug use are

Amount of exposure to drug-using peers Extent of drug use in a given neighborhood Age of first use (exposure to drugs at younger ages results in greater difficulty in stopping drug use) Frequency of drug use among peers

inhibitory synapse

An __________ _______ diminishes likelihood of an impulse in the receiving neuron or reduces the activity in other target cells.

excitatory synapse

An ____________ ________ initiates an impulse in the receiving neuron when stimulated, causing release of neurotransmitters or increasing activity in target cell.

fast track rule

Applied to testing of certain drugs, such as ones for rare cancers and AIDS

anabolic steroids

Are structurally related to the male hormone testosterone Sometimes abused by athletes and body builders to improve strength and appearances Controlled as Schedule III substances

Costs of addiction

As a major social problem, the public's view of drug abuse and addiction has been debatable over the past 20 years while the social costs of addiction have not. The total criminal justice, health insurance, and other costs in the United States are roughly estimated at $90 to $185 billion annually.

supply reduction

Attempts to curtail the supply of illegal drugs or their precursors and exert greater control over other, more therapeutic drugs Includes interdiction, the policy of cutting off or destroying supplies of illicit drugs Limited success

THC

Basal Ganglia, Cerebellum - Both are responsible for movement, coordination, and balance. Because _____ disrupts the function of both, you can (temporarily) become clumsy and move more slowly than normal,

Experimenters

Begin using drugs largely because of peer pressure and curiosity, and they confine their use to recreational settings.

Control theories

Belief that if people are left without attachments (bonds) to other groups (family, peers, social institutions), they have a tendency to deviate from expected cultural values, norms, and attitudes and use drugs

Drug Abuse and Psychiatric Disorders

Biological explanations are thought to be responsible for the substantial overlap that exists between drug addiction and mental illness.

Biological Explanations for the Use and Abuse of Drugs

Biological: Genetic and biophysiological theories Addiction is based on genes, brain dysfunction, and biochemical patterns. Biological explanations emphasize the effects of drugs on the central nervous system (CNS). Reward centers in some people are more sensitive to drugs, resulting in more pleasure and greater rewarding experiences from the use of drugs. Drugs interfere with functioning neurotransmitters (neurotransmitters are chemical messengers used for communication between brain regions).

physical dependence

Body's need to constantly have the drug

drug dependence

Both physical and psychological factors precipitate drug dependence: Physical dependence refers to the need to continue taking the drug to avoid withdrawal symptoms, which often include feelings of discomfort and illness. Psychological dependence refers to the need that a user may mentally feel about continuing the use of a drug to experience its effects and/or relieve withdrawal symptoms.

Genetic Explanations and Drug Abuse Vulnerability

Character traits, such as insecurity and vulnerability, which are often found in many drug users/abusers, may be genetically determined. Factors that determine how difficult it will be to break a drug addiction may be genetically determined. Psychiatric disorders may be relieved by taking drugs of abuse, thus encouraging their use. Drug users may have reward centers in the brain that may be especially sensitive to addictive drugs. Addiction is a medical condition in the brain of addicts. Addiction is genetically determined, and people with this predisposition are less likely to abandon their drug of abuse.

education

College graduates (6.7%) had the lowest rate of current illicit drug use, while those who did not complete high school (11.%) had the highest use of illicit drugs.

Preoccupation

Consists of a constant concern with the substance

Peripheral nervous system (PNS)

Consists of input and output nerves

hypothalamus

Controls endocrine and basic body functions

basal ganglia

Controls motor activity Establishes and maintains behaviors

drug courts

Designed to deal with nonviolent, drug-abusing offenders Integrate mandatory drug testing, substance abuse treatment, sanctions, and incentives in a judicially supervised setting

Compulsive users

Devote considerable time and energy into getting high, talk incessantly (sometimes exclusively) about drug use, and become connoisseurs of street drugs.

Danger Signals of Drug Abuse

Do those close to you often ask about your drug use? Have they noticed changes in your moods or behavior? Are you defensive if a friend or relative mentions your drug or alcohol use? Are you sometimes embarrassed or frightened by your behavior under the influence of drugs or alcohol? Have you ever gone to see a new doctor because your regular physician would not prescribe the drug you wanted? When you are under pressure or feel anxious, do you automatically take a depressant, stimulant, or drink? Do you take drugs more often or for purposes other than those recommended by your doctor? Do you mix other types of drugs with alcohol? Do you drink or take drugs regularly to help you sleep? Do you have to take drugs to relieve boredom or get through the day? Do you personally think you may have a drug problem? Do you avoid people who do not use drugs? Do you believe you cannot have fun without alcohol or other drugs?

Social Disorganization and Social Strain Theories

Drug use is caused by rapid and disruptive social change in society

close proximity

Each neuron in the central nervous system is in ______ _________ with other neurons.

Media influence on drug use

Each year, the alcohol industry spends more than $3.45 billion on advertising (television, radio, print, and outdoor ads). (FTC 2015) The advertising budget for Budweiser beer exceeds the entire budget for research on alcoholism and alcohol abusers. Drug companies spent $232 million a year on televised commercials for Viagra, Claritin, Allegra, and other drugs. In 2014, drug makers spent $5.5 billion marketing prescription drugs (up from $3.5 billion in 2012). Teens viewing photos of inebriated friends posted on social media, such as Facebook, for example, are four times more likely to have used marijuana and three times more likely to have used alcohol and tobacco.

Genetic and Biophysiological

Emphasize that the CNS reward sensors in some people are more sensitive to drugs, making the experience more pleasant Theory of thought assume these substances exert psychoactive effects by altering brain chemistry Generally believed that most drugs with abuse potential enhance pleasure centers in the brain by causing the release of neurotransmitters like dopamine- get used to this and have cravings for more

Psychological factors of addiction include

Escape from reality Boredom Inability to cope with anxiety Destructive self-indulgence (constantly desiring intoxicants) Blind compliance with drug-abusing peers Self-destructiveness Blindly using drugs without wanting to understand the harmful effects of drug use Self medicating (need the drug to feel better)

Miscellaneous drugs

Examples include inhalants, nutmeg, and morning glory seeds Extent of use cannot be verified

Acetylcholine

Excitatory-inhibitory Mild euphoria, Excitation, Insomnia Tobacco, nicotine

Cannabis (Marijuana/Hashish) Narcotics= RX (Oxy, Vicodin, Percocet) Depressants= RX (Xanax, Valium, also alcohol) Stimulants=RX (Adderall, Ritalin, Dexedrine, also includes Meth, Cocaine, Caffeine, Nicotine) Inhalants (Bath Salts, Glue, Paint thinner, gas) Hallucinogens (LSD, Ecstasy, PCP) Synthetic Drugs (Steroids)

Expanded categories

People use drugs as a means to temporarily

Experience pleasure or heighten good feelings Relieve stress, tension, or anxiety Forget one's problems and avoid or postpone worries Relax after a tension-filled day of work Fit in with peers or as a rite of passage Enhance religious or mystical experiences Relieve pain and some symptoms of illness

Career pattern of addiction

Experimentation or initiation of drug use Escalation: increasing use Maintenance: optimistic belief that the drug fits in well with day-to-day goals and activities Dysfunction: problems with use interfering with day-to-day goals Recovery: getting out of drug use/abuse Ex-addict: successfully quitting

Sociological Theories of Explanation

Focus on how factors external to the drug user affect drug use Views the motivation for drug use as largely determined by the types and quality of bonds that the drug user has with others and the environment Two main theories in this area- Social influence (microscopic) Structural influence (macroscopic)

Structural influence theories

Focus on how the organization of a society, group, or subculture is largely responsible for drug abuse by its members

1. Biological, Genetic, and Pharmacological Factors 2. Cultural Factors 3. Social Factors 4. Contextual Factors

Four Principal Factors That Affect Drug Use

Ten Reasons Why Drug Use Is More Serious Today

From 1960 to the present, drug use has become a widespread phenomenon. Drugs are much more potent than they were years ago. Drug use remains extremely popular. Drugs sales are a multibillion-dollar-a-year business, with major influence on many national economies. More so today than years ago, both licit and illicit drugs are experimented with by youths at an increasingly younger age. Older siblings, friends, and acquaintances often supply these drugs. Through the media (such as television, radio, magazine, and newspaper advertising), people in today's society are more directly exposed to drug advertising. There is greater availability and wider dissemination of drug information through emails, drug websites for purchasing prescription drugs without prescriptions, chat rooms, and methods and instructions on how to make drugs. Crack as well as crystal methamphetamine and other manufactured "newer" drugs offer potent effects at a low cost. Drug use endangers the future of a society by harming its youth and potentially destroying the lives of many young men and women. Drug use and especially drug dealing are becoming major factors in the growth of crime rates among the young. Seven in 10 drug users work full time, and this decreases productivity and increases the possibility of serious accidents in the workplace.

the cerebral cortex

Helps interpret, process, and respond to information; selects appropriate behavior and suppresses inappropriate behavior

tissues

Hormones affect selected ________ that are designed to receive the information.

bloodstream blood

Hormones are secreted into the _____________ and carried by the _______ to all the organs and tissues of the body.

selective general

Hormones may be highly __________ or very _________ with regard to the cells or organs they influence.

Contextual factors

How do physical surroundings (music concerts, bars, nightclubs, or fraternity and sorority parties) affect the amount of drug use?

Cultural factors

How do societal views, determined by custom and tradition, affect our initial approach to and use of a drug?

55.2 million

How many Americans in the past month have smoked tobacco?

117,213 million (44.2%)

How many Americans use or have used marijuana/hashish in their lifetime?

139.6 million

How many Americans, age 12 and up, have used alcohol in the past month?

5 drugs (40% prescriptions, 60% OTC)

How many drugs can be found in the average household?

Theories based on learning

Humans acquire drug use behavior by the close association or pairing of one significant reinforcing stimulus (such as friendship and intimacy) with another less significant or neutral stimulus (e.g., initial use of alcohol, marijuana, ecstasy, cocaine). In learning to use drugs, the following occurs: Conditioning: The close association of significant reinforcing stimulus with another less significant or neutral stimulus Habituation: Repeating certain patterns of behavior until they become established or habitual "Addiction to pleasure" theory: Assumes it is biologically normal to continue a pleasure stimulus when once begun

Structural Influence Theories

Idea that the organization/subgroup causes the behavior to occur Social strain-suggests that frustration results from being unable to secure the means to achieve sough-after goals Social disorganization- describes that because of social change, previously affiliated individuals no longer find themselves integrated into the community Control theory- Emphasizes that when people are left without bonds to other groups, they have a tendency to deviate from upheld values and attitudes

Principal Issues Influencing Laws Regarding Substance Abuse

If a person abuses a drug, should he or she be treated as a criminal or as a sick person inflicted with a disease? How is the user (supposedly the victim) distinguished from the distributor (supposedly the criminal) of an illicit drug, and who should be more harshly punished? Are the laws and associated penalties effective deterrents against drug use or abuse, and how is effectiveness determined?

Social Psychological Learning Theories

If the effects of drug use become personally rewarding, "or become reinforcing through conditioning, the chances of continuing to use are greater than for stopping"

New Drug Application (NDA)

If there is sufficient data to demonstrate that a drug is safe and effective, the company submits an NDA as a formal request that the FDA approve it for marketing.

Illicit

Illegal. Examples include marijuana, cocaine, and LSD.

Costs of drug use to society

Illnesses Shortened lifespans Marital and family strife Fetal alcohol syndrome Criminalistic behavior Drugs in the workplace/disruption of careers and professions Cost of assistance programs (e.g., Employee Assistance Programs [EAPs])

neuronal message

Impulse moves from the receiving region of the neuron down the axon to the sending region (terminal). Chemical messengers (neurotransmitters) are released.

The Regulation of Nonprescription Drugs

In 1972, the FDA initiated a program to evaluate the effectiveness and safety of nonprescription drugs. The FDA evaluated each active ingredient in OTC medications and placed ingredients into three categories: I. Generally recognized as safe and effective II. Not safe and effective or unacceptable indications III. Insufficient data to permit final classification

Criminal justice

In 2004, 32% of state prisoners and 26% of federal prisoners reported that they had committed their offenses while under the influence of drugs (see Table 1.5 in text). Arrestee Drug Abuse Monitoring (ADAM) reports that at the time of arrest, 40% of arrestees tested positive for the presence of multiple drugs. Approximately 40% tested positive for marijuana, 30% tested positive for cocaine, and 20% tested positive for crack. (National Institute of Justice [NIJ] 2009)

Non-medical use of prescription drugs

In 2014, 52.0 million Americans age 12 or older had used prescription-type drugs nonmedically at least once in their lifetime.

drug testing

In response to the demand by society to stop the spread of drug abuse and its adverse consequences, drug testing has been implemented in some situations to detect drug users. Breathalyzers Urine, blood, and hair specimens

Drugs in the workplace

In the United States, alcohol and drug use and their related problems costs employers and tax payers billions of dollars per year. The National Household surveys found significant drug use in the workplace with 64.3% of full-time workers reported alcohol use (7% to 9% drinking while working) and 6.4% reported marijuana use within the past month. Among the 19 major industry categories, the highest rates of past-month illicit drug use among full-time workers ages 18 to 64 were found in accommodations and food services (19.1%), construction (11.6%), and arts, entertainment, and recreation (13.7%); (see Figure 1.10). The industry categories with the lowest rates of past month illicit drug use were mining (5.0%), educational services (4.8%), and public administration (4.3%).

Prescription Drug User Fee Act of 1992

Increase reviewers and decrease review time

dopamine

Inhibitory-excitatory Euphoria, Agitation, Paranoia Amphetamines, Cocaine, "Bath salt" active ingredients

Homeostasis

Internal and external changes in the environment Body self-regulates via nervous system and endocrine system Equilibrium

Drug testing

Is used to identify those who may be using drugs Today, drug testing can include the following: urine, breath, hair, oral fluids (saliva or oral fluids collected from the mouth), and sweat. (U.S. Department of Labor 2016) Duration of Detection /"Cut-Offs" for Urine Analysis: Amphetamines: 24-72 hours Cocaine/metabolite: 24-72 hours Opiates: 24-72 hours PCP: 24-96 hours THC/metabolite: 24 hours-3 weeks (depends on frequency of use) Approximately 80% of large companies, 60% of medium companies, and 26% of small companies drug test. In large, medium, and small companies, over 90% use urine analysis, less than 20% use blood analysis, and less than 6% use hair analysis. Most drug-using youth do not cease drug use when they begin working.

Abused Drugs Function as Positive Reinforcers

It is generally believed that most drugs with abuse potential enhance pleasure centers by causing the release of specific brain neurotransmitters such as dopamine

drugs

Like neurotransmitters, ______ can speed up (CNS stimulants) or slow down (CNS depressants) the transfer of electro-chemical messages between neurons in the brain.

Major risk factors for adults

Loss of meaningful role or occupational identity due to pending retirement Loss, grief, or isolation due to divorce, loss of parents, or departure of children ("empty nest syndrome") Loss of positive body image Dealing with a newly diagnosed illness (e.g., diabetes, heart problems, arthritis, cancer) Disappointment when life's expectations are clearly not met

Age related: middle-aged

Loss of role Loss of positive body image Illness Loss of parents, divorce, etc.

Durham-Humphrey Amendment

Made formal distinction between prescription and nonprescription drugs Established drug classification categories: Drug is habit-forming. Drug is not safe for self-medication. Drug is a new drug and has not been shown to be completely safe.

Gender

Males were more likely than females among persons age 12 or older to be current illicit drug users (11.5% vs. 7.3%). The rate of past-month marijuana use was about twice as high for males as that for females (7.9% vs. 6.2%).

synthesis, storage, release, or deactivation.

Many drugs affect the activity of neuro-transmitters by altering their

The Harrison Act of 1914

Marked the first legitimate effort by the federal government to regulate and control the production and importation of addicting substances

Psychological Explanation of Addiction

Mental and Emotional States Focus more on how the internal states of the drug user are affected by social relationships within families, peers, etc. Escape from reality Boredom Inability to cope with anxiety Self destructive behavior Social Learning Theory, Habituation, and Addiction to Pleasure Theory also can help to explain

hallucinogenic

Messages between neurons can also be distorted when ___________ drugs are taken.

Models

Moral Model Disease Model Personality Predisposition Model Career/Steps Addiction Model Biological Model

Abused Drugs are Positive Reinforcers

Most drugs with abuse potential enhance pleasure centers by causing the release of specific brain neurotransmitters such as dopamine.

Direct-to-Consumer (DTC) Advertising

Most physicians surveyed agreed that because their patient saw a DTC advertisement, he/she asked thoughtful questions during the visit. Approximately the same percentage of physicians thought the advertisements made their patients more aware of possible treatments. The physicians surveyed indicated that the advertisements did not convey information about risks and benefits equally well. Approximately 75% of physicians surveyed indicated that DTC ads cause patients to think that the drug works better than it does, and many physicians felt some pressure to prescribe something when patients mentioned DTC ads. The physicians surveyed reported that patients understand that they need to consult a healthcare provider concerning appropriate treatments.

tolerance

Need for increased amounts or diminished effect of same amount

neurons and neurotransmitters

Neurons can send discrete excitatory or inhibitory messages to their target cells. Neurons are distinguished by the type of neurotransmitter they release. Neurotransmitters represent a wide variety of chemical substances and functions. Example: Dopamine activates the pleasure center.

Designer Drugs /Synthetic Drugs or Synthetic Opioids

New categories of hybrid drugs like Ecstasy and Demerol. These relatively recent types of drugs are created as structural analogs of substances already classified under the Controlled Substances Act.

equal-opportunity affliction

No one is immune to drug use (which often leads to drug dependence). Drug use is an ______-_____________ __________

sympathetic system

Norepinephrine

World Health Organization (WHO)

Originally, the _______ _______ ___________ defined it as "a state of periodic or chronic intoxication detrimental to the individual and society, which is characterized by an overwhelming desire to continue taking the drug and to obtain it by any means"

outsiders

People who don't approve or use

Characterological or Personality Predisposition Model

Personality disorder, problems with the personality of the addicted (needs, motives, attitudes of the individual, and impulse control disorders)

Major risk factors for adolescents

Physical or sexual abuse (past and/or present) Peer norms favoring drug use Misperception and/or power of age group peer norms Conflicts, such as dependence versus independence, adult maturational tasks versus fear, and low self-esteem Teenage risk-taking and view of being omnipotent and invulnerable to drug effects Drug use viewed as a rite of passage into adulthood Drug use perceived as glamorous, fun, facilitating, and intimate

Moral model

Poor morals and lifestyle; a choice

androgens

Produce growth of muscle mass Increase body weight

drug advertising

Promotional efforts by pharmaceutical companies have a large impact on the drug-purchasing habits of the general public and health professionals. As a general rule, the FDA oversees most issues related to advertising of prescription products. The FTC regulates OTC advertising.

Psychological Explanations for Drug Use/Abuse

Psychological theories regarding drug use and addiction mostly focus on mental or emotional states of drug users, the possible existence of unconscious motivations that are within all of us, and social and environmental factors. The American Psychiatric Association classifies severe drug dependence as a form of psychiatric disorder. Drugs that are abused can cause mental conditions that mimic major psychiatric illness.

drugs, crime, and violence

Regarding the connection between drug use and crime, the following findings can be summarized: 1. Drug users in comparison to nondrug users are more likely to commit crimes. 2. A high percentage of arrestees are often under the influence of a drug while committing crimes. 3. A high percentage of drug users arrested for drug use and violence are more likely to be under the influence of alcohol and/or stimulant-types of drugs such as cocaine, crack, and methamphetamines.

amygdala

Regulates emotion, so when THC acts on your CB1 receptors, emotional function is affected. While some patients report short-term anxiety or paranoia, many have just the opposite experience, and report feelings of deep relaxation and tranquility.

limbic system

Regulates emotional activities, memory, reward, and endocrine activity Includes the nucleus accumbens, the brain's reward center Dopamine

The 1906 Pure Food and Drug Act

Required manufacturers to include on labels the amounts of alcohol, morphine, opium, cocaine, heroin, or marijuana extract in each product Did not prohibit distribution of dangerous preparations

breakthrough therapy designation

Requires clinical evidence indicating that the agent may provide clinically significant improvement over available therapy on a clinically significant endpoint(s).

Age related Social , Cultural, Biological, Personality Related

Risk Factors for Addiction

Relief

Satisfaction from negative feelings in using the drug

Schedule IV

Schedule ___ drugs, substances, or chemicals are defined as drugs with a low potential for abuse and low risk of dependence. Some examples are: Xanax, Soma, Darvon, Darvocet, Valium, Ativan, Talwin, Ambien, Tramadol

Schedule III

Schedule ___ drugs, substances, or chemicals are defined as drugs with a moderate to low potential for physical and psychological dependence. Schedule III drugs abuse potential is less than Schedule I and Schedule II drugs but more than Schedule IV. Some examples are: Products containing less than 90 milligrams of codeine per dosage unit (Tylenol with codeine), ketamine, anabolic steroids, testosterone

Schedule V

Schedule ___ drugs, substances, or chemicals are defined as drugs with lower potential for abuse than Schedule IV and consist of preparations containing limited quantities of certain narcotics. Schedule ___ drugs are generally used for antidiarrheal, antitussive, and analgesic purposes. Some examples are: cough preparations with less than 200 milligrams of codeine or per 100 milliliters (Robitussin AC), Lomotil, Motofen, Lyrica, Parepectolin

Basic reasons people take drugs

Searching for pleasure Relieve stress, tension, or depression Peer pressure Enhance religious or mystical experiences Enhance social experiences Enhance work performance (i.e., amphetamine-types of drugs and cocaine) Drugs (primarily performance-enhancing drugs) can be used to improve athletic performance Relieve pain or symptoms of illness

electrochemical process

Sending and receiving information is an ________________ _________

Nature of addiction

Should addiction be considered: A bad habit? A failure of healthy choices? A failure of morality? A symptom of other problems? A chronic disease?

Sociological Explanations

Social Influence Theories: Focus on microscopic explanations that concentrate on the roles played by significant others and their impact on the individual. Structural Influence Theories: Focus on macroscopic explanations of drug use and the assumption that the organizational structure of society has a major impact on individual drug use.

Social influence theories

Social learning theory explains drug use as a form of learned behavior. Social influence and the role of significant others says the use of drugs is learned during intimate interaction with others who, while using the drug, serve as a primary group.

Social Influence Theories

Social learning- drug use as learned behavior Trend in use based on significant others Labeling theory- other people's perceptions directly influence one's image Subculture theory- Explains drug use as peer-generated activity

Guidelines for Controlling Drug Development and Marketing

Society has the right to protect itself from the damaging impact of drug use. Society has the right to demand safe and effective drugs.

gateway

Some drugs are considered _____________

relief-->increased use-->preoccupation-->dependency-->withdrawal-->relief

Stages of drug dependence

Regulatory Steps for New Prescription Drugs

Step 1: Preclinical research and development Step 2: Clinical research and development Initial clinical stage Clinical pharmacological evaluation stage Extended clinical evaluation Step 3: Permission to market Postmarketing surveillance

supply reduction inoculation demand reduction

Strategies for Preventing Drug Abuse

Biological, Genetic, and Pharmacological Factors

Substance abuse and addiction involve biological and genetic factors. The pharmacology of drug use focuses on how the ingredients of a particular drug affect the body and the nervous system and, in turn, a person's experience with a particular drug.

Agonists

Substances or drugs that activate receptors

congress

The FDA is mandated by _________ to: Ensure the rights and safety of human subjects during clinical testing Evaluate the safety and efficacy of new treatments Compare benefits and risks of new drugs and determine if approval for marketing is appropriate

Cost of drug use statistics

The National Institute on Drug Abuse (NIDA) estimates that the typical narcotic habit costs $150/day. A heroin addict must steal three to five times the actual cost of the drugs to maintain a habit—about $160,000 per year. Three out of four prostitutes in major cities have a serious drug dependency.

endocrine system

The ________ ________ consists of secreting glands (e.g., adrenal, thyroid, pituitary).

National Institute on Drug Abuse (NIDA)

The _________ __________ __ _____ _______ defines addiction as ". . . a chronic, relapsing brain disease that is characterized by compulsive drug-seeking and use, despite harmful consequences. It is considered a brain disease because drugs change the brain—they change its structure and how it works. These brain changes can be long lasting and can lead to the harmful behaviors seen in people who abuse drugs."

Factors Determining Scheduling

The actual or relative potential for abuse of the drug Scientific evidence of the pharmacological effects of the drug The state of current scientific knowledge regarding the substance Its history and current pattern of abuse What, if any, risk there is to the public health The psychological or physiological dependence liability of the drug The scope, duration, and significance of abuse Whether the substance is an immediate precursor of a substance already controlled

Regulating New Drug Development

The amended Food, Drug, and Cosmetic Act requires that all new drugs be registered with and approved by the FDA.

Kefauver and Harris Amendments

The amendments were passed, in part, as a consequence of the thalidomide tragedy. Drug manufacturers had to demonstrate the efficacy and safety of drugs. The FDA was empowered to withdraw approval of a drug that was already being marketed. The FDA was permitted to regulate and evaluate drug testing by pharmaceutical companies.

When does use lead to abuse

The amount of drug taken does not necessarily determine abuse. The motive for taking the drug is the most important factor in determining presence of abuse. Initial drug abuse symptoms include: Excessive use Constant preoccupation about the availability and supply of the drug Refusal to admit excessive use Reliance on the drug

Cerebral Cortex Hippocampus

The cerebral cortex is the outer layer of your brain. Both play a vital role in memory and cognition.

receptors

The chemical messengers from glands and neurons exert their effects by interacting with special protein regions in membranes called __________. ____________ interact only with molecules that have specific configurations.

Pharmacological - taking the substance in larger doses Excessive time spent obtaining the substance Craving the drug

The diagnosis of substance use disorder includes the following:

switching policy

The drug must have been used by prescription for at least 3 years. Use must have been relatively high during the time it was used by prescription. Adverse drug reactions must not be alarming, and the frequency of side effects must not have increased during the time the drug was available to the public.

Food, Drug, and Cosmetic Act

The sale and use of Elixir Sulfanilamide led to a tragic accident that killed over 100 people. Companies required to file applications with the government showing that new drugs were safe. Required safe tolerances be set for unavoidable poisonous substances. Authorized establishment of identity and quality for foods.

patient medicines

The term ________ __________ signified that the ingredients were secret, not patented. The _________ __________ of the late 1800s and early 1900s demonstrated the problems of insufficient regulation of the drug industry.

addicere

The term addiction is derived from the Latin verb __________, which refers to the process of binding to things. Today, the word largely refers to a chronic adherence (attachment) to drugs.

Genetic and Biophysiological Psychological Explanation of Addiction Sociological Theories of Explanation

Theoretical Explanations of Addiction

psychoactive

These drugs are classified as either illicit or licit.

hormones

These glands produce substances called _________ (e.g., adrenaline, steroids, insulin, sex __________).

information-transferring

These substances are ___________-____________ molecules.

The Comprehensive Drug Abuse Prevention and Control Act

This 1970 act divided substances with abuse potential into categories based on the degree of their abuse potential and clinical usefulness. Schedules I, II, III, IV, and V

Abused Drugs are Positive Reinforcers Drug Abuse and Psychiatric Disorders Genetic Explanations

Three Principle Biological Theories

substance dependence

True addiction, continued use despite significant substance-related problems

Central nervous system (CNS) Peripheral nervous system (PNS)

Two major components of the nervous system are

Racial and ethnic differences

Two or more races: 13.5% American Indian/Alaska Natives: 13.4% Black/African American: 12.4% Whites: 10.4% Hispanic or Latino: 8.9% Asians: 4.1%

output

Two types: Somatic (control of voluntary muscles) Autonomic (control of unconscious functions)

Experimenters Compulsive Users Floaters/Chippers

Types of drug users

Drug compounds (substances) that affect the central nervous system and/or alter consciousness and/or perceptions.

What are psychoactive drugs?

Social factors

What are the specific reasons why a drug is taken (e.g., curing an illness, self-medicating, trying to escape from reality, peer pressure, family upbringing, membership in drug-abusing subcultures)?

Any substance that modifies (enhances, inhibits, or distorts) mind and/or body functioning.

What is a drug?

High-risk

____-_____ drug choices refer to developing values and attitudes that lead to using drugs both habitually and addictively, such as constantly searching for drinking and drug parties and hanging with drug abusers.

Low-risk

____-_____ drug choices refer to values and attitudes that lead to controlling the use of alcohol or drugs—self-monitoring your drug use, behavior, and abstinence.

drug users

______ ______ are found in all occupations and professions, at all income and social class levels, and in all age groups.

input

______ to brain and spinal cord Conveys sensory info (pain, pressure, temperature)

Holistic Self-Awareness Approach

__________ philosophy advocates that the mind, body, and spirit work best when they are drug-free.

cannabis

__________ use can cause short-term (acute) memory impairment, studies have also demonstrated that these effects wear off with time.

Sensation-seekers

__________-_______ continually search for new or novel thrills in their experiences and are known to have a relentless desire to pursue physical and psychological stimulation often involving dangerous behavior. __________-________ attracted to drugs are more likely to maintain a constant preoccupation with altering their consciousness (getting high).

dendrites

are the receiving regions of a neuron's cell body.

CNS

includes the brain and the spinal cord receives information from PNS, evaluates the information, then regulates muscle and organ activity via PNS Reticular activating system. Receives input from all the sensory systems and cerebral cortex Controls the brain's state of arousal (sleep vs. awake) Reticular activating system

Empty stomach

increases drug effects

Fatigue or illness

increases drug effects

Escalation

increasing use

synaptic cleft

is the gap between neurons at the synapse.

synapse

is the point of communication between one neuron and another.

psychological dependence

mental inability to stop using the drug

gender/sex

physical make-up of women has reduced tolerance to drugs in comparison to men

Dysfunction

problems with use interfering with day-to-day goals

neurons

responsible for conducting the homeostatic functions of the brain and other parts of the nervous system by receiving and sending information.

Labeling theory

says people whose opinions we value have a determining influence over our self-image. Key factors in __________ ______ include: Primary deviance Secondary deviance Master status Retrospective interpretation