drugs health society
physiological variables that modify drug effects
- age - gender - pregnancy
Four Principal Factors That Affect Drug Use
1.Biological, Genetic, and Pharmacological Factors 2.Cultural Factors 3.Social Factors 4.Contextual Factors 1. 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. How do societal views, determined by custom and tradition, affect our initial approach to and use of a drug? 3. 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)? 4. How do physical surroundings (music concerts, bars, nightclubs, or fraternity and sorority parties) affect the amount of drug use?
Q: How many Americans use or have used marijuana/hashish in their lifetime?
17,213 million (44.2%)
What age group has the highest concentration of illicit drug users and experimenters?
18- 25
In 2014, what percentage of the U.S. population reported lifetime use of alcohol?
82.1
what is a drug?
Any substance that modifies (enhances, inhibits, or distorts) mind and/or body functioning
how the cocaine addiction rat studies work
At first, when scientists were studying the effects of cocaine on biological organisms, the cocaine was administered by the experimenter in isolated cages. Unfortunately, when these studies first began they left the rats in cages alone. The only stimulus available was cocaine. The rats very quickly became dependent on the cocaine, leaving researchers to speculate that having availability is a risk factor to developing an addiction. When scientists began to consider that there were environmental factors to addiction, they decided to try changing the rat's environment to see what happened.
What are psychoactive drugs?
Drug compounds (substances) that affect the central nervous system and/or alter consciousness and/or perceptions Psychoactive drugs are classified as either: - Licit (Legal): Examples include coffee, tea, alcohol, tobacco, and over-the-counter drugs. - Illicit (Illegal): Examples include marijuana, cocaine, and LSD.
In regard to the connection between drug use and crime, which of the following findings are often true?
Drug users in comparison to non-drug users are more likely to commit crimes, Arrestees are often under the influence of a drug while committing crimes, Drugs and violence often occur together.
the rat pack experiment data
Later, Canadian scientists decided to change the rat's environment. They built an extensive cage that they called the rat park. This cage featured: the ability to socialize with other male and female rats, toys to keep the rats amused, rat condos, multiple levels for sleeping, and tunnels so the rats had somewhere to play and hide. The scientists then discovered something unusual. They found that when given the choice only a small percentage of rats who used the lever with cocaine became addicted to the powerful drug. This study seemed to reveal that the rats who were kept happy and had other things to do did not prefer cocaine and therefore speculated that loneliness, not the availability of a drug, may also be a risk factor for addiction.
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.
why are people attracted to drugs?
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
basic reasons people take drugs
Searching for pleasure Relieve pain, 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
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?
marijuana
THC is the primary psychoactive ingredient in:
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.
neurotransmitter: anandamide
Type of effect: Inhibitory CNS changes: relaxation, increased sense of well being drug of abuse: tetrahydrocannabinol (marijuana like) "spice" active ingredient
Neurotransmitters: acetylcholine
Type of effect: excitatory- inhibitory CNS changes: mid euphoria, excitation, insomnia drug of abuse: tobacco, nicotine
High blood pressure, arrhythmia, and cirrhosis are symptoms from the chronic use of what drug?
alcohol
__________ are known to view their drug use as necessary in order to have fun, and they often use drugs in order to escape, postpone personal problems, and relieve stress and anxieties.
compulsive users
The phase that is synonymous with addiction, where more of the drug is sought despite the presence of negative physical symptoms, is:
dependency
common neurotransmitters
dopamine, GABA, serotonin, acetylcholine, endorphins, anandamide
how many drugs can be found in the average household?
drugs (40% prescriptions, 60% OTC)
drug use is an
equal-opportunity affliction
True or False? Asians have the second highest rate of illicit drug use.
false
True or False? Basically, there is only one belief regarding the drugs and crime connection, namely that criminal behavior develops as a means to support addiction.
false
True or False? Pregnant women are more likely to use drugs than similar-age women who are not pregnant.
false
True or False? Structural analogs refer to the basic ingredients in a drug that are primarily responsible for causing the effect.
false
True or False? The percentage of male and female full-time college students using illicit drugs is the same.
false
True or False? Today, the term addiction generally refers to mostly physical dependence with a drug or drugs.
false
True or False? Unemployed people are much more likely to use alcohol and marijuana than full-time workers.
false
Substances that affect the central nervous system and alter consciousness and/or perception are pharmacologically known as:
psychoactive drugs
physical dependence
refers to the body's need to constantly have the drug or drugs.
psychological dependence
refers to the mental inability to stop using the drug or drugs.
there is a higher chance of overdose if
the person is isolated
True or False? A high percentage of arrestees are often under the influence of a drug while committing crimes.
true
True or False? Advertising over-the-counter drugs relays the message that if you are experiencing some symptoms, taking drugs is an acceptable option.
true
True or False? In 2014, approximately 44 percent of U.S. residents used marijuana sometime during their lifetime.
true
True or False? More than 400,000 EAPs (employee assistance programs) have been established in the United States.
true
True or False? Over half of all full-time employees have substance dependence.
true
Pharmacokinetic Factors That Influence Drug Effects
• Administration • Absorption • Distribution • Inactivation • Biotransformation and elimination
the abuse of hormones: anabolic steroids
• Androgens - Produce growth of muscle mass - Increase body weight •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
intended and unintended effects on drugs
• Intended responses: - Reason for using the drug • Unintended responses: - Side effects •The main distinction between intended responses and side effects depends on the therapeutic objective.
common side effects of drugs
• Nausea or vomiting • Changes in mental alertness • Dependence - Withdrawal • Allergic reactions • Changes in cardiovascular activity
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
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
Biotransformation
•Biotransformation: The process of changing the chemical or pharmacological properties of a drug by metabolism •The liver is the major organ that metabolizes drugs in the body. •The kidney is the next most important organ for drug elimination.
major factors affecting alcohol and drug use
•Body size: smaller or thinner persons experience the effects of drugs more intensely •Gender: physical make-up of women has reduced tolerance to drugs in comparison to men •Other drugs (poly drug use): taking multiple drugs can dramatically increase drug impairment •Fatigue or illness: increases drug effects •Empty stomach: increases drug effects •Strength (alcohol proof) and how the amount of the drug affects one's reaction •Mindset: uncontrollable or impulse drinking and/or use of drugs dramatically increases drug effects
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?
dose response
•Many factors can affect the way an individual responds to a drug, including the following: - Dose - Tolerance - Potency • Additional factors -Pharmacokinetic properties: • Rate of absorption • Manner distributed throughout the body • Rate metabolized and eliminated -Form of the drug - Manner in which the drug is administered
major models of addiction
•Moral Model: Poor morals and lifestyle; a choice •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 •Characterological or Personality Predisposition Model: Personality disorder, problems with the personality of the addicted (needs, motives, attitudes of the individual, and impulse control disorders)
distribution
•Most drugs are distributed throughout the body in the blood. •It takes approximately 1 minute for a drug to circulate throughout the body after it enters the bloodstream. •Drugs have different patterns of distribution depending on their chemical properties.
forms and methods of taking drugs
•Oral ingestion •Inhalation •Injection •Topical application
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. -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. -Sensation-seekers attracted to drugs are more likely to maintain a constant preoccupation with altering their consciousness (getting high).
potency vs toxicity
•Potency: The amount of drug necessary to cause an effect •Toxicity: The capacity of a drug to do damage or cause adverse effects in the body
psychological factors affecting drug effect
- individual's mental set - placebo effect
drug testing
- used to identify those who may be using drugs -can include urine, breath, hair, oral fluids (saliva or oral fluids collected from the mouth), and sweat 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- 3 weeks (depends on frequency of use) approximately 80% of large companies, 60% of medium companies, and 26% of small companies drug test. in a 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 being working
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.
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.
Q: How many Americans, age 12 and up, have used alcohol in the past month?
139.6 million
Q: How many Americans in the past month have smoked tobacco?
55.2 million
the history of CNS depressants
Attempts to find CNS depressants other than alcohol began in the 1800s. •Bromides were introduced to treat nervousness and anxiety in the 1800s.-Very popular but toxic •In the early 1900s, bromides were replaced by barbiturates. -Initially heralded as safe and effective -Apparent problems with tolerance, dependence, and safety •In the 1950s the first benzodiazepines were marketed as substitutes for barbiturates. -Relatively safe when used for short periods -Long-term use can cause dependence and withdrawal problems •Benzodiazepines were routinely prescribed for stress, anxiety, or apprehension. -In 1973, 100 million prescriptions were written for benzodiazepines. -Twice as many women as men taking them. •As medical community became aware of the problem, use of depressants declined, but benzodiazepines remained still very popular. •Classified as Schedule V drugs
what environments cause addiction?
The early studies on rats attempted to prove that addiction was caused by environmental risk factors and not biological.
neurotransmitter: endorphins
Type of effect: inhibitory CNS changes: mild euphoria, block pain drug of abuse: narcotics
neurotransmitter: GABA
Type of effect: inhibitory CNS changes: sedation, relaxation, drowsiness, depression drug of abuse: alcohol, valium type barbiturates
Neurotransmitter: Serotonin
Type of effect: inhibitory CNS changes: sleep, relaxation, sedation drug of abuse: LSD
neurotransmitter: dopamine
Type of effect: inhibitory- excitation CNS changes: euphoria, agitation, paranoia drug of abuse: amphetamines, cocaine, "bath salt" active ingredients
gateway
__________ drugs refer to types of drugs that lead to the use of other more addictive types of drugs.
The idea that drug consumption is found across all income levels, social classes, races, ethnicities, lifestyles, and age groups refers to drugs as:
an equal-opportunity affliction.
True or False? Clandestine illegal drug-producing laboratories are only found in stationary buildings.
false
True or False? Different perspectives regarding drug use are confusing and hamper explanations about drug use and abuse.
false
True or False? Most youths cease their drug use when they begin working.
false
True or False? Trend data show that between the years 2013 through 2014, illicit drug use has been steadily decreasing.
false
True or False? Unmarried workers are less likely than married workers to engage in illicit drug use.
false
true or False? Only certain types of people can become dependent and addicted to a drug.
false
Common communicable diseases that spread through contaminated needle sharing include(s): herpes.
hepatitis and HIV
holistic self-awareness approach
holistic philosophy that advocates that the mind, body, and spirit work best when they are drug free
__________ is characterized by excessive use, constant preoccupation with the availability and supply of the drug, refusal to admit excessive use, and reliance on the drug.
inital drug abuse
homeostasis
internal and external changes in the environment--- body self regulates via nervous system and endocrine system--- equilibrium
drug abuse
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. -Drug abuse refers to a more intense misuse of drugs—often to the point of addiction. - Also known as chemical or substance abuse.
True or False? Studies continually show that the majority of young drug users come from homes in which drugs are liberally used.
true
True or False? The United States incarcerates more people for drug offenses than any other country.
true
True or False? The four principal factors affecting how a drug user experiences a drug include pharmacological, cultural, social, and contextual factors.
true
true or False? In 2013, the rate of current illicit drug use was higher among males aged 12 to 17 than females aged 12 to 17.
true
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 gateway drugs.
drug misuse
unintentional or inappropriate use of prescribed or over-the-counter (OTC) types of drugs. examples 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
3 principle biological theories
•Abused Drugs are Positive Reinforcers -Most drugs with abuse potential enhance pleasure centers by causing the release of specific brain neurotransmitters such as dopamine. •Drug Abuse and Psychiatric Disorders -Biological explanations are thought to be responsible for the substantial overlap that exists between drug addiction and mental illness. •Genetic Explanations -Inherited traits can predispose some individuals to drug addiction.
drug interaction
•Additive effects -Summation of effects of drugs taken concurrently •Antagonistic (inhibitory) effects -One drug cancels or blocks effects of another •Potentiative (synergistic) effects -Effect of a drug is enhanced by another drug or substance
Drug Use: Additional Findings
•Age Patterns: 18-25 age category reports the most illicit drug use •Racial and Ethnic Differences: (rates of use, past month, 2014) -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% •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%). •Pregnant Women -Pregnant women are less likely to use drugs than similar age women who are not pregnant. •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. •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). 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 • 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.
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
Introduction to Nervous Systems
•All nervous systems consist of specialized nerve cells called neurons and glia (supporting cells). •Neurons are responsible for conducting the homeostatic functions of the brain and other parts of the nervous system by receiving and sending information. •Sending and receiving information is an electrochemical process.
synapses
•An excitatory synapse initiates an impulse in the receiving neuron when stimulated, causing release of neurotransmitters or increasing activity in target cell. •An inhibitory synapse diminishes likelihood of an impulse in the receiving neuron or reduces the activity in other target cells. •A receiving neuron or target cell may have many synapses. •Final cellular activity is a summation of these many excitatory and inhibitory synaptic signals.
types of CNS depressants
•Benzodiazepines: Valium-Type Drugs -Prescribed for anxiety, relaxation, and sleep • Medical uses -Relief from anxiety, treatment of neurosis, relaxation of muscles (e.g., alleviation of lower-back pain), treatment of convulsive disorders, induction of sleep, relief from withdrawal symptoms, induction of amnesia •Mechanisms of action for benzodiazepines -Affect neurons that have receptors for the neurotransmitter, GABA •GABA: most common inhibitory transmitter in brain regions - Limbic system (alter mood) - RAS (cause drowsiness) - Motor cortex (relax muscles) •Types of benzodiazepines -Many benzodiazepine compounds available in the United States -Distinguished primarily by their duration of action: short-acting (hypnotics), long-acting (sedatives) •Side effects include drowsiness to paradoxical effects (e.g., increased restlessness), tolerance, dependence, withdrawal, and abuse •Barbiturates played an important historical role as sedative-hypnotic agents. •However, due to their narrow margin of safety (interfere with breathing) and their abuse liability, they were replaced by benzodiazepines. -Caused many negative side effects, from nausea to death, from respiratory or cardiovascular depression
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).
the effects of CNS depressants
•CNS depressants reduce CNS activity and diminish the brain's level of awareness. • Depressant drugs include: -Benzodiazepines - Barbiturate-like drugs - Alcohol - Antihistamines (due to anticholinergic activity) - Opioid narcotics like heroin •Depressants are usually classified according to the degree of their medical effects on the body. For example: -Sedatives cause mild depression and relaxation •Anxiolytic—drugs that relieve anxiety -Hypnotics induce drowsiness and encourage sleep •Amnesiac effects can cause the loss of memory •The same drug can cause different effects depending on dose. -Low dose (sedatives—relieve anxiety and promote relaxation) -Higher doses (hypnotics—can cause drowsiness and promote sleep) -Even higher doses (anesthetics can cause anesthesia and are used for patient management during surgery)
central nervous system (CNS)
•CNS includes the brain and the spinal cord. •CNS 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 •Basal ganglia -Controls motor activity -Establishes and maintains behaviors •Limbic system -Regulates emotional activities, memory, reward, and endocrine activity -Includes the nucleus accumbens, the brain's reward center -Dopamine •The cerebral cortex -Helps interpret, process, and respond to information; selects appropriate behavior and suppresses inappropriate behavior •The hypothalamus -Controls endocrine and basic body functions
genetic explanations of 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.
peripheral nervous system
•Consists of input and output nerves •Input to brain and spinal cord -Conveys sensory info (pain, pressure, temperature) •Output: Two types -Somatic (control of voluntary muscles) -Autonomic (control of unconscious functions)
the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) (APA 2013)
•DSM-5 combines substance abuse and substance dependence into a single condition called substance use disorder. •The diagnosis of substance use disorder includes the following: -Pharmacological - taking the substance in larger doses -Excessive time spent obtaining the substance -Craving the drug •Social impairment: failure to meet goals and obligations •Risky use of the substance: despite physical and/or psychological problems encountered •Tolerance: The individual needs increased amounts to achieve the diminishing effects of the drug •Withdrawal: Symptoms that can often leading to renewed substance dependence
neurons
•Dendrites are the receiving regions of a neuron's cell body. •Each neuron in the central nervous system is in close proximity with other neurons. •Although they are close, neurons never actually touch. •Synapse is the point of communication between one neuron and another. •Synaptic cleft is the gap between neurons at the synapse.
other types of CNS depressants
•Drugs with barbiturate-like properties: -Chloral hydrate -Glutethimide -Methyprylon -Methaqualone •Antihistamines (due to anticholinergic effect) •Propofol (abused as general anesthetic) •GHB (gamma hydroxybutyrate)
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.
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
three 3 types of drug users
•Experimenters: Begin using drugs largely because of peer pressure and curiosity, and they confine their use to recreational settings. •Compulsive users: Devote considerable time and energy into getting high, talk incessantly (sometimes exclusively) about drug use, and become connoisseurs of street drugs. •Floaters or "chippers": Focus more on using other people's drugs without maintaining as much of a personal supply.
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. 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.
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
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" (Akers 1992, p. 86). •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
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. (SAMHSA 2012) •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%).
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 (Bespalov et al. 1999; NIDA 2008b).
Erich Goode's Four Types of Drug Use
•Legal instrumental use: Taking prescribed drugs or OTC drugs to relieve or treat mental or physical symptoms •Legal recreational use: Using licit drugs such as tobacco, alcohol, and caffeine to achieve a certain mental state •Illegal instrumental use: Taking nonprescribed drugs to achieve a task or goal •Illegal recreational use: Taking illicit drugs for fun or pleasure
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
low risk and high risk drug choices
•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. •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.
neurotransmitters
•Many drugs affect the activity of neuro-transmitters by altering their synthesis, storage, release, or deactivation. •Neurotransmitters frequently altered by drugs of abuse: -Acetylcholine -Catecholamines -Serotonin -GABA -Endorphins -Anandamide
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.(withdrawal and rebound) •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. (craving)
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
genetic factors and drug abuse vulnerability
•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.
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. •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)
stages of drug dependence
•Relief: Satisfaction from negative feelings in using the drug •Increased Use: Involves taking greater quantities of the drug •Preoccupation: Consists of a constant concern with the substance •Dependency: A synonym for addiction; when more of the drug is sought despite the presence of physical symptoms •Withdrawal: The physical and/or psychological effects from not using the drug
tolerance
•Reverse tolerance (sensitization): Enhanced response to a given drug dose; opposite of tolerance •Cross-tolerance: Development of tolerance to one drug causes tolerance to related drugs
Drug Use: Statistics and Trends
•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 •OTC Drugs -$30.8 billion •Nonmedical 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. •Miscellaneous Drugs -Examples include inhalants, nutmeg, and morning glory seeds -Extent of use cannot be verified
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. •Labeling theory says people whose opinions we value have a determining influence over our self-image. Key factors in labeling theory include: - Primary deviance • Secondary deviance • Master status • Retrospective interpretation -Can you define these four key factors used in labeling theory? •Subculture theory explains that peer pressure is a determining cause of drug experimentation, use, and/or abuse.
structural influence theories
•Structural Influence Theories: Focus on how the organization of a society, group, or subculture is largely responsible for drug abuse by its members •Social Disorganization and Social Strain Theories: Drug use is caused by rapid and disruptive social change in society •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 -Socialization: Internal and external controls
Designer Drugs/Synthetic Drugs or Synthetic Opioids
•Structural analogs are 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. •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.
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 •Sympathetic system -Norepinephrine •Parasympathetic system -Acetylcholine
Patterns of Abuse with CNS Depressants
•The American Psychiatric Association considers dependence on CNS depressants a psychiatric disorder. •People most likely to abuse CNS depressants include individuals who: -Use drugs to relieve continual stress -Paradoxically feel euphoria and stimulation from depressants -Use depressants to counteract the unpleasant effects of other drugs of abuse -Combine depressants with alcohol and heroin to potentiate the effects •Detoxification: The elimination of a toxic substance, such as a drug, and its effects -With CNS depressants, this is achieved by substituting a longer-acting barbiturate for the offending CNS depressant and gradually reducing the dose to avoid unpleasant withdrawal effects. Withdrawal from CNS depressants, if not managed properly, can be very dangerous, or even fatal.
costs of drug use to society: 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.
drug receptors
•The chemical messengers from glands and neurons exert their effects by interacting with special protein regions in membranes called receptors. •Receptors interact only with molecules that have specific configurations. •Agonists: Substances or drugs that activate receptors •Antagonists: Substances or drugs that attach to receptors and prevent them from being activated
time response factors
•The closer a drug is placed to the target area, the faster the onset of action. •Acute drug response: -Immediate or short-term effects after a single drug dose •Chronic drug response: -Long-term effects after a single dose
introduction to the endocrine system
•The endocrine system consists of secreting glands (e.g., adrenal, thyroid, pituitary). •These glands produce substances called hormones (e.g., adrenaline, steroids, insulin, sex hormones). •These substances are information- transferring molecules. •Hormones are secreted into the bloodstream and carried by the blood to all the organs and tissues of the body. •Hormones affect selected tissues that are designed to receive the information. •Hormones may be highly selective or very general with regard to the cells or organs they influence.
margin of safety
•The range in dose between the amount of drug necessary to cause a therapeutic effect and a toxic effect
transfer of messages by neurons
•The receiving region of the neuron is affected by a chemical message that either excites or inhibits it. •Neuronal message: -Impulse moves from the receiving region of the neuron down the axon to the sending region (terminal) -Chemical messengers (neurotransmitters) are released. •Neurotransmitters travel and attach to receiving proteins called receptors on target cells. •Activation of receptors causes a change in the activity of the target cell; the target cells can be other neurons or cells that make up organs, muscles, or glands.
defining addiction
•The term addiction is derived from the Latin verb addicere, which refers to the process of binding to things. Today, the word largely refers to a chronic adherence (attachment) to drugs. •Originally, the World Health Organization (WHO) 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" (1964, pp. 9-10). •Addiction is a complex disease. •The National Institute on Drug Abuse (NIDA) 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." (NIDA 2008a, p. 5)
addiction and abuse
•The use of the term addiction is sometimes confusing. It is often used interchangeably with dependence, either physiological or psychological in nature. Other times, it is used synonymously with the term drug abuse. More recently the term "substance use disorder" has been used. A common definition for all of these terms is the compulsive drug use despite negative consequences. •Factors affecting variability in dependence/addiction: -Hereditary factors (genetic variants); responsible for 40%-60% vulnerability -Drug craving •Factors affecting variability in dependence/addiction: -Hereditary factors (genetic variants); responsible for 40%-60% vulnerability -Drug craving •Other factors contributing to drug use patterns: -Positive versus negative effects of drug -Peer pressure -Home, school, and work environment -Mental state
required doses for effects
•Threshold dose: The minimum amount of a drug necessary to have an effect •Plateau effect: The maximum effect a drug can have regardless of the dose •Cumulative effect: The buildup of drug concentration in the body due to multiple doses taken within short intervals
adaptive processes
•Tolerance: Changes causing decreased response to a set dose of a drug •Dependence: The physiological and psychological changes or adaptations that occur in response to the frequent administration of a drug •Withdrawal
major divisions of the nervous system
•Two major components of the nervous system - Central nervous system (CNS) - Peripheral nervous system (PNS)
introduction to CNS depressants
•Why are CNS depressants problematic? -Usually prescribed under physician's direction -Second most frequently abused prescription drug and sometimes contributes to death due to accidental overdoses -Can cause very alarming and dangerous behavior if not closely monitored •Most problems associated with these drugs due to inadequate professional supervision • Why are CNS depressants problematic? -Seemingly unrelated drug groups can cause CNS depression -Combination use can cause dangerous drug interactions -Can cause disruptive personality changes
