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Chapter 13

Chapter 13. Substance Use and Abuse. Addictive Behavior. Habits that have gotten out of control, with a resulting negative effect on a person’s health. Addiction is the habitual use of a drug produced chemical changes in the user’s body . Drug Addiction (four important characteristics)

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Chapter 13

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  1. Chapter 13 Substance Use and Abuse

  2. Addictive Behavior • Habitsthat have gotten out of control, with a resulting negative effect on a person’s health. • Addiction is the habitual use of a drug produced chemical changes in the user’s body. • Drug Addiction (four important characteristics) • Compulsive desire • Need to increase the dosage • Harmful effects to the individual • Harm to society

  3. Development of Addiction • Often starts to bring pleasure or to avoid pain. • Harmless or even beneficial if done in moderation • Examples of addictive behaviors: • Gambling • Compulsive Exercising • Work Addiction • Sex and love addiction • Compulsive buying or shopping • Internet addiction • Characteristics of people with addition (e.g., risk takers or genetic disposition)

  4. Drug Use, Abuse, and Dependence • Drugs are chemicals other than food that are intended to affect the structure or function of the body • Prescription medicines • Over-the-counter substances • Caffeine • Tobacco • Alcohol • Illegal substances

  5. Drug Abuse and Dependence • The APA’s Diagnostics and Statistical Manual of Mental Disorders – authoritative reference • Abuse • APA definition • Failure to fulfill major responsibilities • Drug use in situations that are hazardous • Drug related legal problems • Drug use despite persistent social or interpersonal problems • Physically dependent may or may not present

  6. Dependence • Substance dependence 1. Developing tolerance to the substance 2. Experiencing withdrawal 3. Taking in larger amounts 4. Expressing a persistent desire to cut down 5. Spending great deal of time obtaining 6. Giving up or reducing important activities 7. Continual usage even with recognition of a problem • Diagnosed with at least 3 or more symptoms during a 12-month period

  7. Who uses drugs? • All income and education levels • All ethnic groups • All ages • Young people are at a higher risk • Males (Twice as likely) • Troubled adolescent • Thrill-seeker • Dysfunctional families • Peer group or family that accepts • Low Socio-economical status • Dating young

  8. Why Do People Use Drugs? • Experiment • Escape • Reliance • Magnification of residence (i.e. the need for escape from poverty becomes more compelling)

  9. Risk Factors for Dependence • Psychological risks • Difficulty in controlling impulses • Strong need for excitement • Feelings of rejection • Hostility • Aggression • Anxiety • Mental illness • Dual (co-occurring disorders)

  10. Risk Factors for Dependence • Social Factors • Growing up in a family with drug abuse • Peer group • Poverty

  11. Other Risks of Drug Use • Intoxication • Side effects • Unknown drug constituents • Risks associated with injection drug use • Legal consequences

  12. How Drugs Affect the Body • Changes in Brain chemistry • Drug factors: • Pharmacological properties • Dose-Response function • Time-action function • Drug use history • Method of use (e.g., inhalation, injection, ingest)

  13. Representative Psychoactive Drugs • Opioids (narcotics) • Natural or synthetic (laboratory-made) • Opium, morphine, heroin, methadone, codeine, hydrocodone, oxycodone, meperidine, and fentanly • Effects on the body: induced euphoria • Methods of administration • Injection, snorting, sniffing or smoking • Symptoms of overdose: respiratory depression, coma, constriction of the pupils, or death.

  14. Heroin

  15. Central Nervous System Depressants • Slow down the overall activity of the CNS • Sedative-hypnotics • Types: barbiturates, valium, methaqualone, GHB • Effects on the body: reduce anxiety, impair muscle coordination, induce drowsiness • Medical uses: Treat insomnia and anxiety disorders; control seizures • From use to abuse (“Club Drugs”) • Overdosing may result in respiratory complications

  16. Central Nervous System Stimulants • Speed up the activity of the nervous or muscular system • Cocaine • Methods of use (snort or injection) • Effects (euphoria sensation for ~5 to 20 minutes) • Use during pregnancy (consequences include: miscarriage, premature labor, stillbirth, and low-birth-weight baby)

  17. Cocaine

  18. Central Nervous System Stimulants • Amphetamines • Effects (increase in alertness) • Dependence (may lead to the development of a temporary state of paranoid psychosis or delusion) • Ritalin (used to treat attention-deficit/hyperactivity disorder, ADHD) • Ephedrine (a less potent form of amphetamines) • Caffeine

  19. Marijuana • Cannabis Sativa • THC (tetrahydrocannabinol) • Short term effects and uses: euphoria, increases in sensation, relaxed attitude • Long-term effects and uses: respiratory damage such as impaired lung function and chronic bronchial irritation

  20. Hallucinogens • Altered state of consciousness, perceptions, feelings and thoughts • LSD, Mascaline, DMT, MDMA, Ketamine, PCP (angel dust), and certain mushrooms • Altered states of consciousness • Flashbacks are perceptual distortions and bizarre thoughts that occur after the drug has been entirely eliminated from the body.

  21. Inhalants • Nearly all inhalants produce effects similar to those of anesthetics, slow down the bodies functions • Volatile solvents • Nitrates • Anesthetics • Methods of use • Sniffing • Snorting • “Bagging” • “Huffing”

  22. Treatment for Drug Dependence • Medication-assisted treatment • Drug substitution • Treatment centers • Self-help groups and peer counseling • Harm reduction strategies • Codependency http://www.youtube.com/watch?v=J46pvxFWNTY

  23. Tobacco

  24. Use of Tobacco 71 Million Americans, including 13.7 million college-aged Americans. 2008, nearly 21% of Americans age 18 describe themselves as current smokers. Nicotine Addiction Powerful psychoactive drug Reaches Brain via bloodstream in seconds Most physically addictive of the psychoactive drugs. Loss of control Tolerance and Withdrawal 27

  25. Why Start in the First Place? Children and teenagers make-up 90% of all new smokers in this country. Thousands of children and adolescents (12-17) start smoking everyday. Average age 13 for smoking 10 for spit tobacco 28

  26. Characteristics which could increase the potential for use. A parent or sibling uses tobacco Peers use tobacco Child comes from blue-collar family Child comes from low-income home Single parent. Performs poorly in school Child drops out of school Has positive attitudes towards tobacco 29

  27. Reasons Why College Students Smoke

  28. Health Hazards Contains hundreds of damaging chemical substances, including acetone (nail polish remover), ammonia, hexamine (lighter fluid), and toluene (industrial solvent). Unfiltered cigarettes = 5 billion particles per cubic mm 50,000 times more than polluted urban air Condensed particles in the cigarette produce the tar (brown, sticky mass) Chapter 8 31

  29. Health Hazards (cont) Carcinogens and Poisons 43 chemicals are linked to cancer (Carcinogen) Benzo(a)pyrene (yellowish tar) Urethane (ex: solution used in making foams) Cocarcinogens Combine with other chemicals to cause cancer (e.g., formaldehyde) Poisonous substances Arsenic (e.g., insectides and weed killers) Hydrogen cyanide (e.g., flammable liquid used in dye) Carbon monoxide 400 times greater than is considered safe in industrial workplaces Displaces oxygen in red blood cells Additives Nearly 600 chemicals Chapter 8 32

  30. “Light” and Low-Tar Cigarettes Low-tar, low-nicotine, or filtered cigarettes No such thing as a safe cigarette Often smoke more 34

  31. The effects of smoking a cigarette 35

  32. Additional Health, Cosmetic, and Economic Concerns Ulcers Impotence Reproductive health problems Dental diseases Diminished physical senses Injuries Cosmetic concerns Economic costs 36

  33. Cumulative Effects Males before 15 yrs. old are half as likely to live to 75 versus those who did not smoke Females with similar habits reduce life expectancy by more than 10 years Female smokers spend 17% more sick days in bed than nonsmokers Both men and women show a greater rate of acute and chronic diseases 37

  34. Other Forms of Tobacco Spit (Smokeless) Tobacco More than 6.6 million adults 8% of all high school students Cigar and Pipes Cigar smoking has increased by 148% from 1993-2006. Cigars contain more tobacco than cigarettes. Clover cigarettes and Bidis Twice the tar, nicotine, and carbon monoxide 38

  35. 39

  36. The Effects of Smoking on the Nonsmoker Environmental Tobacco smoke (ETS) Environmental Protection Agency (EPA) designated ETS as a class A carcinogen Department of Health and Human Services’ National Toxicology Program - “known human carcinogen” Surgeon General – 2006 – “there is no safe level of exposure to ETS; even brief exposure can cause serious harm”. 40

  37. Environmental Tobacco Smoke Mainstream smoke Smoke exhaled by smokers Sidestream smoke Smoke from the burning end of a cigarette, cigar, or pipe. 85% of smoke in a room is second hand Twice the tar and nicotine Three times the benzo(a)pyrene Three times the ammonia Smoke from a cigar can be even more dangerous 30 times more carbon monoxide 41

  38. ETS Effects Develop cough, headaches, nasal discomfort, eye irritation, breathlessness and sinus problems Allergies will be exacerbated Causes 3,000 deaths due to lung cancer Contributes to about 35,000 overall deaths each year. 20% increase in the progression of atherosclerosis. Contributes to increased asthma attacks 42

  39. How Cigarette Smoking Damages the Lungs

  40. Lung Cancer from Tobacco Smoking Healthy Lung Lung Cancer 44

  41. Oral Cancer from Tobacco Smoking 45

  42. Oral Cancer from Tobacco Smoking http://www.youtube.com/watch?v=0hySFt8O11A 46

  43. Cancer Survivor 47

  44. Infants, Children, and ETS More likely to develop Bronchitis, pneumonia,& respiratory infections More complications from asthma Increased chance of SIDS (sudden infant death syndrome) Low-birth weight Bronchitis Chemicals from smoking show up in breast milk Children inhale three times more pollutants per unit of body weight than adults. 48

  45. Smoking and Pregnancy Estimated 4,600 infant deaths in the U.S. Miscarriage, premature birth, low birth weight, long term impairments in growth and intellectual development Possible higher risks of getting cancer 16% of pregnant women smoke 49

  46. Cost of Tobacco Use to Society Lost productivity from sickness, disability, and premature death makes it close to $167 billion per year. 1998 Master Settlement Agreement (MSA) 43 states filed suit against tobacco companies to recoup public health care expenditures Tobacco companies have to pay $206 billion over 25 years. Limits or bans certain types of advertising, promotions, and lobbying. 50

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