Abnormal psychology chapter 11
injection can take 20sec or 4 min to reach the brain
Drug in liquid form directly enters the body through a needle. Injection may be intravenous or intramuscular (subcutaneous) .
snorting takes 4 min to reach the brain
Drug in powdered form is snorted into the nose. Some of the drug lands on the nasal mucous membranes, is absorbed by blood vessels, and enters the bloodstream.
oral ingestion takes 30min to reach the brain
Drug in solid or liquid form passes through esophagus and stomach and finally to the small intestines. It is absorbed by blood vessels in the intestines.
inhaling takes 7 sec to reach the brain
Drug in vapor form is inhaled through mouth and lungs into circulatory system.
other routes, time varies
Drugs can be absorbed through areas that include mucous membranes. Drugs can be placed under the tongue, inserted anally and vaginally, and administered as eye drops.
MDMA (3,4-methylenedioxymethamphetamine)
Ecstasy, Molly Stimulant that produces hallucinogenic effects; provides an energy boost and strong feelings of connectedness
Street tag MDMA
Ecstasy, Molly, X, beans
Vaping
Electronic cigarettes, or e-cigarettes. Tobacco, cannabis (THC) Potential addiction, major medical problems (EVALI)
Caffeine effects
Enhances physical stamina and reduces fatigue Can disrupt mood, fine motor movements, reaction time, and sleep Increases gastric acid secretions and breathing rate at high doses
Cocaine; processed cocaine (hydrochloride powder)
Most powerful known natural stimulant Produces a euphoric rush of well-being, followed by letdown (crashing) Increases the supply of dopamine at key neurons throughout brain as well as norepinephrine and serotonin levels Can be snorted, injected, or smoked Tried by 40 million people; currently used by 2 million people
How Easy Is It for Teenagers to Acquire Substances?
Most surveyed high school seniors say it is easy to get alcohol and marijuana, and more than one third say it is easy to get amphetamines, pain relievers, and Ecstasy.
Tolerance
Need for increasing doses of substances to produce desired effect
Methamphetamine (meth, crank)
Recent surge in its popularity: Used at least once by 5.4 percent of all U.S. residents older than age 11; spreading across the United States Equally popular among men and women and among a wide range of people Designated as a club drug and often tied to raves Use dangers
Alcohol use disorder (alcoholism) statistics
U.S. population older than 11 years: 5.4 percent Teenagers: 2.3 percent Men versus women: 2:1 Ethnic differences Alcohol use disorder rates: American Indians: 7.1 percent Hispanic: 5.3 percent Non-Hispanic white: 5.7 percent African Americans: 4.5 percent Asian Americans: 3.8 percent
Withdrawal
Unpleasant and sometimes dangerous symptoms occurring with drug stopping or cutting back
Vaping popular beliefs
Vaping nicotine is less dangerous than tobacco smoking. Vaping nicotine is less addictive than tobacco smoking. Vaping can help people avoid or stop tobacco smoking.
Vaping incidence
50 percent yearly increase in teenage nicotine vaping 26 percent of all high school seniors vape
Half of all campus sexual assaults involve alcohol use.
700,000 students are physically or emotionally traumatized or assaulted yearly by student drinkers. 2,000 college-age deaths are tied to binge drinking.
Street tag Cocaine
blow, Charlie, rock, snow
Street tag Alcohol
booze, brew
College Binge Drinking: An Extracurricular Crisis
38 percent of students binge drink once a month; one-third binge 6 times or more monthly. Bingeing has lingering impacts on mood, memory, and brain/heart functioning. Alcohol consumption is related to academic problems and dropping out of college.
alcohol prevalence
2 billion people worldwide consume alcohol. More than half of U.S. residents drink alcoholic beverages.
Opioid use disorder
After just a few weeks, users may become caught in a pattern of abuse (and often dependence. Tolerance for the drug quickly builds and withdrawal occurs when drug ingestion stops. Early withdrawal symptoms include anxiety and restlessness; later symptoms include twitching, aches, fever, vomiting, diarrhea, and weight loss from dehydration. Increased doses are required to avoid withdrawal. Use interferes significantly with social and occupational function; lives center on drugs. Affects 2 million people in the United States within a given year. 75 percent are addicted to pain relievers; 25 percent are addicted to heroin. Rates have increased over past several years.
Most widely used depressants
Alcohol Sedative-hypnotic drugs Opioids
effects of alcohol
Alcohol consumption may inhibit judgment and reduce inhibition, cause motor difficulties, and reduce driving safety. Alcohol blocks messages between neurons. Alcohol helps GABA (an inhibitory messenger) shut down neurons and relax the drinker. The first brain area affected is that which controls judgment and inhibition. Next affected are additional areas in the CNS, leaving the drinker even less able to make sound judgments, speak clearly, and remember well. Motor difficulties increase as drinking continues, and reaction times slow. Extent of the effect of ethyl alcohol is determined by its concentration (proportion) in the blood; intoxication = 0.09 percent. Level of impairment is closely tied to the concentration of ethyl alcohol in the blood. Effects of alcohol subside only after alcohol is metabolized by the liver. Alcohol increases the activity of the neurotransmitter GABA at key sites in the brain. Gender affects blood alcohol concentration. A given amount of alcohol has a lesser effect on a large person than on a small one. Women have less alcohol dehydrogenase, an enzyme in the stomach that metabolizes alcohol before it enters the blood. Women become more intoxicated than men on equal doses of alcohol. Levels of impairment: BAC = 0.06: Relaxation and comfort BAC = 0.09: Intoxication BAC > 0.55: Death Most people lose consciousness before they can drink this much. The effects of alcohol subside only after alcohol is metabolized by the liver. The average rate of this metabolism is 25 percent of 1 ounce per hour. You cannot increase the speed of this process!
What are the personal and social impacts of alcoholism?
Alcoholism destroys families, social relationships, and careers. Alcohol plays a role in suicides, homicides, assaults, rapes, and fatal automobile accidents Long-term excessive drinking can seriously damage physical health (cirrhosis) and major nutritional problems (Korsakoff's syndrome). The 27 million children of alcoholics are likely to experience a wide range of social and psychological struggles, including risk from fetal alcohol syndrome (FAS), fetal alcohol spectrum disorder, and miscarriage.
alcohol
All alcoholic beverages contain ethyl alcohol. Absorbed into the blood through the stomach lining Takes effect in bloodstream and CNS
Drug
Any substance other than food affecting our bodies or minds, including alcohol, tobacco, and caffeine
Substance intoxication
Cluster of changes in behavior, emotion, or thought caused by substances (DSM-5)
Most common stimulants
Cocaine Amphetamines Caffeine
Difference between substance and drug
Current language uses the term "substance" rather than "drug" to overtly include alcohol, tobacco, and caffeine. The substances people misuse fall into several categories: depressants, stimulants, hallucinogens, and cannabis. Substances from each of these categories may be ingested in various ways, from inhaling or snorting them to swallowing or injecting them.
alcohol use disorder tolerance and withdraw
For many people, the pattern of alcohol misuse includes dependence. They build up a physiological tolerance and need to drink greater amounts to feel its effects. They may experience withdrawal, including nausea and vomiting, when they stop drinking. A small percentage of alcohol-dependent people experience a dramatic and dangerous withdrawal syndrome known as delirium tremens ("the DTs"). Consists of confusion, clouded consciousness, and terrifying visual hallucinations Alcohol withdrawal can be fatal.
Hallucinogen use prevalence
Hallucinogens use at some point in their lives: 10 percent of U.S. population Current users: around 0.2 percent, or 485,000 people
alcohol, mixed drugs
High Risk of Organ Damage or Death
opioids, alcohol, mixed drugs
High Risk of Severe Social or Economic Consequences
alcohol, mixed drugs
High Risk of Severe or Long-Lasting Mental & Behavioral Change
Stimulants
High to Moderate Risk of Severe or Long-Lasting Mental & Behavioral Change
Cannabis's role in society
Historically, marijuana was replaced by more effective drugs in the medical field and then outlawed. THC-related research opened cannabis use for new medical applications and legalization. Medical use now allowed in 30 states Recreational use legalized in 10 states 67 percent of people in the United States believe marijuana should be legalized. The U.S. federal government has continued to fight and punish the production and distribution of marijuana for medical purposes. In 2009, the U.S. Attorney General directed federal prosecutors to not pursue cases against medical marijuana users complying with state laws. Canada permits recreational use of marijuana.
MDMA Dangers
Immediate psychological problems, cognitive impairment, unpleasant and potential dangerous physical symptoms Today, in the United States alone, consumers collectively take hundreds of thousands of doses of MDMA. Altogether, 20 million Americans older than the age of 11 have now tried MDMA at least once in their lifetime, and 2.5 million in the past year. Approximately 2.2 percent of all high school seniors have used MDMA within the past year.
Statistics of substance abuse
In any given year, 7.4 percent of all teens and adults in the United States, more than 20 million people, have a substance use disorder. American Indians have the highest rate of substance use disorders in the United States (10.1 percent). Asian Americans have the lowest (4.8 percent). Non-Hispanic white Americans, Hispanic Americans, and African Americans have rates between 6.9 and 7.7 percent. Only 18.4 percent of all those with substance use disorders receive treatment from a mental health professional.
Opioids
In injections, the opioid may be deposited just beneath the skin ("skin-popping"), deep into a muscle, or directly into a vein ("mainlining"). An injection quickly brings on a rush—a spasm of warmth and ecstasy that is sometimes compared with orgasm. The brief spasm is followed by several hours of a pleasant feeling called a high or nod. Include natural (opium, heroin, morphine, codeine) and synthetic (methadone) blended drugs Known collectively as narcotics By 1917, opium-derived drugs were deemed addictive and illegal in U.S. Most are smoked, inhaled, snorted, injected (skin-pop or mainline), or swallowed. Cause CNS depression; drugs attach to endorphin-related brain receptors.
How Do Racial/Ethnic Groups Differ in Substance Use Disorders?
In the United States, American Indians are more likely than members of other ethnic or cultural groups to have substance use disorders. (Information from: SAMHSA, 2020, 2019b.)
Small doses of amphetamines
Increase energy and alertness and reduce appetite
Canabis effects
Most of the effects last 2 to 6 hours At low doses, the cannabis user feels joy and relaxation. May become anxious, suspicious, or irritated This overall "high" is technically called cannabis intoxication. At high doses, cannabis produces odd visual experiences, changes in body image, and hallucinations.
Substance Use Disorder Checklist
Individual displays a maladaptive pattern of substance use leading to significant impairment or distress. Presence of at least 2 of the following symptoms within a 1-year period Substance often taken in larger amounts Unsuccessful efforts to reduce or control substance use Much time spent trying to obtain, use, or recover from the effects of substance use Failure to fulfill major role obligations Continued use despite persistent interpersonal problems Reduction of important activities Continuing use in dangerous situations Continued use despite worsening of physical or psychological problems Craving for substance Tolerance effects Withdrawal reactions
Caffeine use disorder is not listed in DSM-5
Is Caffeine use disorder listed in DSM-5?
Hallucinogens use
LSD tolerance and withdrawal are rare Danger is long-term effects Self-injury, bad trips, flashbacks Users may experience a "bad trip"—the experience of enormous unpleasant perceptual, emotional, and behavioral reactions. Another danger is the risk of "flashbacks," which can occur days or months after last drug use.
Amphetamines
Laboratory-manufactured stimulant drugs Examples: Amphetamine, dextroamphetamine, methamphetamine Most often taken in pill or capsule form
Most likely to binge drink
Live in fraternity or sorority houses, pursue party-centered lifestyle, engage in high-risk behaviors, were binge drinkers in high school
Benzodiazepines, cannabis
Low Risk of Organ Damage or Death
Benzodiazepines
Low Risk of Severe Social or Economic Consequences
Barbiturates, Benzodiazepines, Cannabis
Low Risk of Severe or Long-Lasting Mental & Behavioral Change
stimulants, cannabis
Low to Moderate Risk of Severe Social or Economic Consequences
Opioids
Low to Moderate Risk of Severe or Long-Lasting Mental & Behavioral Change
Natural hallucinogens
Lysergic acid diethylamide (LSD) Mescaline Psilocybin MDMA (Ecstasy)
Substance use disorders
Maladaptive behavior patterns and reactions caused by repeated substance use
inhaling, snorting, injection, oral ingestion, other routes
Methods of Taking Substances
Alcohol use
Middle schoolers: 25 percent report some use High school seniors: 29 percent drink monthly; 2 percent drink daily College students: 38 percent engage in monthly binge drinking
stimulants
Moderate risk of organ damage or death
Barbiturates
Moderate to High Risk of Severe Social or Economic Consequences
Where Do People Obtain Pain Killers for Nonmedical Use?
More than 39 percent of people with opioid use disorder get the drugs from friends or relatives, and 37 percent obtain them from a doctor. Only 6 percent buy them from a drug dealer.
Medical opioids
Morphine Codeine Oxycodone Each drugs has a different strength, speed of action, and tolerance level; prescribed for pain 86 million over age 11 have taken medical opioids in past year About 12 percent illicit
Danger of opioid use
Most immediate danger is overdose Ignorance of tolerance Getting impure drugs Infection from dirty needles and other equipment, deadly substances mixed with opioid Opioid overdose closes down the respiratory center in the brain, paralyzing breathing and causing death. Currently, approximately 32,000 people in the United States die from pain reliever overdoses each year, and 15,000 die from heroin overdoses. Opioid users run other risks. On the street, drug dealers often mix opioids with a cheaper drug or even a deadly substance such as cyanide or battery acid. In addition, dirty needles and other unsterilized equipment used by opioid injectors spread infections such as AIDS, hepatitis C, and skin abscesses.
LSD (lysergic acid diethylamide)
One of most powerful hallucinogens derived from ergot alkaloids Brings on a state of hallucinogen intoxication (hallucinosis) Increased and altered sensory perception, psychological changes, and physical symptoms Hallucinations and/or synesthesia Effects wear off in about 6 hours Produces these symptoms by binding to serotonin receptors These neurons help control visual information and emotions, thereby causing the various effects of the drug on the user.
Many consumed substances cause harm or disruption to behavior or mood.
Overall cost of substance misuse is $740 billion in U.S. alone (combing costs of crime, lost work productivity, and health care). 135 million people in U.S. have used cocaine, heroin, or another illegal substance; 32 million have used illegal substances with past month. One-quarter of all teenagers have used an illegal substance.
What are the physical dangers of cocaine?
Overdose: greatest risk Excessive doses: depress the brain's respiratory function and stop breathing Heart irregularities or brain seizures: death Increased likelihood of pregnancy complications: miscarriage or having children with abnormalities Death: Over 10,000 persons in the United States die from a cocaine overdose each year, a 50 percent increase over the fatality rate of a decade ago. Pregnant women who use cocaine run the risk of having a miscarriage and of having children with predispositions to later drug use and with abnormalities in immune functioning, attention and learning, thyroid size, and dopamine and serotonin activity in the brain
Street tag Pain relievers
Oxy, Percs, Vikes
polysubstance use
People often take more than one drug at a time Each year tens of thousands of people are hospitalized because of this use May be accidental or intentional
What Causes Substance Use Disorders? Psychodynamic views
People who are most likely to develop these disorders: Have powerful early years dependency needs Display substance abuse personality These theorists believe that people who abuse substances have powerful dependency needs that can be traced to their early years. Caused by a lack of parental nurturing Some people may develop a "substance abuse personality" as a result. Limited research links early impulsivity to later substance use, but the findings are correlational and researchers cannot presently conclude that any one personality trait or group of traits stands out in substance use disorders.
What Causes Substance Use Disorders? Sociocultural views
People who are most likely to develop these disorders: Living in stressful socioeconomic conditions Have families that value or tolerate drug use Are confronted regularly by other kinds of stress
What Causes Substance Use Disorders? Cognitive-behavioral views
People who are most likely to develop these disorders: Operant conditioned by tension-reduction, rewarding effects of drugs (self-medication) Have rewards-produced expectancy that substances will be rewarding Influenced by classical conditioning when cues or objects are present during drug use
high doses of amphetamines
Produce a rush, intoxication, and psychosis Cause an emotional letdown as amphetamines leave the body
Sedative-hypnotic (anxiolytic) drugs
Produce feelings of relaxation and drowsiness to reduce anxiety and help people sleep Low doses = calming or sedative effect High doses = sleep inducers or hypnotics
Hallucinogens (psychedelic drugs)
Produce powerful changes primarily in sensory perception (trips)
Cannabis
Produced from varieties of hemp plants Hashish: Solidified resin of the cannabis plant Marijuana: Mixture of buds, crushed leaves, and flowering tops Major active ingredient: tetrahydrocannabinol (THC) Potency influenced by environmental conditions When smoked, produces a mixture of hallucinogenic, depressant, and stimulant effects, known as cannabis intoxication Most of the effects last 2 to 6 hours
Alcohol use disorder clinical picture
Regular consumption and reliance affects cognition, social life, and work behaviors. Individual alcoholism patterns vary. Damage in various structures of the brain and, correspondingly, impairments in memory, speed of thinking, attention skills, and balance found in chronic heavy drinkers.
Benzodiazepines
Safer and less likely to lead to intoxication, tolerance effects, and withdrawal reactions Long term use by elderly can cause severe cognitive impairment. Increase GABA activity In high doses, can cause intoxication and lead to sedative-hypnotic use disorder As many as 17 percent of the elderly population are prescribed benzodiazepine medications, including as many as 40 percent of elderly individuals living in nursing homes.
The Opioid Crisis
See page 325 for additional information. (add in later)
Effects of Methamphetamine (meth, crank)
Serious negative effects on physical, mental, and social life Linked to increased ER visits May cause neurotoxicity; methamphetamine-induced psychosis
Depressants
Slow the activity of the central nervous system (CNS) Reduce tension and inhibitions May interfere with judgment, motor activity, and concentration
Cannabis use disorder influenced by regular use
Social and occupational lives of 1.6 percent of people in the United States are affected, including a large number of high school students The current varieties of marijuana are 7 times more powerful than those found in 1970s, due to the higher THC content (8 percent)
Stimulant use disorder
Stimulant dominates the individual's life Leads to poor functioning in social relationships and at work Tolerance and withdrawal reactions tied to increased doses Annual rates among people older than age 11 Disorders centered on cocaine: 0.4 percent Disorders centered on methamphetamines or another kind of amphetamine: 0.6 percent
Efforts to change
Substance-free dorms
Caffeine reduction
Sudden stop or cutback of usual caffeine intake can cause withdrawal symptoms, including headaches, depression, anxiety, and fatigue
Cannabis use disorder dangers
Tolerance and withdrawal symptoms Occasional panic reactions, automobile accidents, and decreased memory while high Long-term health problems; reproduction problems Marijuana was once thought not to cause abuse or dependence. One theory about the recent increases in risk of abuse and dependence relates to the changes in the drug itself. The marijuana available today is significantly more potent than the drug used in the early 1970s. As the strength and use of the drug have increased, so have the risks of using it. May cause panic reactions similar to those caused by hallucinogens Because of its sensorimotor effects, has been implicated in accidents Has been linked to poor concentration and impaired memory Long-term use poses additional dangers. May cause respiratory problems and lung cancer May affect reproduction In males, it may lower sperm count. In women, abnormal ovulation has been found.
Barbiturates
Widely prescribed for first half of twentieth century; largely replaced
Street tag Amphetamines
bennies, speed, uppers
Street tag Heroin
black tar, horse, smack
Street tag Marijuana
grass, Mary Jane, reefer, weed
opioids, stimulants mixed drugs
high addiction potential
opioids, stimulants, alcohol, cannabis, mixed drugs
high potential intoxication
Stimulants
increase the activity of the central nervous system (CNS). Increases in blood pressure, heart rate, and alertness Rapid behavior and thinking
Street tag Methamphetamine
meth, crank, crystal, ice
Benzodiazepines, Alcohol
moderate addiction potential
Barbiturates, Benzodiazepines
moderate potential intoxication
Barbiturates
moderate to high addiction potential
Barbiturates
moderate to high risk of organ damage or death
Cannabis
moderate to low addiction potential
Effects of high doses of cocaine
produce cocaine intoxication, whose symptoms include mania, paranoia, and impaired judgment. Some people also experience hallucinations and/or delusions, a condition known as cocaine-induced psychotic disorder. As the stimulant effects of the drug subside, the user experiences a depression-like letdown, popularly called "crashing." Cocaine intoxication, Cocaine-induced psychotic disorder Depression-like letdown (crashing) More powerful, cheaper forms have been available since 1984. Freebasing Crack Crack, a powerful form of freebase cocaine, is produced by boiling cocaine down into crystalline balls and is smoked with a crack pipe. The prevalence of crack use has decreased during the past two decades; however, it is still the case that 0.3 percent of all people over the age of 11 almost 800,000 individuals—use it over the course of a year.
Caffeine
the world's most widely used stimulant. Most is in the form of coffee; the rest is in the form of tea, cola, energy drinks, chocolate, and over-the-counter medications. Nearly 99 percent of ingested caffeine is absorbed by the body and reaches its peak concentration within an hour. Consumed daily by around 90 percent of the world's population Absorbed by body and serves as a CNS stimulant, triggering the release of dopamine, serotonin, and norepinephrine in the brain More than 2 to 3 cups of brewed coffee, 6 cans of cola, or 3 cans of Red Bull can lead to caffeine intoxication. Seizures and fatal respiratory failure can occur at doses greater than 10 grams of caffeine (about 100 cups of coffee).
