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Chapter 7 Drug Misuse and Addiction Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Psychoactive Drugs Drugs that alter a person’s experiences or consciousness Can cause intoxication A state in which sometimes unpredictable physical and emotional changes occur Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent 2 of McGraw-Hill Education. Addictive Behavior Habits that have gotten out of control, with a resulting negative effect on a person’s health Addiction is a chronic disease that disrupts the brain systems that regulate motivation and reward What is addiction? Behavioral characteristics (psychological) Changes in brain chemistry (physiological) Development of tolerance Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent 3 of McGraw-Hill Education. Diagnostic and Statistical Manual of Mental Disorders (DSM-5) Substance use disorder Continuum from mild to severe Dependence Can occur with or without a physical component DSM-5 criteria for substance use disorder Severity determined by the number of criteria a person meets 2–3 criteria—mild disorder 4–5 criteria—moderate disorder 6 or more criteria—severe disorder Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent 4 of McGraw-Hill Education. The Development of Addiction Often starts as a way to bring pleasure or avoid pain Reinforcement; tolerance; withdrawal A combination of factors is involved in the development of addiction Personality Lifestyle Heredity Social and physical environment Nature of the substance or behavior in question Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent 5 of McGraw-Hill Education. Characteristics of People with Addictions Use of a substance or activity as a substitution for healthier coping strategies Genetic predisposition Distinct preference for a particular addictive behavior Problems with impulse control and self-regulation Tend to be risk takers Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent 6 of McGraw-Hill Education. Psychoactive Drugs and Their Potential for Substance Disorder and Addiction Very high Amphetamine, cocaine, nicotine, heroin, and other opiates High Caffeine, PCP Moderate Alcohol, marijuana, benzodiazepines Low Psychedelics, steroids Very low Antidepressant, antimanic, and antipsychotic medications Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent 7 of McGraw-Hill Education. Risk Factors for Misuse and Addiction Physical factors Brain chemistry; metabolism Psychological factors Mental disorders Social factors Family; peers; poverty Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent 8 of McGraw-Hill Education. Other Risks of Drug Misuse Intoxication Unexpected side effects Unknown drug constituents Risks associated with injection use HIV and HCV Legal consequences Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent 9 of McGraw-Hill Education. How Drugs Affect the Body (1) Changes in brain chemistry Effect on neurotransmitters Factors that influence a drug’s effect Pharmacological properties Dose-response function Time-action function Person’s drug use history Method of drug use Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent 10 of McGraw-Hill Education. How Drugs Affect the Body (2) Physical factors Body mass General health and genetics Interactions between drugs Psychological factors Expectations Placebo effect Social factors Setting Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent 11 of McGraw-Hill Education. Representative Psychoactive Drugs Opioids Central nervous system depressants Central nervous system stimulants Marijuana and other cannabis products Hallucinogens Inhalants Prescription drugs Synthetic recreational drugs Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent 12 of McGraw-Hill Education. Opioids (1) Natural or synthetic drugs that relieve pain, cause drowsiness, and induce euphoria At prescribed doses, beneficial medical uses Can still lead to misuse and addiction Tolerance can develop rapidly Withdrawal symptoms include cramps, sweating, nausea, tremors, irritability, and feelings of panic Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent 13 of McGraw-Hill Education. Opiods (2) Representative Drugs Street names Appearance Methods of use Heroin Dope, H, junk, brown sugar, smack White/dark brown powder; dark tar or coal-like substance Injected, smoked, snorted Opium Big O, black stuff, hop Dark brown or black Chunks Swallowed, Smoked Morphine M, Miss Emma, monkey, white stuff White crystals, liquid solution Injected, swallowed, smoked Oxycodone, codeine, hydrocodone Oxy, O.C., killer, Captain Cody, schoolboy, vike Tablets, powder made from crushing tablets Swallowed, injected, snorted Short Term Effects of Opiods: Relief of anxiety and pain; euphoria; lethargy, apathy, drowsiness, confusion, inability to concentrate; nausea, constipation, respiratory depression Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent 14 of McGraw-Hill Education. Central Nervous System Depressants (1) Types: barbiturates, sedatives, tranquilizers Effects: reduced anxiety, change in mood, impaired muscular coordination, slurring of speech, drowsiness, sleep, impaired mental functioning Medical uses: to treat insomnia and anxiety disorders, and to control seizures From use to misuse Tolerance and withdrawal Overdose: slowing and stopping of respiration Club drugs: Rohypnol, GHB Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent 15 of McGraw-Hill Education. Central Nervous System Depressants (2) Representative Drugs Street names Appearance Methods of use Barbiturates Barbs, reds, red birds, yellows, yellow jackets Colored capsules Swallowed, injected Benzodiazepines (e.g., Valium, Xanax, Rohypnol) Candy, downers, tranks, roofies, forget-me pill Tablets Swallowed, injected Methaqualone Ludes, quad, quay Tablets Injected, swallowed Gamma hydroxy butyrate (GHB) G, Georgia home boy, grievous bodily harm Clear liquid, white powder Swallowed Short Term Effects of Central Nervous System Depressants: Reduced anxiety, mood changes, lowered inhibitions, impaired muscle coordination, reduced pulse rate, drowsiness, loss of consciousness, respiratory depression Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent 16 of McGraw-Hill Education. Central Nervous System Stimulants (1) Speed up activity of nervous or muscular system Cocaine Produces feelings of euphoria Snorted or used intravenously; crack Intense but short-lived effects Euphoria replaced by irritability, anxiety, slight depression “Crash” Other effects Sudden death from excessive CNS stimulation Persistent nose bleeds Paranoia and aggression Serious effects on developing fetus Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent 17 of McGraw-Hill Education. Central Nervous System Stimulants (2) Amphetamines Potent, synthetic CNS stimulants Small doses make people feel more alert Sometimes used to curb appetite Misuse and addiction Often starts as an attempt to cope with a temporary situation State dependence Tolerance leads to increased doses and psychosis Methamphetamine is more addictive than others Severe risks to fetus Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent 18 of McGraw-Hill Education. Central Nervous System Stimulants (3) Ritalin (methylphenidate) (used to treat ADHD) Caffeine Most popular psychoactive drug Rarely harmful, but withdrawal symptoms can develop Energy “shots” Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent 19 of McGraw-Hill Education. Central Nervous System Stimulants (4) Representative Drugs Street names Appearance Methods of use Amphetamine, methamphetamine Bennies, speed, black beauties, uppers, chalk, crank, crystal, ice, meth Tablets, capsules, white powder, clear crystals Injected, swallowed, smoked, snorted Cocaine, crack cocaine Blow, C, candy, coke, flake, rock, toot, snow White powder, beige pellets or rocks Injected, smoked, snorted Ritalin JIF, MPH, R-ball, Skippy Tablets Injected, swallowed, snorted Short Term Effects of Central Nervous System Stimulants: Increased and irregular heart rate, blood pressure, metabolism; increased mental alertness and energy; nervousness, insomnia, impulsive behavior; reduced appetite Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent 20 of McGraw-Hill Education. Marijuana and Other Cannabis Products (1) Marijuana is the most widely used illegal drug in the United States THC (tetrahydrocannabinol) is the active ingredient; potency has increased Short-term effects and uses are influenced by the dose Long-term effects Respiratory damage Learning, attention, memory problems Decreased testosterone levels Impaired fetal growth and development Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent 21 of McGraw-Hill Education. Marijuana and Other Cannabis Products (2) Representative Drugs Street names Appearance Methods of use Marijuana Dope, grass, joints, Mary Jane, reefer, skunk, weed, pot Dried leaves and stems Smoked, swallowed Hashish (most potent material from cannabis plants) Hash, hemp, boom, gangster Dark, resin-like compound formed into rocks or blocks Smoked, swallowed Short Term Effects of Marijuana and Other Cannabis Products: Euphoria, slowed thinking and reaction time, confusion, anxiety, impaired balance and coordination, increased heart rate Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent 22 of McGraw-Hill Education. Hallucinogens (1) Drugs that alter the user’s perceptions, feelings, and thoughts LSD (Lysergic acid diethylamide) Synesthesia Stimulation of one sensory or cognitive pathway leads to automatic, involuntary experiences in a second sensory or cognitive pathway Altered state of consciousness Flashbacks MDMA (3,4-methylenedioxy-methamphetamine) Variants: ecstasy, molly Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent 23 of McGraw-Hill Education. Hallucinogens (2) Other hallucinogens: DMT (Dimethyltryptamine) Ketamine STP (2,5-Dimethoxy-4-methylamphetamine) “Serenity, Tranquility and Peace” PCP (Phencyclidine) Mescaline (3,4,5-trimethoxyphenethylamine) Naturally occurring psychedelic alkaloid Peyote Cactus Mushrooms Botanical products Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent 24 of McGraw-Hill Education. Hallucinogens (3) Representative Drugs Street names Appearance Methods of use LSD Acid, boomers, blotter, yellow sunshines Blotter paper, liquid, gelatin tabs, pills Swallowed, absorbed through mouth tissues Mescaline (peyote) Buttons, cactus, mesc Brown buttons, liquid Swallowed, smoked Psilocybin Shrooms, magic mushrooms Dried mushrooms Swallowed Ketamine K, special K, cat valium, vitamin K Clear liquid, white or beige powder Injected, snorted, smoked PCP Angel dust, hog, love boat, peace pill White to brown powder, tablets Injected, swallowed, smoked, snorted MDMA (ecstasy) X, peace, clarity, Adam, Molly Tablets Swallowed Short Term Effects of Hallucinogens: Altered states of perception and feeling; nausea; increased heart rate, blood pressure; delirium; impaired motor function; numbness, weakness Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent 25 of McGraw-Hill Education. Inhalants (1) Slow down body functions Types: Volatile solvents Aerosols Nitrites Anesthetics Use is high among youth and declines with age Difficult to control because they are easy to obtain Suffocation is among the many risks Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent 26 of McGraw-Hill Education. Inhalants (2) Representative Drugs Street names Appearance Methods of use Solvents, aerosols, nitrites, anesthetics Laughing gas, poppers, snappers, whippets Household products, sprays, glues, paint thinner, petroleum products Inhaled through nose or mouth Short Term Effects of Inhalants: Stimulation, loss of inhibition, slurred speech, loss of motor coordination, loss of consciousness Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent 27 of McGraw-Hill Education. Prescription Drug Misuse Use of medication without a prescription in a way other than as prescribed, or for the experience or feelings elicited Misuse has increased Abused at a rate behind only marijuana and alcohol Adderall (treat attention deficit hyperactivity disorder (ADHD) and narcolepsy) Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent 28 of McGraw-Hill Education. Synthetic Recreational Drugs “Designer drugs” Chemically distinct—so either legal or impossible to detect on drug screenings Two main groups Synthetic marijuana (“herbal incense”) Produces effects similar to THC Bath salts Produces severe effects From violent behavior to chest pain Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent 29 of McGraw-Hill Education. Treatment for Drug Addiction Medication-assisted treatment Treatment centers Groups and peer counseling Alcoholics Anonymous (AA); Narcotics Anonymous (NA) Harm-reduction strategies Minimize the effects of drug use and misuse Using a designated driver Methadone Syringe exchange Codependency Enabling behaviors Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent 30 of McGraw-Hill Education.
