Drug Abuse Midterm
CHAPTER 1 4 Principal Factors P. 5
1. 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. 2. Cultural factors. Society's views of drug use, as determined by custom and tradition, affect our initial approach to and use of a particular drug. 3. Social factors. The motivation for taking a particular drug is affected by needs such as diminishing physical pain; curing an illness; providing relaxation; relieving stress or anxiety; trying to escape reality; self-medicating; heightening awareness; wanting to distort and change visual, auditory, or sensory inputs; or strengthening confidence. Included in the category of social factors is the belief that attitudes about drug use develop from the values and attitudes of other drug users; the norms in their communities, subcultures, peer groups, and families; and the drug user's personal experiences with using drugs. (These are also known as influencing social factors.) 4. Contextual factors. Specific contexts define and determine personal dispositions toward drug use as demonstrated by moods and attitudes about such activity. Specifically, these factors encompass the drug-taking social behavior that develops from the physical surroundings where the drug is used. For example, drug use may be perceived as more acceptable at fraternity parties, while socializing with drug-using friends, outdoors in a secluded area with other drug users, in private homes, secretly at work, or at music concerts.
CHAPTER 1 Table 1.2 Commonly Used Terms P. 9
1. Gateway drugs- The word gateway suggests a path or entryway leading to an entrance. Gateway is a theory that the early use of alcohol, tobacco products, and marijuana (the most heavily used illicit type of drug) leads to the use of more powerfully addictive drugs such as cocaine, heroin, and highly addictive prescription medicines. 2. Medicines Compounds- generally prescribed by a physician that treats, prevent, or alleviate the symptoms of the disease. (These can also include over-the-counter [OTC] drugs purchased at pharmacies.) 3. Prescription medicines- Drugs that are prescribed by a physician. Common examples include antibiotics, antidepressants, and drugs prescribed to relieve pain, induce stimulation, or induce relaxation. These drugs are taken under a physician's recommendation because they are more potent than OTC drugs. In the United States, on a yearly basis, physicians write approximately 4.0 billion prescriptions (Henry J. Kaiser Family Foundation, 2015), with sales totaling $374 billion in 2015 ("U.S. Prescription Drug Spending," 2015). 4. Over-the-counter (OTC)OTC drugs- can be purchased at will without seeking medical advice or a prescription. Examples include aspirin, laxatives, diet pills, cough suppressants, and sore throat medicines. Approximately 1,000 active ingredients are used in the more than 100,000 OTC products available in the marketplace today (Consumer Healthcare Products Association [CHPA], 2012), and it is estimated that there are more than 300,000 marketed OTC drug products (U.S. Food and Drug Administration 2015). In 2010, $23 billion were spent in the United States on OTC medicines* (CHPA, 2012). 5. Drug misuse- The unintentional or inappropriate use of prescribed or OTC drugs. Misuse includes but is not limited to (l) taking more drugs than prescribed; (2) using OTC or psychoactive drugs in excess without medical supervision; (3) mixing drugs with alcohol or other drugs, often to accentuate euphoric effects or simply not caring about the effects of mixing drugs; (4) using old medicines to self-treat new symptoms of an illness or ailment; (5) discontinuing certain prescribed drugs at will or against a physician's recommendation; and (6) administering prescription drugs to family members or friends without medical approval and supervision. 6. Drug abuse- Also known as chemical or substance abuse. The willful misuse of either licit or illicit drugs for recreation, perceived necessity, or convenience. Drug abuse differs from drug use in that drug use is taking or using drugs, whereas drug abuse is a more intense and often willful misuse of drugs, often to the point of becoming addicted 7..Drug addiction- Drug addiction involves noncasual or nonrecreational drug use. A frequent symptom is an intense psychological preoccupation with obtaining and consuming drugs. Most often psychological and—in some cases, depending on the drug—physiological symptoms of withdrawal are manifested when the craving for the drug is not satisfied. Today, more emphasis is placed on the psychological craving (mental attachment) to the drug than on the more physiologically based withdrawal symptoms of addiction.
CHAPTER 1 Key Terms P. 6
1. addiction - a mostly psychological attachment defined as "a complex condition, a brain disease that is manifested by compulsive substance use despite harmful consequences . . ." (APA, 2019) and experiences 2. withdrawal symptoms - that are psychological or physical in nature whenever the drug is not consumed. 3. drug - any substance that modifies the nervous system and state of consciousness 4. Psychoactive drugs are classified as either licit (legal) or illicit (illegal). 5. coffee, tea, cocoa, alcohol, tobacco, and over-the-counter (OTC) drugs are licit.
CHAPTER 1 Race and Ethnic Differences P. 29
African Americans - 13.7 % Whites - 12% Hispanics - 9.7% Asians - 6.7%
CHAPTER 1 Drug Use Page P. 3
Anyone can come depended on or addicted to a drug. The desire to use a drug before drug dependence occurs in both seductive and indiscriminate of its users. 4 major stimulus changes. 1. Social Psychological basis can be explained as feeling rewarded or satisficed because social pressures can be seen as neutralized. 2. Nonmedical use of drugs alters the body's chemistry by messing with homeostatic functions. Drugs can enhance, accelerate, depress, and distort the perception of reality. 3. Drugs may satisfy an inborn or genetic need or desire. Interfere with the way neurons send, receive, and process signals via neurotransmitters.
CHAPTER 1 Drug Dependence P. 37
Both physical and psychological factors precipitate drug dependence. Recently, closer attention has been focused on the mental (psychological) attachments than on the physical addiction to drug use as principally indicative of addiction—mostly, the craving aspect of wanting the drug for consumption. More specifically, psychological dependence refers to the need that a user may feel for continued use of a drug to experience its effects. Physical dependence refers to the need to continue taking the drug to avoid withdrawal symptoms that often include feelings of discomfort and illness. With repeated use, there is a tendency to become dependent on and addicted to most psychoactive drugs. Addiction to a drug sets in when the drug user has advanced within the dependence phase. (Having an addiction to a drug is simply an advanced stage of dependence.) Generally, the addiction process involves mental (psychological) and physical (physiological or biophysiological) dependence.
CHAPTER 1 Types of drug users P.31
Experimenters begin using drugs largely because of peer pressure and curiosity, and they confine their use to recreational settings. Generally, they more often enjoy being with peers who also use drugs recreationally. Alcohol, tobacco, marijuana, prescription drugs, hallucinogens, and many of the major stimulants are the drugs they are most likely to use. They are usually able to set limits on when these drugs are taken (often preferred in social settings), and they are more likely to know the difference between light, moderate, and chronic use. Compulsive users, in contrast, "devote considerable time and energy to getting high, talk incessantly (sometimes exclusively) about drug use . . . [and 'funny' or 'weird' experiences] . . . and become connoisseurs of street drugs" (Beschner, 1986, p. 7). For compulsive users, recreational fun is impossible without getting high. Other characteristics of these users include the need to escape or postpone personal problems, avoid stress and anxiety, and enjoy the sensation of the drug's euphoric effects. Often, they have difficulty assuming personal responsibility and suffer from low self-esteem. Many compulsive users are from dysfunctional families, have persistent problems with the law, or have serious psychological problems underlying their drug-taking behavior. Problems with personal and public identity, excessive confusion about their sexual identity and at times sexual orientation, boredom, family discord, childhood sexual or mental abuse, academic pressure, and chronic depression all contribute to the inability to cope with issues without drugs. Floaters or chippers initially focus more on using other people's drugs without maintaining a steady supply of drugs. Nonetheless, floaters or chippers, like experimenters, are generally light to moderate drug users. Floaters or chippers feel a largely unconscious need to seek pleasure from using drugs and the desire to relieve moderate to serious psychological problems. Even though most are on a path to drug dependence, at this stage they may generally drift between or simultaneously intermix with other experimental drug-taking peers and chronic drug-using peers. In a sense, these types of drug users feel marginally attached to conventional society and often appear to conventional members of society as norm abiding, while masking their secret drug use. At this stage, floaters or chippers are not yet firmly attached to compulsive users often because they have not made the commitment to continually do drugs. (See "Signs & Symptoms: Who Is More Likely to Use Licit and Illicit Drugs?")
CHAPTER 1 Gender P.29
In 2018, as in preceding years, the rate of past-month illicit drug use among persons 12 and older was higher for males (14.0%) than for females (9.5%). Males were more likely than females to be current users of several different illicit drugs, including marijuana (12.3% vs. 8.0%), cocaine (1.0 vs. 0.4%), hallucinogens (0.8 vs. 0.4%), and crack (0.2% vs. 0.1%). In 2015, women continually have lower rates of substance use and substance use disorders (SUDs) than men. For example, past-year illicit drug dependence or abuse was 3.4% for men and 1.9% for women (SAMHSA, 2015). Rates of alcohol, drug, and tobacco use are lower among pregnant women than nonpregnant women (SAMHSA, 2015).
CHAPTER 1 Extent and Frequency of Drug Use in Society
Legal instrumental use: Taking prescribed drugs and OTC drugs to relieve or treat mental or physical symptoms. Legal recreational use: Using such licit drugs as tobacco, alcohol, and caffeine to achieve a certain mental or psychic state. Illegal instrumental use: Taking drugs without a prescription to accomplish a task or goal such as taking nonprescription amphetamines to drive through the night or relying excessively on barbiturates to get through the day. Illegal recreational use: Taking illicit drugs for fun or pleasure to experience euphoria such as abusing prescribed methylphenidate (Ritalin) as a substitute for cocaine. Fifty-two million people in the United States older than 12 have used prescription drugs nonmedically in their lifetime. Percentage of persons using at least one prescription drug in the past 30 days: 48.4% (2013-2016) (CDC, 2017a). Nearly 70% of Americans are on at least one prescription drug, and more than half take two. Approximately 6.1 million Americans have used prescription drugs nonmedically in the past month. Although the United States is just 5% of the world's population, it consumes 75% of the world's prescription drugs. With regards to obtaining prescription drugs, 54.2% reported obtaining them for free from a friend or relative, 18.1% from one doctor, and 16.6% buying or taking them from a friend or relative.
CHAPTER 1 Narcotics and Heroin Usage P. 39
The National Institute on Drug Abuse (NIDA) has estimated that the typical narcotic habit costs the user approximately $150 a day to support his or her addiction. The precise dollar amount spent to support a narcotic addiction largely depends on the geographic location where the drug is procured and used, availability of the drug affecting the price, and numerous other factors. For example, a heroin addict, will spend "$150-200 per day in order to support his or her habit" (Heroin.net 2016), which adds up to $54,750 to $73,000 per year just to maintain the drug supply. It is impossible for most addicts to get this amount of money legally; therefore, many support their habits by resorting to criminal activity or by working as or for drug dealers.
CHAPTER 1 Meth Usage P. 39
The misuse of methamphetamine—a potent and highly addictive stimulant—remains an extremely serious problem in the United States. In some areas of the country, it poses an even greater threat than opioids, and it is the drug that most contributes to violent crime. According to data from the 2017 National Survey on Drug Use and Health, more than 14.7 million people (5.4% of the population) have tried methamphetamine at least once. NSDUH also reports that almost 1.6 million people used methamphetamine in the year leading up to the survey, and it remains one of the most commonly misused stimulant drugs in the world (NIDA, 2019d).
CHAPTER 1 Major Types of commonly abused drugs P. 10-16
The six types of major drugs in use are (l) prescription drugs, (2) over-the-counter drugs, (3) recreational drugs (e.g., coffee, tea, alcohol, tobacco, and chocolate), (4) illicit drugs, (5) herbal preparations (generally derived from plants), and (6) commercial drugs (paints, glues, pesticides, and household cleaning products).
CHAPTER 1 When does it lead to abuse P. 36-37
There are many possible answers to this question. Initially, most drug abusers perceive some psychological advantage when using these compounds. For many, the psychological lift is significant enough that they are willing to risk social exclusion, health problems, dramatic changes in personality, arrest, incarceration, and fines to have their drug. The psychological effects that these drugs cause may entail an array of diverse feelings. Different types of drugs have different psychological effects. The type of drug an individual selects to abuse may ultimately reflect his or her own mental state. For example, people who experience chronic depression, feel intense job pressures, are unable to focus on accomplishing goals, or have a sense of inferiority may find that a stimulant such as cocaine or an amphetamine-type drug appears to provide immediate relief—a solution to a set of psychological frustrations. These drugs cause a spurt of energy, a feeling of euphoria, a sense of superiority, and imagined self-confidence. In contrast, people who experience nervousness and anxiety and want instant relief from the pressures of life may choose a depressant such as alcohol or barbiturates. These agents sedate, relax, provide relief, and even have some amnesiac properties, allowing users to suspend or forget their immediate pressing concerns or problems. People who perceive themselves as creative or who have artistic talents may select hallucinogenic types of drugs to "expand" their minds, heighten their senses, and distort what appears to be a confining and sometimes monotonous nature of reality. As individuals come to rely more on drugs to inhibit, deny, accelerate, or distort their realities, they run the risk of becoming psychologically dependent on drugs. Some people have argued that taking a particular drug to meet a psychological need, especially if a person is 21 years of age or older, is not especially different from taking a drug to cure an ailment. The belief here is that physical needs and psychological needs are really indistinguishable. In fact, several drug researchers and writers, including Szasz (1992) and Lenson (1995), believe that drug taking is a citizen's right and a personal matter involving individual decision making. They see drug taking as simply a personal choice to depart from or alter consciousness. Lenson states that taking drugs for recreational purposes is simply an additional form of diversity, a type of mental diversity that should exist with many other acceptable forms of diversity such as cultural, racial, religious, gender, and sexual orientation diversity. (For additional elaboration on these views, see Venturelli, 2000.) Obviously, this is a strikingly different and often extremely controversial point of view that can easily cause polemic and highly debatable perspectives!
CHAPTER 1 Signs and symptoms P. 32
To fit in: Many teens use drugs "because others are doing it"—or they think others are doing it—and they fear not being accepted in a social circle that includes drug-using peers. To feel good: Abused drugs interact with the neurochemistry of the brain to produce feelings of pleasure. The intensity of this euphoria differs by the type of drug and how it is used. To feel better: Some adolescents suffer from depression, social anxiety, stress-related disorders, and physical pain. Using drugs may be an attempt to lessen these feelings of distress. Stress especially plays a significant role in starting and continuing drug use as well as returning to drug use (relapsing) for those recovering from an addiction. To do better: Ours is a highly competitive society in which the pressure to perform athletically and academically can be intense. Some adolescents may turn to certain drugs like illegal or prescription stimulants because they think those substances will enhance or improve their performance. To experiment: Adolescents are often motivated to seek new experiences, particularly those they perceive as thrilling or daring. In addition, adolescents' years can also be preoccupied with the need to explore. They can be preoccupied with using alcohol or other drugs to do the following (DEA, 2018): relieve boredom, feel good, forget their troubles and relax, satisfy their curiosity, ease their pain, feel grown up, show their independence, and belong to a specific group. Finally, when attempting to determine who among drug users has a greater likelihood of becoming addicted, one research finding reports, "As with many other conditions and diseases, vulnerability to addiction differs from person to person. Your genes, mental health, family and social environment all play a role in addiction" (Helpguide.org, n.d.). The following risk factors increase a person's vulnerability to addiction (Helpguide.org, n.d.): family history of addiction; abuse, neglect, or other traumatic experiences; mental disorders such as depression and anxiety; early use of drugs; and method of administration (smoking or injecting a drug may increase its addictive potential).
CHAPTER 1 Figure 1.1 P. 8
Tobacco - 480,000 19% Alcohol - 88,000 3.5% All illicit drugs - 69,096
CHAPTER 1 The holistic self-awareness approach to drug use P. 51
Whenever drug use leads to abuse, it rarely results from a single, isolated cause. Instead, it is often caused or preceded by multiple factors, which may include combinations of the following: hereditary (genetic) factors, psychological conditioning, peer-group pressures, inability to cope with the stress and anxiety of daily living, quality of role models, degree of attachment to a family structure, level of security with gender identity and sexual orientation, personality traits, and perceived ethnic and racial compatibility with society as a whole and socioeconomic status (social class). As authors, we strongly endorse and advocate a holistic self-awareness approach that emphasizes a healthy balance among mind, body, and spirit. Health and wellness can be achieved only when these three domains of existence are free from any unnecessary use of psychoactive substances.
CHAPTER 1 Drug use and dependence P. 36
searching for pleasure and using drugs to heighten good feelings; taking drugs to temporarily relieve stress or tension or provide a temporary escape for people with anxiety; taking drugs to temporarily forget one's problems and avoid or postpone worries; viewing certain drugs (such as alcohol, marijuana, and tobacco) as necessary to relax after a tension-filled day at work; taking drugs to fit in with peers, especially when peer pressure is strong during early and late adolescence; seeing drugs as a rite of passage; taking drugs to enhance religious or mystical experiences (few cultures teach children how to use specific drugs for this purpose); taking drugs to relieve pain and some symptoms of illness; and resuming drug use from teenage and young adult periods of life—for example, elderly baby boomers who may have used drugs in their youth. It is important to understand why, historically, many people have been unsuccessful in eliminating their fascination with drugs. To understand, we must address questions dealing with (1) why people are attracted to drugs, (2) how experiences with the different types of drugs vary (here many attitudes are conveyed from the "inside"—the users themselves), (3) how each of the major drugs affects the body and the mind, (4) how patterns of use vary among different groups, and (5) what forms of treatment are available for the addicted.