Download Substance Classifications, Effects, and Associated

CHAPTER 3: Substance
Classifications, Effects, and
Associated Dangers
Substance Abuse and Addiction Treatment:
Practical Application of Counseling Theory
First Edition
Todd F. Lewis
Developed by Katie A. Wachtel, University of North
Carolina at Greensboro
Introduction
•It
is important to have a basic understanding of the
physiology and pharmacology of specific drugs and
addiction.
•Knowledge
of drug categories, effects and
withdrawal symptoms can help clinicians to be more in
tune with the needs of their clients.
•This
chapter aims to discuss additional important
terms, increase knowledge of physiological and
pharmacological concepts related to addiction, and
describe major drugs of abuse, their classification,
effects and associated dangers.
Lewis. Substance Abuse and Addiction Treatment: Practical Application of
Counseling Theory, First Edition. © 2014 by Pearson Education, Inc. All Rights
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Physiological and Pharmacological
Aspects Related to Substance Abuse
and Addiction
•
Drugs have a significant affect on brain functioning
Drugs impact neurotransmitters in the brain which help the
brain communicate messages
•
•
The most commonly affected neurotransmitters are:
--Serotonin - regulates sleep, mood and appetite
--Aminobutyric acid (GABA)-promotes relaxation
--Catecholamines:
---Dopamine - helps control pleasure and motivation
---Norepinephrine - helps control the fight or flight
response and sympathetic nervous activity
Lewis. Substance Abuse and Addiction Treatment: Practical Application of
Counseling Theory, First Edition. © 2014 by Pearson Education, Inc. All Rights
Reserved
3-3
Physiological and Pharmacological
Aspects Related to Substance Abuse
and Addiction Cont.
Mechanisms of action on the brain
1. Drugs increase the release of neurotransmitters
2. Mimicry - drugs mimic the action of neurotransmitters
3. Drugs block receptor sites - preventing
neurotransmitters from making connections, resulting in
more neurotransmitter in the synapse.
4. Drugs block the reuptake process - this also results in
excess neurotransmitter in the synapse
Drugs can affect the brain in hundreds of different ways and can
affect different people in different ways
Lewis. Substance Abuse and Addiction Treatment: Practical Application of
Counseling Theory, First Edition. © 2014 by Pearson Education, Inc. All Rights
Reserved
3-4
Routes of Administration
Oral
Approximately 15 minutes to take effect
Effects often last longer than other routes of
administration
Intravenous injection
Rapid onset of effect (from 30-120 seconds)
Peak highs
Short overall duration
Lewis. Substance Abuse and Addiction Treatment: Practical Application of
Counseling Theory, First Edition. © 2014 by Pearson Education, Inc. All Rights
Reserved
3-5
Routes of Administration
Continued
Inhalation
Fastest onset of effect
Experience an immediate high
Short duration of effect
Insufflation
Inhaling drug powder through the nose
Slowest onset of effect
Peak effects from 15-60 minutes
Lewis. Substance Abuse and Addiction Treatment: Practical Application of
Counseling Theory, First Edition. © 2014 by Pearson Education, Inc. All Rights
Reserved
3-6
How the Brain Becomes Addicted:
A Theory
•Drug
use increases dopamine which creates an
experience of pleasure
•When
of it
the brain experiences pleasure, it wants more
•This
desire for pleasure can lead people to ignore
basic needs to obtain pleasure
•The
brain responds to the rapid release of dopamine
caused by drug use by naturally producing less
dopamine
•Over
time, individuals are unable to naturally
experience pleasure, which can lead to more drugseeking
Lewis. Substance Abuse and Addiction Treatment: Practical Application of
Counseling Theory, First Edition. © 2014 by Pearson Education, Inc. All Rights
Reserved
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Additional Terminology
Cross-tolerance
When an individual develops a tolerance to one
drug, then begins to take another drug within the same
classification and does not feel much of an effect of the
second drug
Potentiate
When one drug increases the activity and effect of
another drug
Effective dose (ED)
The percentage of the population who would
respond to a given dose of a drug
Lewis. Substance Abuse and Addiction Treatment: Practical Application of
Counseling Theory, First Edition. © 2014 by Pearson Education, Inc. All Rights
Reserved
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Additional Terminology Continued
Lethal dose (LD)
The percentage of the population that, in theory, would
die from a certain dose of a chemical
Therapeutic Index (TI)
Used to determine the safety of a drug
“The ratio between the effectiveness of a chemical and its
potential for harm” (Doweiko, 2009)
Drug half-life
The period of time required for the individual to get rid of
50 percent of an ingested dose of a drug (Liska, 1997)
Lewis. Substance Abuse and Addiction Treatment: Practical Application of
Counseling Theory, First Edition. © 2014 by Pearson Education, Inc. All Rights
Reserved
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Central Nervous System
Depressants
•Includes
hypnotics
CNS depressants, sedatives, or sedative-
•Work
on the brain and body by slowing down
nervous tissue throughout the nervous system
•General
effects: slurred speech, disorientation,
drunken behavior, relaxed inhibitions
•Withdrawal
symptoms: anxiety, insomnia, tremors,
delirium, convulsions, or death
•Common
CNS depressants: alcohol, barbiturates, and
benzodiazepines
Lewis. Substance Abuse and Addiction Treatment: Practical Application of
Counseling Theory, First Edition. © 2014 by Pearson Education, Inc. All Rights
Reserved
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Alcohol
Effects and dangers
•Slows
down general physiological functioning
•Metabolized
•Continued
problems:
by the liver, which can be overworked
use can lead to physical and medical
--Liver disease
--Impairs quality of sleep and sexual
functioning
--Wernicke’s syndrome and Korsakoff’s
syndrome implicated with long-term alcohol use
Lewis. Substance Abuse and Addiction Treatment: Practical Application of
Counseling Theory, First Edition. © 2014 by Pearson Education, Inc. All Rights
Reserved
3-11
Barbiturates
•Powerful
sedatives used to aid anxiety and sleep and to
control seizures
•Phenobarbital,
•Effects
pentobarbital, secobarbital, and amobarbital
and dangers
--Have a small TI
--Excessive doses inhibit the respiratory centers in the
brain
--Can slow down physiological functioning to the point of
breathing cessation
--Lower inhibitions, enhance mood, increase selfesteem, vigor and confidence,
Lewis. Substance Abuse and Addiction Treatment: Practical Application of
Counseling Theory, First Edition. © 2014 by Pearson Education, Inc. All Rights
Reserved
3-12
Benzodiazepines
•Most
commonly prescribed drugs for sleep
problems, acute stress reactions, convulsions,
and anxiety
•Safer
sedatives than Barbiturates due to the
higher TI
•Dangerous
depressants
•Effects
when combined with other CNS
and dangers
--Cross-tolerance and potentiation are
common
--Can develop physiological addiction
Lewis. Substance Abuse and Addiction Treatment: Practical Application of
Counseling Theory, First Edition. © 2014 by Pearson Education, Inc. All Rights
Reserved
3-13
Central Nervous System Stimulants
•CNS
stimulants, uppers
•Opposite
effect on the brain as CNS
depressants
•General
effects: elevation of mood, increased
feelings of well-being, and increased energy and
alertness (NIDA, 2011)
•Withdrawal
symptoms: apathy, long periods of
sleep, irritability, depression and disorientation
•Common
CNS stimulants: amphetamines,
methamphetamines, cocaine, ecstasy, Ritalin,
and Adderall
Lewis. Substance Abuse and Addiction Treatment: Practical Application of
Counseling Theory, First Edition. © 2014 by Pearson Education, Inc. All Rights
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Amphetamines
•Many
come in pill form and are prescribed to treat disorders
such as Attention-Deficit Hyperactivity Disorder (ADHD)
•Effects
and dangers
Produce feelings of euphoria
Relief from fatigue
Increase mental alertness
Enhance mood
Insomnia
Irregular heartbeat
Mild paranoia
Cardiovascular effects
Lewis. Substance Abuse and Addiction Treatment: Practical Application of
Counseling Theory, First Edition. © 2014 by Pearson Education, Inc. All Rights
Reserved
3-15
Methamphetamines
•A
derivative of amphetamine and comes in clear crystals or
powder that is odorless and colorless
•Effects
and dangers
Increasing activity and feelings of euphoria
Increased anxiety, confusion, paranoia and aggression
Psychotic behavior
Hallucinations
Respiratory problems
Cardiovascular problems
Extreme weight loss/anorexia
Meth mouth
Lewis. Substance Abuse and Addiction Treatment: Practical Application of
Counseling Theory, First Edition. © 2014 by Pearson Education, Inc. All Rights
Reserved
3-16
Cocaine
•Two
common forms: powder cocaine and crack cocaine
•Effects
and dangers
Increased feelings of well-being, self-confidence, and power
Enhanced alertness and energy
Decreased anxiety
Heightened sex drive
Cardiovascular problems
Irritability, nervousness and agitation
Strong connection between cocaine use and depression
Increased respiratory function and blood pressure
Mimics manic symptoms
Lewis. Substance Abuse and Addiction Treatment: Practical Application of
Counseling Theory, First Edition. © 2014 by Pearson Education, Inc. All Rights
Reserved
3-17
Opiates
•Also
referred to as narcotics and used to kill pain
(analgesics)
•Commonly
experience a rush of pleasure followed by a
dreamy, pleasant state
•General
effects: slowed breathing, flushed skin,
drowsiness, reduction in pain, sense of tranquility, and
pinpoint pupils
•Withdrawal
symptoms: dilated pupils, vasodilation,
rapid heartbeat, elevated blood pressure, vomiting,
diarrhea, goose bumps, tremors, chills, nausea, cramps
and loss of appetite
•Common
opiates: opium, heroin, morphine, codeine,
prescription pain killers
Lewis. Substance Abuse and Addiction Treatment: Practical Application of
Counseling Theory, First Edition. © 2014 by Pearson Education, Inc. All Rights
Reserved
3-18
Heroin
•Creates
pleasure
•Effects
a rapid experience of a “rush” or “flash” of
and danger
Initial surge of euphoria followed by a dreamlike
state of drowsiness
Clouded mental functioning
Increased self-esteem and decreased concern for
life stressors
HIV and hepatitis (from sharing needles)
Heart, lung, kidney, liver, or brain damage
Pulmonary complications
Strong addiction potential-small window between
abuse and addiction
Lewis. Substance Abuse and Addiction Treatment: Practical Application of
Counseling Theory, First Edition. © 2014 by Pearson Education, Inc. All Rights
Reserved
3-19
Prescription Pain Medication
•Oxycodone,
Vicodin
•Effects
Oxycontin, Percocet, Percodan, and
and Dangers
Similar effects as heroin without the initial rush
Drowsiness, constipation, nausea, and
depressed breathing
Euphoria, lack of motivation, pain relief
Potential for physical addiction and withdrawal
symptoms
Lewis. Substance Abuse and Addiction Treatment: Practical Application of
Counseling Theory, First Edition. © 2014 by Pearson Education, Inc. All Rights
Reserved
3-20
Hallucinogens
•Produce
visual and/or auditory perceptual distortions
•General
effects: feelings of detachment, emotional
ups and downs, and altered sensations,
hallucinations, pseudo-hallucinations and illusions
•Psychological
addiction may occur, but physical
addiction does not
•Common
hallucinogens: lysergic acid (LSD), MDMA
(ecstasy), phencyclidine (PCP)
Lewis. Substance Abuse and Addiction Treatment: Practical Application of
Counseling Theory, First Edition. © 2014 by Pearson Education, Inc. All Rights
Reserved
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PCP and LSD
Effects and dangers of PCP
Effects and dangers of LSD
•Increased
•Numbness,
feelings of wellbeing, manic-like symptoms
•belligerence,
•Coma,
agitation
seizures, death
•Body
dysmorphic effects,
increased blood pressure,
dizziness, nausea, blurred
vision, no experience of pain,
hallucinations, aggression
Lewis. Substance Abuse and Addiction Treatment: Practical Application of
Counseling Theory, First Edition. © 2014 by Pearson Education, Inc. All Rights
Reserved
weakness,
trembling, elevated heart rate
and blood pressure, dilated
pupils, nausea, dizziness
•Enhanced
visual effects,
wavelike motions, feelings of
euphoria, distorted space
perceptions and slowing of
time
•Sleeplessness,
dry mouth,
tremors, flashbacks,
psychopathology
3-22
Marijuana
•Tetrahydrocannabinol
ingredient
•Difficult
•Effects
(THC) is the main psychoactive
to classify, but legally considered a Schedule I narcotic
and dangers
Effects mood, memory, coordination, cognitive ability
and sense perception
Wide range of effects including mild euphoria,
perceptual and time distortions, low motivation,
hallucinations and body image distortions
Respiratory problems
Impaired reaction time
Lower intensity of dependence
Lewis. Substance Abuse and Addiction Treatment: Practical Application of
Counseling Theory, First Edition. © 2014 by Pearson Education, Inc. All Rights
Reserved
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Inhalants
•A
group of substances made up of assorted chemical
structures that produce a state of intoxication when inhaled
•Often
commonly kept household items, such as glue, aerosols,
gasoline, spray paint, cleaning products, etc.
•Hydrocarbon
•Popular
•Effects
is the active ingredient
among youth
and dangers
Altered state, delirium, restlessness, confusion,
disorientation
High potential for danger when combined with other
drugs
Coma or death
Lewis. Substance Abuse and Addiction Treatment: Practical Application of
Counseling Theory, First Edition. © 2014 by Pearson Education, Inc. All Rights
Reserved
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Schedule of Substances
•Controlled
Substances Act-categorized all
drugs into five schedules based on abuse
potential and medicinal value
•The
lowest level (Schedule I) drugs are the
most dangerous, have no medicinal value
and have a high abuse/addiction potential
Lewis. Substance Abuse and Addiction Treatment: Practical Application of
Counseling Theory, First Edition. © 2014 by Pearson Education, Inc. All Rights
Reserved
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