DRUGS and Addictive Behavior

1. DRUGS and Addictive Behavior

2. SOME THINGS WE WANT TO LEARN • What is the definition of a DRUG? • How are Drugs classified? How do they differ? • What is Tolerance? • What is DEPENDENCE? How is this ACHIEVED? • What is Physical Drug Addiction? • What is Psychological Drug Addiction?

3. Addictive Behaviors and Drug Abuse • Addictive behaviors • Drugs and their effects • Medications • Substance use disorders • Commonly abused drugs

4. Drug Use on Campus • Steepest rise during mid-90s • Almost half of undergrads say they have used marijuana • Drug use up most among minorities • Ecstasy use way up in recent years (up almost 70% in 2 years)

6. Drugs and Their Effects • Drug: chemical substance that affects the way you feel and function • Some drugs have a positive effect- they help the body heal • Other drugs have a negative effect- they distort reality, etc. • All drugs have some side-effects, often they interact with each other

7. Drugs and Their Effects • Drug misuse: taking of a drug for a purpose other than what is medically recommended • Drug abuse: excessive drug use that’s inconsistent with accepted medical practice • Factors that influence the effect of a drug: • Administration, dosage, drug action, other drugs in the system, individual involved

8. Inhalation Oral dosage Subcutaneous injection Intravenous Intravenous injection Intramuscular injection Fig. 11-1, p. 307

9. Routes of Administration • Swallowed pills do not reach the blood stream as fast as other routes • Inhale smoke or gases into lungs • Inject subcutaneously (slowest), intramuscularly, intravenously (fastest)

10. Dosage and Toxicity • Increasing the dose usually intensifies the effects produced by smaller doses • Kind of effect may change at different dose levels • Toxicity: dosage at which the drug becomes poisonous to the body

11. Other Factors Influencing Drugs • Individual differences: • Everyone’s body chemistry is unique • Emotional state can influence drug’s effect • Setting: • Location, location, location • Types of Action: • Locally: effect is local to where it is administered; generally: effect throughout the body; selectively: effect in specific locations; cumulatively: taken in faster than metabolized

12. Interactions with Other Drugs/Alcohol • Some drugs have additive effect • Some have synergistic effect- the effect of two drugs together is much greater than the sum of their individual effects • A drug can be potentiating- increase the effect of another drug • Drugs can interact antagonistically- one can block the action of another

13. Medications • Over-the-counter drugs: • Just because they are available OTC, does not mean they have no risks • Interactions still possible, and misuse is rampant • Commonly misused OTCs: • Nasal sprays, laxatives, eye drops, sleep aids, cough syrup

14. Medications • Prescriptions: • Prescriptions must be written by physicians • Ask physician to tell you prescription, too • Commonly abused prescriptions: • Opiods, CNS depressants, stimulants • Nonadherence: large numbers of medications are not taken properly

16. Medications- Prescriptions • Physical side effects • Heart failure, heart attack, seizures, kidney or liver failure, blood disorders, birth defects, blindness, memory problems, allergic reactions • Psychological side effects • Problems often from: high blood pressure, heart disease, asthma, epilepsy, arthritis, Parkinson’s disease, anxiety, insomnia, depression

17. Medications- Prescriptions • Drug interactions • Check label for instructions, no hot beverages with medications • No alcohol with medications • Generic drugs • Usually cost 20-80% less than brand names • Same active ingredient, filler/binders different (can affect absorption)

18. Buying Drugs Online • BE VERY CAREFUL • Only buy from reputable sources • Remember, shipping usually adds $$ • Bad idea to get prescription from a physician who has not seen you in person

19. Caffeine • Most widely used psychotropic drug in the world • 80% of Americans drink coffee • Coffee:100-150 mg caffeine/cup • Tea: 40-100 mg caffeine/cup • Cola: 45 mg caffeine/cup • Some medications contain caffeine

20. Caffeine • Benefits: • Reduced risk of type 2 diabetes, gallstones, Parkinson’s disease, and colon cancer • What is does: • Improves focus, improves endurance, reduces fatigue, sharpens allertness • You can overdose • Withdrawal symptoms: headaches

21. Substance Use Disorders • Psychoactive drugs have been used for a long time • Addiction: habitual use of substances • Psychological dependence: strong craving • Physical dependence: occurs when you develop a tolerance to a substance • Withdrawal: typically involves breaking psychological and physiological dependence

22. Biology of Dependence • Dependence is a brain disorder triggered by frequent use • Many drugs cause release of dopamine (neurotransmitter) • Can reach a point that natural [dopamine] are not adequate to cause satisfaction

23. Nerve impulse Terminal of neuron Uptake pump Dendrite of adjacent neuron Synapse Dopamine receptor Dopamine Cocaine

24. Psychoactive substances and their potential for producing dependence

25. Cannabis • Marijuana - most widely used illegal drug in the US • Active ingredient=THC. • Effects: • euphoria, sense of slowed time, impaired thinking/communicating • Euphoria peaks within half hour, usually lasts about 3 hours.

27. Cannabis • Effects: • Depression, diminished immune responses • Damage to brain, lungs, heart • Brain • Damages memory and learning centers, difficulty thinking/problem solving, loss of coordination • Lungs • Similar to smoking, but more exposure to CO

28. Negative Long-Term Effects Positive Short-Term Therapeutic Effects for Patients Brain and central nervous system • Dulls sensory and cognitive skills • Impairs short-term memory • Alters motor coordination • Causes changes in brain chemistry • Leads to difficulty in concentration, attention to detail, and learning new, complex information Brain and central nervous system • May help minimize pain from the spread of cancer Vision • Reduces intraocular pressure, helping those afflicted with glaucoma Cardiovascular system • Increases heart rate • Increases blood pressure • Decreases blood flow to the limbs, which in extreme cases could require an amputation Digestive system • Combats nausea from chemotherapy and helps minimize vomiting • Helps restore appetite in people who have lost weight from cancer or AIDS Respiratory system • Damages the lungs (50% more tar than tobacco) • May cause lung cancer • May damage throat from inhalation Muscular system • May help calm spasms from spinal-cord injury, multiple sclerosis, and possibly epilepsy Reproductive system • In women, may impair ovulation and cause fetal abnormalities if used during pregnancy • In men, may suppress sexual functioning and may reduce the number, quality and mobility of sperm, possibly affecting fertility Impact of Marijuana

29. Club Drugs • Refers to a group of drugs currently used at all night dance parties • Dangerous by themselves, many are tasteless, odorless and people try to assault or sedate others in cocktails. • Ecstasy, Rohypnol (roofies) and LSD. See list in text.

30. Ecstasy • Ecstasy=methylene-dioxymethamphetamine (MDMA) • Causes relaxed euphoric state without hallucinations • Can be smoked, inhaled, injected, ingested (most common) • Negative impact on memory and learning, effect can persist for years after use

31. Ecstasy

32. Ecstasy Risks • Psychological difficulties • Confusion, depression, sleep problems, drug cravings, paranoia, anxiety • Physical symptoms • Muscle tension, faintness, chills, sweating, increased HR, hyperthermia (overheating)

33. GHB/GBL • Stimulates release of HGH, no known effects on muscle growth. • Small doses induce euphoria and enhance sex (raises dopamine) • Large doses can cause individuals to pass out (possibly coma)

34. Club DrugsThe Risks of GHB/GBL • Short term side effects: • Nausea, amnesia, hallucinations, decreased heart rate, convulsions, • Long Term Side Effects • Withdrawal reaction=rapid heartbeat, tremor, insomnia, anxiety • The danger is greatest when GHB is mixed with alcohol or opiates.

35. Ketamine • Anesthetic used by vets • Cooked, dried, ground into a powder for snorting • Blocks brain signals, brain fills void with hallucinations • Risks: • Anxiety, agitation, paranoia, vomiting, stroke, heart attack • Can experience flashbacks

36. Other “Club Drugs” • Nitrites • Clear, amber colored liquids • Inhaled • Risks: headaches, dizziness, drop in BP, etc. • Herbal Ecstasy • Mix of stimulants such as ephedrine, pseudoephedrine, caffeine • Risks: stroke, heart attack

37. Stimulants • Increase activity in the central nervous system (CNS) • Some increase motor activity, enhance mental alertness • Some combat mental fatigue • Ex: amphetamine, meth, caffeine, cocaine

38. Amphetamine • Trigger release of epinephrine (adrenaline) • Suppress appetite, state of hyperalertness • Ritalin is a related drug • Risks: dependence can develop quickly • Anxiety, tension, hallucinations, increased heart rate, paranoia, etc. • Withdrawal: crash includes being shaky, irritable, anxious, depressed

39. Methamphetamine • Probably more addictive than cocaine or heroine • 12 million have tried it, 1.5 use regularly • Effects on CNS are greater than amphetamine • Snorted, smoked, injected • Causes release of large amounts of dopamine

40. Methamphetamine • Euphoria, increases self-esteem, alertness • Increase in sexual appetite • Addiction is fast • Meth mouth: teeth become gray, twisted, fall out • Risks: • Insomnia, depressed appetite, raise body temp., irritability, confusion, tremors, anxiety, paranoia • Can cause strokes, convulsions, permanent brain damage • Withdrawal is very hard

41. Cocaine • White crystalline powder extracted from coca leaves • Rapidly metabolized by liver, so high is brief • Crack: smokeable and potent form of cocaine • Results: euphoria, boundless energy, restlessness, anxiety • Dependence develops quickly

42. Cocaine • Risks: • Tolerance develops quickly • Dilated pupils, elevated or lowered BP, perspiration or chills, nausea, vomiting, impaired breathing, impaired sexual functioning, stroke • Withdrawal: • Depression, fatigue, vivid and disturbing dreams, sleep problems, irritability, increased appetite • Cravings can last for quite some time

43. Depressants • Depress the CNS • Reduce activity, induce relaxation, drowsiness, or sleep • Include benzodiazepines and barbiturates, opioids, alcohol

44. CNS depressants: - sedatives - hypnotics • Slow nervous system down • alcohol • tranquilizers • barbiturates • Effects - • reduce anxiety • mood changes • slurring of speech • drowsiness, sleep

45. Benzodiazepines and Barbiturates • Benzodiazepines: • Prescribed for tension, muscular strains, sleep problems, anxiety, panic attacks, anesthesia • Include: Librium, Valium, Xanax, Rhohypnol • Barbiturates: • Induce relaxation and seep, relieve tension, treat epileptic seizures • Mostly replaced by benzodiazepines

46. Benzodiazepines and Barbiturates • Feelings: • Low doses relieve tension • Larger doses used for feeling of euphoria • Users will seek prescriptions from several physicians • Physical, psych. dependence within 2 weeks • Risks: • Changes in mood or behavior, slurred speech, poor coordination, involuntary eye movements • Synergistic effect with alcohol

47. Benzodiazepines and Barbiturates • Withdrawal: • Grand mal seizures, malaise, sweating, rapid pulse, tremors of hands/eyelids, insomnia, nausea/vomiting, hallucinations, anxiety • Symptoms start within short period of time after discontinuing use

48. Opium: Papaver somniferans

49. Opiods • Opium and derivatives (morphine, codeine, heroin) and synthetics based on opium • From resin in poppy • Heroin (typically injected) abused more by men than women (3:1) • Growing problem in suburbs

50. Prescription Opioids • Dilaudid: 2-8x painkilling effect of morphine • Oxycodone (OxyContin, Percocet, Percodan)- similar to codeine, more potent • Demerol (synthetic) very similar to morphine • Abuse high and spreading