Download Prescription Drug Abuse

PowerPoint® Lecture Outlines prepared by
Dr. Lana Zinger, QCCCUNY
7
Addiction and
Drug Abuse
Copyright © 2011 Pearson Education, Inc.
Defining Addiction
 Defined as continued involvement with a substance or
activity despite its ongoing negative consequences.
 When the individual eventually needs to consume the
addictive substance or enact the behavior to feel normal.
 Classified by the American Psychiatric Association (APA)
as a mental disorder
Copyright © 2011 Pearson Education, Inc.
Defining Addiction
 Physiological/Psychological Dependence
• Inextricably tied together
• Addiction traditionally based on four criteria:
1. Relief of withdrawal symptoms
2. Continued use despite harm to self and others
3. Unsuccessful efforts to cease using or cut down on
use, including relapse
4. Tolerance
Copyright © 2011 Pearson Education, Inc.
Defining Addiction
 Signs of Addiction
• Addictions are characterized by four common
symptoms
1. Compulsion (can include obsession)
2. Loss of control
3. Negative consequences
4. Denial
• Process Addictions
• Behaviors known to be addictive because they are
mood altering
Copyright © 2011 Pearson Education, Inc.
Addictive Behaviors
 Compulsive or Pathological Gambling
• Cravings or highs similar to those experienced by drug
users
• Often seek the excitement more than the money
• Incidence higher in men, lower-income individuals,
those who are divorced, African Americans, older
adults, those living within 50 miles of a casino, and
college students
• 38 percent have cardiovascular problems
• Suicide rate 20 times higher than that of general
population
Copyright © 2011 Pearson Education, Inc.
Addictive Behaviors
 Compulsive Spending
• On average, compulsive spenders are $23,000 in debt.
• Compulsive spending often leads to compulsive
borrowing to help support addiction.
 Symptoms that a spender has crossed the line
into addiction include
• Buying more than one of the same item
• Keeping items in the closet with the tags still attached
• Repeatedly buying much more than the person needs or
can afford
• Hiding purchases from relatives and loved ones
• Experiencing feelings of excitement when shopping
Copyright © 2011 Pearson Education, Inc.
Addictive Behaviors
 Exercise Addiction
• About 2 million people with anorexia nervosa and bulimia nervosa
use exercise to purge instead of, or in addition to, self-induced
vomiting
• Try to meet needs for nurturance, intimacy, self-esteem, and selfcompetency that an object or activity cannot truly meet
• Men are increasingly abusing steroids and overexercising to attain
an ideal frame
• Muscle dysmorphia (bigarexia) is a pathological preoccupation
with being larger and more muscular
• Symptoms include excessive weight lifting, excessive exercising,
and steroid or supplement abuse
Copyright © 2011 Pearson Education, Inc.
Addictive Behaviors
 Technology Addictions
• Cell phones, video games, PDAs,
networking sites, and the Internet
can all be addictive.
• An estimated 5 to 10 percent of
Internet users will likely
experience Internet addiction.
• Symptoms include general
disregard for one’s health, sleep
deprivation, neglecting family and
friends, lack of physical activity,
euphoria when online, lower
grades in school, and poor job
performance.
• Compensation for feelings of
loneliness, marital or work
problems, a poor social life, or
financial problems
Copyright © 2011 Pearson Education, Inc.
ABC News Video: Kick Your Habit—Soft Addictions
| Kick Your Habit—Soft Addictions
Discussion Questions
1. What is the difference between a bad habit and an
addiction?
2. In what way do soft addictions affect friends and
family? Is it better or worse for friends and family
than if the addict had a “hard” addiction?
3. How do you recognize a bad habit? How do you go
about changing it?
Copyright © 2011 Pearson Education, Inc.
Addiction Affects Family and Friends
 Codependence
• Pattern of behavior
• Person becomes “addicted to the addict”
• Disregard personal needs in order to meet needs or
desires of addict
 Enabling
• Knowingly or unknowingly protects addict from
consequences of behavior
• Rarely conscious and generally unintentional
Copyright © 2011 Pearson Education, Inc.
Drug Dynamics
 Abuse often associated with illegal drugs, but many
people abuse and misuse legal drugs
• Drug misuse—use for purpose not intended
• Drug abuse—excessive use
• Misuse and abuse may lead to addiction
• Drug and alcohol abuse contributes to more than
120,000 American deaths a year
• Costs $294 billion in preventable health care
expenses annually.
• Although overall use of drugs in the United States
has fallen by 50 percent in the past 20 years, the past
10 years have shown an increase in the use of certain
drugs by adolescents.
Copyright © 2011 Pearson Education, Inc.
Drug Dynamics
 How Drugs Affect the Brain
• Mesolimbic dopamine—neurons relay messages
about pleasure
• Psychoactive drugs—affects chemical
neurotransmission, either enhancing it, suppressing
it, or interfering with it
• Some people’s bodies naturally produce insufficient
quantities of neurotransmitters, which predisposes
them to addictions such as alcohol, drugs, or exercise
Copyright © 2011 Pearson Education, Inc.
The Action of Cocaine at Dopamine Receptors in the
Brain, an Example of Psychoactive Drug Action
Copyright © 2011 Pearson Education, Inc.
Drug Dynamics
 Types of Drugs
• Prescription—more than 10,000 types sold in U.S
• Over-the-counter (OTC) drugs—no prescription
needed
• Recreational—alcohol, tobacco, coffee, etc.
• Herbal preparations—products of plant origin
• Illicit (illegal)—all are psychoactive
• Commercial preparations—household cleaners,
pesticides, etc.
Copyright © 2011 Pearson Education, Inc.
Drug Dynamics
• Routes of Drug Administration
• Oral
• Injection
• Intravenous—into bloodstream
• Intramuscular—into muscle
• Subcutaneous—just under the skin
• Inhalation
• through the nose or mouth
• Inunction
• through the skin
• Suppositories
• through the vagina or anus
Copyright © 2011 Pearson Education, Inc.
Drug Dynamics
 Drug Interactions
• Polydrug Use
• Taking several substances simultaneously
• Synergism
• Effects are multiplied
• Expressed as 2 + 2 = 10
• Example: Alcohol and barbiturates
• Antagonism
• Work at same receptor
• Inhibition—the effects of one drug are eliminated or
reduced by the presence of another drug
• Example: Alcohol and antibiotics
Copyright © 2011 Pearson Education, Inc.
Drug Dynamics
• Intolerance
• When drugs combine to produce extremely
uncomfortable reactions
• Example: Antabuse and alcohol
• Cross-tolerance
• Tolerance for one drug creates a similar reaction to
another drug
• Example: Alcohol and barbiturates
Copyright © 2011 Pearson Education, Inc.
Abuse of Over-the-Counter (OTC) Drugs
• Nonprescription medicine
• High doses can cause
hallucinations, bizarre sleep
patterns, mood changes, and
sometimes death.
• Those most vulnerable to
abusing OTC drugs are
teenagers, young adults, and
people over the age of 65.
Copyright © 2011 Pearson Education, Inc.
Abuse of Over-the-Counter (OTC) Drugs
 Sleep Aids
• Excedrin PM, Sominex, Unisom, and Tylenol PM
• Can cause problems with the sleep cycle, weaken areas of the
body, or induce narcolepsy
 Cold Medicines
• Robitussin, Vicks, Coricidin, and NyQuil
• Dextromethorphan (DXM) can cause hallucinations, loss of
motor control, and “out-of body” sensations
• Pseudoephedrine is being used to illegally manufacture
methamphetamine
 Diet Pills
• Contain stimulants such as caffeine or Hoodia gordonii
Copyright © 2011 Pearson Education, Inc.
Prescription Drug Abuse
• 15.2 million people over the age of 12 (6.2%) report abusing
controlled prescription drugs in the past year.
• Prescription drug abuse is particularly common among
teenagers.
• Abuse of opioids, narcotics, and pain relievers can result in
life-threatening respiratory depression (reduced breathing).
• Abuse of depressants, including benzodiazepines,
tranquilizers, barbiturates, and sedatives can result in
seizures, respiratory depression, and decreased heart rate.
• Abuse of stimulants can cause elevated body temperature,
irregular heart rate, cardiovascular system failure, and fatal
seizures.
Copyright © 2011 Pearson Education, Inc.
Prescription Drug Abuse
 College Students and Prescription Drug Abuse
• Increased dramatically over the past decade
• Marijuana use has risen in recent years.
• Students who abuse Adderal and Ritalin say they help
them concentrate and study to increase alertness.
• Students who abuse Vicodin, OxyContin, or Percocet
say they do so to relax or get high.
• College men are more likely to abuse prescription drugs
than women.
Copyright © 2011 Pearson Education, Inc.
ABC News Video: Campus Drug Dealers
| Campus Drug Dealers
Discussion Questions
1. Do you believe the statistics about heavy drug use
and binge drinking on campus?
2. Why do you think fraternities play a large role in the
drug trade? Would this type of drug ring be
successful in a different format on campus?
Copyright © 2011 Pearson Education, Inc.
Illicit Drugs
 Users of Illicit Drugs
• In 2004, an estimated 20.4 million Americans were
illicit drug users.
• Among youth, marijuana use has been rising in recent
years.
 Drug Use on Campus
• In 2006 51 percent of college students reported trying
any drug; a third have smoked marijuana in the past
year, and 20 percent have done so in the past month.
• For many students, their college environment coupled
with our culture’s societal mores regarding substance
use on college campuses may make substance use and
abuse seem like the norm.
Copyright © 2011 Pearson Education, Inc.
Reasons Why College Students Use Illicit Drugs or
Controlled Prescription Drugs
Copyright © 2011 Pearson Education, Inc.
Illicit Drugs
 Why Do Some College
Students Use Drugs?
• Genetics and family history
• Substance use in high
school
 Why Do Some College
Students Not Use Drugs?
• Parental attitudes and
behavior
• Religion and spirituality
• Positive expectations
• Student engagement
• Mental health problems
• College athletics
• Sorority and fraternity
membership
Copyright © 2011 Pearson Education, Inc.
Annual Drug Use Prevalence, Full-time College Students vs.
Respondents 1 to 4 Years Beyond High School
Copyright © 2011 Pearson Education, Inc.
Common Drugs of Abuse
 Stimulants
• Cocaine
• White crystalline powder
• Derived from the leaves of the south American coca shrub
• Cocaine rapidly enters bloodstream
• Exposed fetus is likely to suffer damage
• Methods of use vary
• Freebase cocaine
• Crack
• Treatment for cocaine addiction involves mainly psychiatric
counseling and 12-step programs.
Copyright © 2011 Pearson Education, Inc.
Common Drugs of Abuse
 Amphetamines
• Synthetic agents that stimulate the central nervous
system (CNS)
• Some are used for medicinal purposes
• Ritalin and Adderall are used for attention
deficit/hyperactivity disorder (ADHD)
• High potential for abuse
Copyright © 2011 Pearson Education, Inc.
College Students’ Stated Reasons for Nonmedical Use of
ADHD Drugs
Copyright © 2011 Pearson Education, Inc.
Common Drugs of Abuse
 Methamphetamine
• Affects brain and CNS
• Euphoria lasts 6 to 8
hours
• Methods of use:
snorted, injected,
smoked, and ingested
• Increasingly common
in rural America
Copyright © 2011 Pearson Education, Inc.
ABC News Video: Eliminating Meth
| Elimination Meth
Discussion Questions
1. Do you find the anti-meth ads effective?
2. Are there better ideas to curb meth use than with shock
ads?
3. Could this type of ad be effective against other drugs?
What might be the drawbacks to using the same format?
Copyright © 2011 Pearson Education, Inc.
Common Drugs of Abuse
 Caffeine
• Most popular and widely consumed drug in the United
States
• Caffeine is derived from the chemical family called
xanthines, which are found in plant products such as
coffee, tea, and chocolate.
• Enhance mental alertness and reduce feelings of fatigue
• Side effects include wakefulness, insomnia, irregular
heartbeat, dizziness, nausea, indigestion, mild delirium,
and heartburn.
• Caffeine meets the requirements for addiction:
tolerance, psychological dependence, and withdrawal
symptoms.
Copyright © 2011 Pearson Education, Inc.
Caffeine Content Comparison
Copyright © 2011 Pearson Education, Inc.
Common Drugs of Abuse
 Marijuana and Other Cannabinoids
• Methods of Use and Physical Effects
• People have been using these substances for 6,000
years
• Derived from Cannabis sativa or Cannabis indica
(hemp)
• Tetrahydrocannabinol (THC) is the active ingredient
• Hashish, a potent cannabis preparation, is derived
from the resin of the plant.
• Long-term studies have not been conducted in the
United States.
• Inhalation from smoking is harmful.
Copyright © 2011 Pearson Education, Inc.
Common Drugs of Abuse
 Marijuana and Medicine
• Helps with severe nausea and vomiting during
chemotherapy
• Improves appetite of those with AIDS related wasting
syndrome
• Aids those with multiple sclerosis by reducing pain and
spasticity
• Reduces eye pressure of glaucoma
Copyright © 2011 Pearson Education, Inc.
Common Drugs of Abuse
 Effects of Chronic Marijuana Use
• Carbon monoxide in blood stream causes heart to work
harder
• Contains high levels of carcinogens
• Suppression of the immune system
• Pregnant women at higher risk for stillbirth or
miscarriage
Copyright © 2011 Pearson Education, Inc.
Common Drugs of Abuse
 Depressants
• Opiates
• Cause drowsiness, relieve pain, and induce euphoria
• Called narcotics
• Derived from opium
• Include morphine, codeine, heroin, and black tar
heroin
• Depress CNS and lower heart rate, respiration, and
blood pressure
• Decrease sex drive
Copyright © 2011 Pearson Education, Inc.
Common Drugs of Abuse
 Heroin Addiction
• Heroin is a white powder derived from morphine.
• Black tar heroin is a sticky, dark brown, foul smelling
form of heroin that is relatively pure and inexpensive.
• Heroin withdrawal is distinct, including an intense
desire for the drug, sleep disturbances, dilated pupils,
and muscle tremors
• An estimated 3.7 million people have used heroin at one
time in their lives
• Mainlining—intravenous injection of powdered heroin
mixed in a solution and is the most common route of
administration
Copyright © 2011 Pearson Education, Inc.
Depressants: Opiates
 Treatment of Opiates
• Methadone
• Blocks effects of opiates withdrawal
• Potentially addictive itself
• Naltrexone
• Opiate antagonist
• Lose compulsion to use heroin
• Buprenorphine
• Blocks cravings for heroin
• Nonaddictive
Copyright © 2011 Pearson Education, Inc.
Common Drugs of Abuse
 Benzodiazepines and Barbiturates
• Benzodiazepines (tranquilizers )
• The most common sedative-hypnotic drugs
• Valium, Ativan, and Xanax
• Barbiturates
• Sedative-hypnotic drugs
• Amytal and Seconal
• Less safe than benzodiazepines
• Synergistic effect when combined with alcohol, can lead to
respiratory failure and death
• Can produce physical and psychological dependence in several weeks
• Cross-tolerance is a complication specific to sedatives
Copyright © 2011 Pearson Education, Inc.
Common Drugs of Abuse
 Rohypnol
• A tranquilizer and “date rape” drug
• Produces a sedative effect, amnesia, muscle relaxation, and
slowed psychomotor responses
• Has gained notoriety as a growing problem on college
campuses as it has been added to punch and other drinks at
parties in hopes of lowering women’s inhibitions and
facilitating potential sexual conquests
 Gamma-hydroxybutyrate (GHB)
• CNS depressant known to have euphoric, sedative, and
anabolic (bodybuilding) effects
• Another “date rape” drug
• Side effects include loss of memory, unconsciousness,
amnesia, hallucinations, and death
Copyright © 2011 Pearson Education, Inc.
Common Drugs of Abuse
 Hallucinogens
• Scramble messages coming to reticular formation
• Synesthesia—mixing of sensory messages
• May “hear colors” and “smell tastes”
• Lysergic acid diethylamide (LSD)
• Also called acid
• Common hallucinogen used to “unlock secrets” of
the mind
• Used to “turn on” and “tune out” world
• In 1970 it was placed on controlled substances list
• Over 11 million Americans have tried acid
• Commonly sold as a “blotter” on paper
Copyright © 2011 Pearson Education, Inc.
Common Drugs of Abuse
 Ecstasy methylene-dioxymethamphetamine
(MDMA)
• Most common club drug
• Side effects include hallucination, paranoia, and
amnesia
• Causes death in some cases, especially when combined
with alcohol
• Chronic use can damage the brain
Copyright © 2011 Pearson Education, Inc.
Common Drugs of Abuse
 Mescaline
• Derived from peyote cactus
• Native Americans use it for religious
purposes
• Users typically swallow 10 to 12 dried
peyote buttons
• Generally induces immediate vomiting
 Psilocybin
• “Magic mushrooms”
• Effects generally wear off in 4 to 6 hours
• Cultivated from spores or harvested wild
• Similar to LSD in effect
• Mushroom varieties can be easily
misidentified, and mistakes can be fatal
Copyright © 2011 Pearson Education, Inc.
Common Drugs of Abuse
 Phencyclidine (PCP)
• Originally used as a dissociative anesthetic
• Side effects such as amnesia led doctors to abandon use
• May cause euphoria or dysphoria
• Known to cause hallucinations, delusions, and overall
delirium
 Ketamine (Special K)
• Used as an anesthetic in many hospital and veterinary
clinics
• Causes hallucinations and sensory distortions
Copyright © 2011 Pearson Education, Inc.
Common Drugs of Abuse
 Inhalants
• Users inhale chemicals
• Legal to purchase and not commonly recognized as
drugs, though dangerous when used incorrectly
• Includes: glue, paint thinner, and rubber cement
• Amyl Nitrate and Nitrous Oxide
• Commonly known as laughing gas
• Imparts a “silly feeling”
• An overdose of fumes from inhalants can cause
unconsciousness and death
Copyright © 2011 Pearson Education, Inc.
Common Drugs of Abuse
 Anabolic Steroids
• Artificial forms of the male hormone testosterone that
promote muscle growth and strength
• Ergogenic drugs
• Adverse effects occur
• “Performance-enhancing” steroid alternatives
• Gamma-hydroxybutyrate (GHB)
• Clenbuterol
• The 2007 Mitchell Report investigated steroid use among
Major League Baseball players, 89 of whom were alleged to
have used steroids
Copyright © 2011 Pearson Education, Inc.
ABC News Video: The Mitchell Report
| The Mitchell Report
Discussion Questions
1. What sort of long-term effects can taking performanceenhancing drugs have on the muscles and the rest of the
body? What about psychological and social
consequences?
2. Should professional athletes who use performanceenhancing drugs be punished?
3. Would it be acceptable to use performance- enhancing
drugs if other athletes are doing the same thing?
Copyright © 2011 Pearson Education, Inc.
Treatment and Recovery
 An estimated 23.6 million Americans aged 12 or older
needed treatment for illicit drug or alcohol use problem in
2007.
 Of these, approximately 10 percent received treatment
 Detoxification—an early abstinence period during which
an addict adjusts physically and cognitively to being free
from the addiction’s influence
Copyright © 2011 Pearson Education, Inc.
Treatment and Recovery
 Treatment Approaches
• Outpatient Behavioral Treatment
•
•
•
•
Cognitive behavioral therapy
Multidimensional family therapy
Motivational interviewing
Motivational incentives (contingency management)
• Residential Treatment Programs
• Therapeutic communities (TCs) are highly structured
programs in which addicts remain at a residence,
typically for 6 to 12 months
• 12-Step Programs
• Nonjudgmental treatment programs that aim to work
on personal recovery
Copyright © 2011 Pearson Education, Inc.
Treatment and Recovery
• College Students’ Treatment and Recovery
• Early intervention increases the likelihood of
successful treatment.
• Private therapy, group therapy, cognitive training,
nutrition counseling, and health therapies all induce a
better chance of recovery.
• A growing number of colleges are offering special
services to students who are recovering from alcohol
and other drug addictions.
• Texas Tech University received a $250,000 federal
grant to create a national model of its students-inrecovery program.
Copyright © 2011 Pearson Education, Inc.
ABC News Video: Treating Addiction with Virtual Reality
| Treating Addiction with Virtual Reality
Discussion Questions
1. Do you think treating addiction with virtual reality is a
viable form of treating addiction?
2. Could this type of behavior modification be used to treat
other chemical dependencies?
3. What steps are necessary in order to overcome an
addiction?
Copyright © 2011 Pearson Education, Inc.
Addressing Drug Misuse and Abuse in the U.S
• The financial burden of illegal drug use on the U.S.
economy is around $180.9 billion per year.
 Possible Solutions to the Problem
• Scare tactics—shown not to be effective
• War on drugs—laws and policies to reduce illegal drug trade
• Multimodal approach—most effective when young people
are taught to differentiate drug use, misuse, and abuse
• Harm Reduction Strategies—practical approaches to
reducing negative consequences of drug use
Copyright © 2011 Pearson Education, Inc.