Chapter 16 Drug Use and Abuse

Four Most Common Sources for 12 Graders Obtaining Prescription Drugs (2017-2018)

"Given for free by a friend or relative" (43.7%) "Bought from a friend or relative" (37.8%) "Bought from drug dealer/stranger" (18.8%) "Took from friend/relative without asking" (10.1%) "Bought prescription drugs on the Internet" (5.7%)

How Social Networking Motivates Drug Use? (3 of 3)

"Teens who are exposed to these types of images are three times likelier to consume alcohol, and it's four times as likely that they'll use marijuana" (12 Keys Rehab 2016). "These teens are able to access mind-altering substances, including prescription drugs, more readily than teens who don't use social media" (12 Keys Rehab 2016).

Drugs Used by Athletes

- Anabolic steroids: consist of a group of natural and synthetic drugs that are chemically similar to cholesterol and related to the male hormone testosterone. - Naturally occurring male hormones, or androgens, are produced by the testes in males.

Athletes and Drug abuse

- Greeks in Olympics(776BC) - Doping among world class competitors is rampant - young athletes receive a great amount of attention in almost every level of school - athletes are not more likely than nonathletes to use drugs of abuse such as marijuana, alcohol, barbiturates, cocaine, and hallucinogens.

Steroid Usage in Professional Sports

- Usage patterns vary on: motivation, level of competition, type of sport, pressure of winning - "Of the 26 sports included in the 2012 Games, the worst offender in terms of the rate of findings per sample (averaged across all eight years) is cycling, 3.71%." - "The second highest rate—3.05%—was found among boxers. Badminton had the lowest rate of usage-indication findings per sample, at 0.87%." - "Footballers were the most tested athletes in terms of the total number of samples (30,398), followed by athletics (25,013), cycling (21,427), and aquatics (13,138)" (Burn-Murdoch 2012).

Abuse of Anabolic Steroids by Athletes

- androgen like drugs can increase muscle mass and strength - The American Journal of Sports Medicine: the number of anabolic steroid users in US ~3 million - males are more likely to use - 2019 Monitoring the Future: 1.5% 8th grade 1.6% 10th and 12th use steroids -Football players have highest rate and Track has lowest (NCAA 2014)

Major Reasons for the Use/Abuse of Anabolic Steroids

- improve athletic performance - increase muscle size or reduce body fat - Experienced physical or sexual abuse (e.g., female weightlifters who had been raped were found to be twice as likely to use anabolic steroids) - Adolescent steroid abusers often take risks such as drinking and driving, carrying a gun, driving a motorcycle without a helmet, and abusing other types of illicit drugs. - Muscle dysmorphia (also a key term in text), a behavioral syndrome that causes individuals to have a distorted image of their bodies (i.e., perceiving themselves as looking small and weak, even when they may be large and muscular), may be a reason to use anabolic steroids

why adolescents use drugs

- use during psychosocial development do not develop problematic drug dependence - those with difficulty with drugs often lack: coping skills, from dysfunctional families, maintain poor self-images, and feel socially and emotionally insecure - peer drug use - correlation between strong family bond and non drug users - use drugs to cope with boredom, unpleasant feelings, emotions, stress, relieve depression, reduce tension, reduce alienation

Ex of Drugs used by Athletes

-Amphetamines and cocaine -Dianabol (methandrostenolone) -Ephedrine -Furosemide -Over-the-counter decongestants -Protein powders -Thyroid hormone

Effects of anabolic steroids

-Increased strength -Increased lean body mass -Increased "bad" blood cholesterol -Increased risk of liver disorders -Psychological effects: irritability, outbursts of anger such as "road rage," mania, psychosis, and major depression -Psychological and physical dependence with continual use of high doses -Withdrawal symptoms: cravings, fatigue, depression, restlessness, loss of appetite, insomnia, diminished sex drive, headaches -Alterations in reproductive systems and sex hormones: =Breast enlargement in males; breast reduction and hair growth in females =Infertility =Atrophy (shrinkage of the penis and testicles in males and enlargement of external genitalia in females) -Stunted growth in adolescents -Deepening of voice in females -Water retention -Change in skin and hair (severe acne, male pattern baldness, and increased body hair) -Persistent unpleasant breath odor -Swelling of feet and limbs

Drug Use among women vs men

-Overall, females consistently use fewer illicit drugs: 40.8% of females versus 43.9% of males use illicit drugs. -Most types of abused drugs by females (in descending order): Alcohol, females 83.2% (males 81.5%) Flavored alcoholic beverages, females 57.2% (males 48.9%) Marijuana, females 36.9% (males 40.0%) -Most types of abused drugs by females (in descending order) (cont.): Binge drinking (5 or more drinks in last two weeks), females 27.4% (males 36.6%) Cigarettes, females 20.2% (males 25.9%) Any illicit drug other than marijuana, females 17.4% (males 22.0%)

NCAA Banned Drug List (2019-20)

-Stimulants -Anabolic agents -Alcohol and beta blockers (banned for rifle only) -Diuretics and other masking agents -Narcotics -Cannabinoids -Peptide hormones, growth factors, related substances and mimetics -Hormone and metabolic modulators (anti-estrogens) -Beta-2 agonists

Figure 16.4 Estimated new HIV infections by transmission category: 2018

A. 70 % male to male sexual contact B. _8_ % injection drug use C. __3 % male-to-male sexual contact and injection drug use D. _24_ % heterosexual contact E. _1_ % other

Consequences of Adolescent Drug Use

Adolescent suicide Sexual violence Gangs

Youths and HIV/AIDS (2 of 2)

Adolescents who are most vulnerable to HIV infection include those who are homeless or runaways, juvenile offenders, and school dropouts (CDC 2010b, CDC 2020b). Most new HIV diagnoses among youth were among young gay and bisexual men.

Drug Use in the Entertainment Industry

Alcohol appeared in 93% of movies and 17% of songs; tobacco appeared in 89% of movies. "About one-third of hit songs—including three-quarters of rap songs—have some form of explicit reference to drug, alcohol, or tobacco use . . ." (Yahoo! News 2008). In movies depicting illicit drugs, marijuana appeared most frequently (51%); hallucinogens, heroin and other opiates, and miscellaneous others (each 12%); and crack cocaine (2%).

Women and Alcohol

Alcohol is the drug most widely used and abused by women in the United States. -In general, men have higher rates of alcohol use, including binge drinking. (NIDA 2020). -Men and women metabolize alcohol differently due to differences in gastric tissue activity. In fact, after drinking comparable amounts of alcohol, women have higher blood ethanol concentrations. As a result, women become intoxicated from smaller quantities of alcohol than men. Women dependent on alcohol are judged more harshly than men dependent on alcohol.

Nature and Extent of HIV/AIDS (3 of 3)

Although cases have been reported in all regions of the world, almost all those living with HIV (97%) reside in low- and middle-income countries, disproportionately found in sub-Saharan Africa. Injection drug users represented 8% of new HIV infections in 2010 and 15% of those living with HIV in 2011.

HIV-Infected Individuals (1 of 2)

An HIV-infected individual may not manifest symptoms of AIDS for as many as 2 to 15 years after the initial infection. Further, after AIDS diagnosis, people who do not have treatment typically survive for 3 years. Although the HIV-infected individual may experience no symptoms, he or she is highly contagious. After an individual has become infected, he or she may have a brief flu-like illness usually within 6 to 12 weeks. It is not known what determines the length of the latency period, when symptoms are not present. The asymptomatic period eventually ends, however, and signs of immune disorder appear. Initial symptoms of this disease include night sweats, swollen lymph glands, fever, and/or headaches. Medications used to treat HIV infection (antiretroviral drugs) help many people with HIV to lower the levels of virus in their blood (viral load) to undetectable levels.

Major Reasons Cited by College Students for Using Alcohol* (1 of 2)

Breaks the ice (75.1%) Enhances social activity (74.6%) Gives people something to do (73.0%) Gives people something to talk about (67.3%) Allows people to have more fun (62.5%) Peer bonding (62.4%) Male bonding (60.6%) Facilitates sex (53%) Facilitates female bonding (51.2%) Female bonding (52.9%) Makes it easier to deal with stress (43.6%) * Sample survey of 53,622 total students with 36.8% male and 62.2% female college students and their use of alcohol and other drugs (SIUCC/Core Institute 2014)

How Do These Drugs Affect a Woman's Reproduction?

Cocaine? A substantial threat to the fetus Alcohol? Crosses the placenta and affects the fetus's development Tobacco? Approximately 10% of women reported smoking during the last 3 months of pregnancy. (May be greater threat to the fetus than cocaine.) Other drugs (marijuana, LSD, other depressant drugs)? Associated with abnormal fetal development when used during pregnancy

Drug Use by College Students

College students who frequently binge drink are more likely to smoke cigarettes and use illegal drugs as well . A clear relationship exists between alcohol use and grade point average (GPA). (The more alcohol consumed, the lower the GPA.) Alcohol use by college students is associated with serious and acute problems such as alcoholism, poor academic performance, drinking and driving, and criminalistic behavior (e.g., driving while intoxicated, vandalism, violence). Studies show that two major drinking patterns appear dominant among college students: (1) drinking related to impulsivity, disinhibition, and sensation-seeking, and (2) drinking to manage negative emotional states, such as depression.

Drugs Abused by Adolescents Aged 12-17

Drinking alcohol to the point of inebriation: 18% of 8th graders, 37% of 10th graders, and 54.2% of 12th graders said they had been drunk at least once in their lifetime. The prescription drugs most commonly abused by teens are painkillers, powerful narcotics prescribed to treat pain; depressants, such as sleeping pills or anti-anxiety drugs; and stimulants, mainly prescribed to treat attention-deficit hyperactivity disorder (ADHD). Among teens who have abused prescription pain relievers, nearly one-fifth (18%) used them at least weekly in the past year. Each year, "more teens die from prescription drugs than heroin/cocaine combined" (Teendrugsrehabs.com 2015).

Parents who are most likely to foster drug using children are

Drug abusers themselves Excessively rigid and condemning or range from intermittent extreme rigidity to extreme neglect Overly demanding Overly protective Overwhelmed with their own personal conflicts Unable to effectively communicate with their children

Summary Findings: Drug Use and College Students from 2015 to 2018

Drugs that have increased in usage: marijuana, hallucinogens, LSD, Adderall, and cocaine. Drugs that have declined in usage: alcohol, heroin, amphetamines, Ritalin, tranquilizers, sedatives (barbiturates), and inhalants. Drugs that have remained steady in usage: any illicit drug, any illicit drug other than marijuana, MDMA (Ecstasy), methamphetamine, narcotics (other than heroin), and ketamine.

Prevention and Treatment of Adolescent Drug Problems

Encourage parental awareness of gangs. Encourage alternative participation in organizations or groups (athletics, school activities, career development, or involvement in volunteering programs). Help children to develop coping skills regarding frustration and stress. Educate children about gang-related problems and help them understand that like drugs, gangs are the result of problems and are not the solutions to problems.

College Students and Adults Ages 19-60 (2 of 3)

For females, most common types of abused drugs were: alcohol (83.2%), flavored alcoholic beverages (57.2%), any illicit drug use (40.8%), marijuana (36.9%), binge drinking (five or more drinks in a row in last 2 weeks) (27.4%), cigarettes (20.2%), and any illicit drug other than marijuana (17.4%).

Promoters of Drug Use: The Entertainment Industry and the Internet (2 of 3)

For recreational drug users the top drug-related information sources were the Internet (74%), friends (75.3%), dealer (38.2%), radio/TV (17.1%), and Scene magazines (15.7%) (Stetina et al. 2008).* *Interesting how recreational drug users primarily relied on the Internet and secondarily relied on friends and acquaintances for drug information and usage.

College Students: Heavy Drinking Settings (Stewart 2013)

Fraternity parties Drinking in conjunction with athletic events Drinking in residence halls Drinking in off-campus housing areas with a high proportion of students Drinking in bars adjacent to campus

Nature and Extent of HIV/AIDS (1 of 3)

Globally: More than 37.9 million people worldwide are living with HIV since the first cases were first reported in 1981 (WHO 2020). In the U.S.: In 2018, because of gaps in HIV services, 770,000 people died from HIV-related causes in 2018 and 1.7 million people were newly infected. Key populations infected include men who have sex with men, people who inject drugs, people in prisons and other closed settings, sex workers and their clients, and transgender people.

Adolescent Drug Use: Additional Recent Findings: e-cigarettes

In 2014, it was reported that the use of electronic cigarettes (e-cigarettes) was high among teens, with 9.5% of 8th graders, 14% of 10th graders, and 16.2% of 12th graders using e-cigarettes in the past month (Johnston et al. 2016b). Only 14.2% of 12th graders viewed regular e-cigarette use as harmful. The nicotine in e-cigarettes is vaporized and inhaled (not smoked); however, the health impact of e-cigarette use is not yet clear, nor is it known (NIDA 2014a).

Drug Use by College Students Versus Noncollege Youth at Same Age (1 of 3)

In 2018, college students (59.8%) were moderately higher in annual and 30-day use of alcohol than the noncollege group (50.1%). Regarding heavy and binge drinking, the opposite occurs with 10th and 12th grade students. Students who were college-bound were far less likely to drink alcohol at any level compared to their noncollege-bound peers. Annual marijuana use was somewhat similar among college students and high school graduates of the same age who were not in college (42.3% vs. 41.4%). More significant differences were seen regarding cigarette usage: college students 15.3% versus 27.0% noncollege students

drug use college stats

In 2019 (Schulenberg et al., 2019): Most popular substance of use and abuse is alcohol (74.6% of college students). 45.2% of college students report use of illicit drugs. 42.6% report use of marijuana.

Nature and Extent of HIV/AIDS (2 of 3)

In the United States: Gay, bisexual, and other men who have sex with men (MSM), particularly young black/African American MSM, are most seriously affected by HIV. By race, blacks/African Americans face the most severe burden of HIV. Over two-thirds of all people living with HIV live in the WHO African Region (25.7 million).

Two Most Important Factors for Transmitting HIV/AIDS in the United States

Intravenous drug use of heroin, cocaine, or both: most important factor for the spread of HIV/AIDS Crack, cocaine, and methamphetamine encourages high-risk sexual activities

external subcultural forces

Law enforcement, availability of drug dealers, and concerns with being caught using drugs

Most commonly Abused steroids

Oral steroids: Anadrol (oxymetholone), Oxandrin (oxandrolone), Dianabol (methandrostenolone), and Winstrol (stanozolol) Injectable Steroids: Deca-Durabolin (nandrolone decanoate), Durabolin (nandrolone phenpropionate), Depo-Testosterone (testosterone cypionate), Equipoise (boldenone undecylenate), and Tetrahydrogestrinone (THG)

College Students and Adults Ages 19-60 (1 of 3)

Overall, use of illicit drugs is consistently lower in females (40.8%) than in males (43.9%). Males have higher annual prevalence rates for nearly all illicit drugs. They are twice as likely or more to use synthetic marijuana, hallucinogens, LSD, hallucinogens other than LSD, salvia, heroin, heroin with a needle, GHB (not shown in table), ketamine (not shown in table), bath salts (not shown in table), and steroids.

Current Major Treatments for HIV

Protease inhibitors Reverse transcriptase inhibitors: nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs) Treatment with combinations of other medications is often referred to as antiretroviral therapy (ART), which slows the rate at which HIV multiplies in the body and may decrease the chance that an infected person will transmit HIV to others through sex

Patterns of Drug Use (8th grade)

Regarding recent surveys on lifetime drug use by 8th graders in 2018: 23.5% used alcohol 18.7% used any illicit drug(s) 9.1% used cigarettes 13.9% used marijuana/hashish 8.7% used inhalants 5.9% used amphetamines

Patterns of Drug Use (12th grade)

Regarding recent surveys on lifetime drug use by12th graders in 2018: 66.0% used alcohol 58.5% used any illicit drug(s) 43.6% used marijuana/hashish 23.8% used cigarettes 4.4% used inhalants

How Social Networking Motivates Drug Use? (1 of 3)

Research at The National Center on Addiction and Substance Abuse at Columbia University conducted a survey of 12- to 17-year-olds, they found that the vast majority (70%) of the teens surveyed used the sites and that 40% of all teens had "seen pictures on those sites of kids drinking or using drugs and that half of those teens were not yet teens—they were 13 years old or younger" (Reuters and Fox News Network 2011).

Athletes who dope and their role as role models

Seventy-three percent of youth want to be like a famous athlete; 53% of youth say it is common for famous athletes to use banned substances to get ahead.

Internal subcultural forces

Shared attitudes that are favorable of drug use, habitual, and/or addictive behavior

Patterns of Anabolic Steroid Use by Athletes

Stacking, Cycling, Plateauing, Pyramiding, Arraying

Drug Use by College Students Versus Noncollege Youth at Same Age (3 of 3)

Table 16.6 reveals that full-time college students of the same age had significantly higher rates of drug use for the following drugs: alcohol, amphetamines, Adderall, hallucinogens and MDMA (Ecstasy and Molly), and cocaine. Noncollege youth had significantly higher rates of nonprescription drug use for the following drugs: cigarettes, methamphetamine, hallucinogens and LSD, and sedatives (barbiturates).

Promoters of Drug Use: The Entertainment Industry and the Internet (1 of 3)

The Internet maintains a unique subculture of drug enthusiasts. Numerous web sites are used by a growing number of drug users as forums for learning and exchanging the latest information and techniques about drug use (i.e., purchasing equipment for growing; chat rooms sharing information about the use of illicit drugs; news about drug "get togethers," such as parties, raves, festival locations where drugs are prevalent).

Promoters of Drug Use: The Entertainment Industry and the Internet (3 of 3)

The potential impact of acquiring illicit drugs from Internet sites was emphasized by a journalist warning that we should "Forget the drug dealer on the corner, teens are increasingly turning to the Internet to get high" (Fiore 2008).

College Students and Adults Ages 19-60 (3 of 3)

There are large gender differences regarding extreme binge drinking (10 or more drinks on at least one occasion): 17.2% for males versus 7.7% for females. The rate for having 15 or more drinks was 7.0% for males and 1.4% for females.

Figure 16.5 Diagnosis of HIV infections of male and female adults and adolescents by transmission categories, 2018

What are the approximate percentages of HIV cases in female adults and adolescent females by transmission categories? A. _84.7_ % heterosexual contact B. _14.7_ % injection drug use C. _>1_ % other

Youths and HIV/AIDS (1 of 2)

Worldwide, sexual intercourse is by far the most common mode of HIV transmission. In the United States, however, as many as half of all new HIV infections are associated either directly or indirectly with injection drug use (i.e., using HIV-contaminated needles to inject drugs or having sexual contact with an HIV-infected drug user) (amFAR 2010).

Subculture

a special population or subgroup whose members share similar values and patterns of related bahaviors that differ from the larger population

Pyramiding

beginning steroid use with low doses moving to higher doses, then reducing the dosage at the end of the cycle.

Stacking

combining two or more different steroids and mixing oral and/or injectable types

Plateauing

developing tolerance to the effects of anabolic steroids

athletes are much more likely than other subcultures of drug users to take drugs to enhance performance.

drugs include stimulants such as amphetamines, cocaine, and an array of drugs with presumed ergogenic effects, such as anabolic steroids.

Two Types of Forces affecting members of a drug-using subculture

internal subcultural forces external subcultural forces

Cycling

taking multiple doses for an extended period, stopping for a time, and then restarting to take steroids

How Social Networking Motivates Drug Use? (2 of 3)

the top social media platforms for American teens are Facebook (71%), Instagram (52%), Snapchat (41%), and Twitter (33%). "90% of teens are initially exposed to picture of their peers drink, using drugs or passing out on social media before the reach the age of 15 years old" (12 Keys Rehab 2016).

Arraying

use of other drugs while taking anabolic steroids to avoid possible side effects, such as taking diuretics, anti-acne medications, and anti-estrogens

insider's perspective

viewing a group or subculture from inside the group; seeing members as they perceive themselves

outsider's perspective

viewing a group or subculture from outside the group and viewing the group and its members as an observer; looking "in" at the members