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Chapter 7 Lecture
Health: The Basics
Tenth Edition
Recognizing and
Avoiding Addiction
and Drug Abuse
OBJECTIVES
• Identify the signs of addiction and discuss types of addictions,
including compulsive behaviors such as gambling and shopping.
• Identify the six categories of drugs and distinguish between drug
misuse and drug abuse.
• Discuss the issues of over-the-counter and prescription drug misuse
and abuse, including their impact on college campuses.
• Profile illicit drug use in the United States, including who uses illicit
drugs, financial impact, and prevalence on college campuses.
• Discuss the use and abuse of controlled substances, including
cocaine, amphetamines, marijuana, opioids, hallucinogens,
inhalants, and steroids.
• Discuss treatment and recovery options for addicts, and discuss
public health approaches to preventing drug abuse and reducing the
impact of addiction on our society.
© 2013 Pearson Education, Inc.
Defining Addiction
• Defined as continued involvement with a
substance or activity despite its ongoing
negative consequences.
• Classified by the American Psychiatric
Association (APA) as a mental disorder.
• Physiological dependence results in tolerance
and withdrawal.
• Psychological dependence is the dependency of
the mind on a substance or behavior, which can
lead to psychological withdrawal symptoms,
such as anxiety, irritability, or cravings.
© 2013 Pearson Education, Inc.
Signs of Addiction
• Compulsion, which is characterized by obsession, or
excessive preoccupation, with the behavior and an
overwhelming need to perform it
• Loss of control, or the inability to predict reliably
whether any isolated occurrence of the behavior will be
healthy or damaging
• Negative consequences, such as physical damage,
legal trouble, financial problems, academic failure, or
family dissolution, which do not occur with healthy
involvement in any behavior
• Denial, the inability to perceive that the behavior is selfdestructive
© 2013 Pearson Education, Inc.
Addiction Affects Family and Friends
• Codependence, a condition in which a
person is controlled by an addict's
addictive behavior
– Defined by lack of ability to set boundaries
– Living in a chaotic, crisis-oriented mode
– Assuming responsibility for meeting others'
needs to the point of subordinating own needs
or even being unaware of personal needs
• Enablers, people who knowingly or
unknowingly protect addicts from the
consequences of their behavior
© 2013 Pearson Education, Inc.
Addictive Behaviors
• Drug chemicals are not the only source of
addiction. People can become addicted to
certain behaviors.
• Process addictions are behaviors known
to be addictive because they are mood
altering.
– Gambling, compulsive buying, compulsive
exercise, and compulsive Internet or
technology use are all process addictions.
© 2013 Pearson Education, Inc.
Disordered or Compulsive Gambling
• More than 2 million Americans are
considered compulsive gamblers, and 6
million more are considered to be at risk
for developing gambling addiction.
• Previously called pathological gambling
and now referred to as disordered
gambling by the APA, it is recognized as
a mental disorder.
© 2013 Pearson Education, Inc.
Compulsive Buying Disorder
• Shopping is often used as a way to make
people feel better about themselves, but
for compulsive shoppers, shopping
eventually makes them feel worse.
Symptoms include
– Buying more than one of the same item
– Keeping items in the closet with tags attached
– Repeatedly buying more than is needed or
can be afforded
– Hiding purchases from relatives and loved
ones
© 2013 Pearson Education, Inc.
ABC News Video: Money Rehab
Discussion Questions
1. In what ways do you think Nikki's compulsive spending
disorder causes stress and problems in her marriage?
2. What do you think the clinical psychologist means
when he states, "Money is the symptom but not the
disease"?
3. What connections did Nikki make between her
shopping compulsion and childhood memories and
trauma? What does this suggest about the effects that
psychological factors can have on addiction?
© 2013 Pearson Education, Inc.
Exercise Addiction
• A large portion of people with eating disorders
use exercise to purge, instead of, or in addition
to, self-induced vomiting.
• Exercise addicts use exercise compulsively to
meet needs for nurturance, intimacy, selfesteem, and self-competency.
• Warning signs include working out alone, rigid
exercise patterns, exercising for more than 2
hours daily, exercising when sick or injured or to
avoid social events, school, or work.
© 2013 Pearson Education, Inc.
Technology Addictions
• Cell phones, video games, PDAs, networking
sites, and the Internet can all be addictive.
• An estimated 1 in 8 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
© 2013 Pearson Education, Inc.
What Is A Drug?
• Drugs are chemicals, other than food, that
are intended to affect the structure or
function of the mind or body through
chemical action.
• Prescription medications, OTC
medications, legal substances such as
alcohol, caffeine, and tobacco, and illegal
substances such as heroin and
methamphetamines are all drugs.
© 2013 Pearson Education, Inc.
Drug Misuse and Abuse
• Abuse is 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 cause serious harm
Drug and alcohol abuse contributes to more than
120,000 American deaths a year
– Costs $467.7 billion in preventable health care
expenses, extra law enforcement, vehicle crashes,
crime, and lost productivity annually.
© 2013 Pearson Education, Inc.
The Action of Cocaine at Dopamine
Receptors in the Brain, an Example of
Psychoactive Drug Action
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How Drugs Affect the Brain
• The brain is wired to repeat pleasurable experiences.
• Life-sustaining activities activate a "pleasure circuit" of
nerve cells. One nerve cell set uses dopamine, a
neurotransmitter, and sits at the top of the brainstem in
the ventral tegmental area (VTA).
• This "pleasure circuit" is known as the mesolimbic
dopamine system.
• All addictive drugs activate the brain's pleasure circuit
and addiction alters the way the pleasure center, and
other parts of the brain, function.
– Psychoactive drugs—affect chemical neurotransmission, either
enhancing it, suppressing it, or interfering with it.
© 2013 Pearson Education, Inc.
Types of Drugs
• Prescription: obtained only with a prescription
from a licensed physician
• Over-the-counter (OTC): no prescription
needed and more than 100,000 available
• Recreational: most are legal substances:
alcohol, tobacco, coffee, etc.
• Herbal preparations: products of plant origin
• Illicit (illegal): all are psychoactive
• Commercial: found in commercially sold
products such as household cleaners,
pesticides, etc.
© 2013 Pearson Education, Inc.
Routes of Administration
• Oral Ingestion
• Inhalation
– Through the nose or mouth
• Injection
– Intravenous—into bloodstream
– Intramuscular—into muscle
– Subcutaneous—just under the skin
• Transdermal
– Through the skin
• Suppositories
– Through the vagina or anus
© 2013 Pearson Education, Inc.
Drug Interactions
• Polydrug Use
– Taking several substances simultaneously
• Synergism (Potentiation)
– Effects of both drugs are multiplied beyond the effects of each on
its own.
• Antagonism
– Drugs work at same receptor site so one drug blocks the action
of another.
• Intolerance
– When drugs combine to produce extremely uncomfortable
reactions
• Cross-tolerance
– Tolerance for one drug creates a similar reaction to another
drug.
© 2013 Pearson Education, Inc.
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.
– Enhances mental alertness and reduces 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.
© 2013 Pearson Education, Inc.
Caffeine Content Consumption
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Abuse of Over-the-Counter (OTC) Drugs
• 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.
• 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.
• Diet Pills
– Contain stimulants such as caffeine or Hoodia gordoni
– Ephedra was banned in 2004 after more than 16,000 adverse
side effects were reported.
© 2013 Pearson Education, Inc.
Prescription Drug Abuse
• Prescription drug abuse is particularly common among
teenagers and young adults.
• Abuse of opioids, narcotics, and pain relievers can result
in life-threatening respiratory depression (reduced
breathing).
• Abuse of depressants 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.
• Injecting prescription drugs can expose abusers to HIV,
hepatitis B and C, and other blood-borne viruses.
© 2013 Pearson Education, Inc.
College Students and Prescription Drug
Abuse
• Increased dramatically over the past decade
• Students who abuse Vicodin, OxyContin, or
Percocet say they do so to relax or get high.
• Students who abuse Adderal and Ritalin
(intended to treat attention deficit disorder
[ADHD]) say they do so for academic gain.
• ADHD drug users tend to have a lower grade
point average than non-users and to engage in
illegal substance use or other risky behaviors.
© 2013 Pearson Education, Inc.
College Students' Stated Reasons for
Nonmedical Use of ADHD Drugs
© 2013 Pearson Education, Inc.
Illicit Drugs
• Illicit drug use spans all age groups,
genders, ethnicities, occupations,
socioeconomic groups.
• Marijuana use has risen in recent years.
• College Students and Illicit Drug Use
– In 2009 just over 50% of college students
reported trying any drug; a third have smoked
marijuana in the past year, and 20% have
done so in the past month.
– Cocaine use is down but LSD use has more
than doubled.
© 2013 Pearson Education, Inc.
© 2013 Pearson Education, Inc.
Illicit Drugs (cont.)
• Why Do Some College
Students Use Drugs?
– Genetics and family
history
– Substance use in high
school
– Positive expectations
– Mental health problems
– Sorority and fraternity
membership
© 2013 Pearson Education, Inc.
• Why Don't Some
College Students
Use Drugs?
– Parental attitudes and
behavior
– Religion and
spirituality
– Student engagement
– College athletics
– Healthy social
network
Reasons Why College Students Use Illicit
Drugs or Controlled Prescriptions Drugs
© 2013 Pearson Education, Inc.
Common Drugs of Abuse – Stimulants
• Stimulants: increase activity of the central
nervous system.
• 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.
© 2013 Pearson Education, Inc.
Common Drugs of Abuse – Stimulants
(cont.)
• 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
• Methamphetamine
–
–
–
–
Affects brain and CNS
Euphoria lasts 6 to 8 hours.
Methods of use: snorted, injected, smoked, and ingested
Short-term effects include increased physical activity, alertness,
rapid breathing, increased body temperature, insomnia, tremors,
anxiety, confusion, and decreased appetite.
© 2013 Pearson Education, Inc.
ABC News Video: Eliminating 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?
© 2013 Pearson Education, Inc.
Marijuana and Other Cannabinoids
• Derived from either the Cannabis sativa or Cannabis
indica (hemp) plant.
• Tetrahydrocannabinol (THC) is the psychoactive
substance in marijuana; average concentration is 10
percent but some forms can contain up to 27%.
– Has many medical purposes as it controls nausea and vomiting,
improves appetite, and forestalls loss of lean muscle mass
associated with AIDS wasting syndrome, and reduces muscle
pain and spasticity caused by multiple sclerosis.
• Frequent and/or long-term use may increase risk for
testicular cancer, serious mental health problems,
suppressed immune system, and impaired memory.
© 2013 Pearson Education, Inc.
Common Drugs of Abuse – Depressants
• Opioids
– 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
© 2013 Pearson Education, Inc.
Common Drugs of Abuse – Depressants
(cont.)
• 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
– Mainlining—intravenous injection of powdered heroin
mixed in a solution; the most common route of
administration
© 2013 Pearson Education, Inc.
ABC News Video: Heroin in Suburbia
Discussion Questions
1.
2.
3.
Are you surprised that a drug like heroin is widely
available in many American suburbs? Why or why not?
Why do you think many people do not associate a drug
like heroin with middle-class America?
Why do you think rehab is not always successful for an
addict? What do you think is necessary for a person to
beat an addiction?
What are some possible signs that someone you know
might be experimenting with drugs? Name some steps
you might take to help someone you know get help
with his or her addiction.
© 2013 Pearson Education, Inc.
Treatment for Heroin Addiction
• Methadone Maintenance
– Blocks effects of opiates withdrawal
– Potentially addictive itself
• Naltrexone (Trexan)
– Opiate antagonist
– Lose compulsion to use heroin
• Temgesic (buprenorphine)
– Blocks cravings for heroin
– Non-addictive
© 2013 Pearson Education, Inc.
Common Drugs of Abuse – Depressants
• 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.
© 2013 Pearson Education, Inc.
Common Drugs of Abuse – Depressants
(cont.)
• 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 (body building) effects
– Another "date rape" drug
– Side effects include loss of memory,
unconsciousness, amnesia, hallucinations, and death.
© 2013 Pearson Education, Inc.
Common Drugs of Abuse – Hallucinogens
• Hallucinogens create auditory or visual
changes in mood, thoughts, and feelings.
– Synesthesia—mixing of sensory messages
– May "hear colors" and "smell tastes"
• Lysergic Acid Diethylamide (LSD) (acid)
– In 1970 it was placed on controlled substances list.
– Over 9% of Americans have tried acid.
– Commonly sold as a "blotter" on paper, it is one of the
most powerful drugs known to science, and minute
quantities produce strong effects.
© 2013 Pearson Education, Inc.
Common Drugs of Abuse – Hallucinogens
(cont.)
• Ecstasy methylenedioxymethamphetamine (MDMA)
– Most common club drug causes feelings of
extreme euphoria, openness, and warmth.
– Risks include inappropriate emotional
bonding, jaw clenching, tongue and cheek
chewing, short-term memory loss or
confusion.
– Chronic use can damage the brain.
– Combined with alcohol, Ecstasy can be fatal.
© 2013 Pearson Education, Inc.
Common Drugs of Abuse – Hallucinogens
(cont.)
• PCP – Phencyclidine
– Originally developed as a dissociative anesthetic
– Effects depend on dose and include slurred speech,
impaired coordination, fever, nausea, and total loss of
sensitivity to pain.
– Doses greater than 10 mg can cause convulsions and
death.
• Mescaline
– Derived from peyote cactus; Native Americans have
used it for religious purposes.
– It is a powerful hallucinogen and CNS stimulant.
– Generally induces immediate vomiting.
© 2013 Pearson Education, Inc.
Common Drugs of Abuse – Hallucinogens
(cont.)
• Psilocybin
– Similar to LSD in effect
– Effects generally wear off in 4 to 6 hours.
– Cultivated from spores or harvested wild.
– Mushroom varieties can be easily
misidentified, and mistakes can be fatal.
• Ketamine (Special K)
– Used as an anesthetic in many hospital and
veterinary clinics.
– Causes hallucinations and sensory
distortions.
© 2013 Pearson Education, Inc.
Common Drugs of Abuse – Inhalants
• Users inhale chemicals causing hallucinations
and euphoric effects.
• Legal to purchase and not commonly recognized
as drugs, though dangerous when used
incorrectly
• Include glue, paint thinner, and rubber cement.
• Amyl nitrate and nitrous oxide are also abused.
• Users experience dizziness, disorientation,
impaired coordination and judgment; combined
with alcohol may be fatal.
© 2013 Pearson Education, Inc.
Common Drugs of Abuse – Anabolic
Steroids
• Artificial forms of the male hormone testosterone
that promote muscle growth and strength
• Produce state of euphoria, diminished fatigue,
and increase bulk and power in both sexes
• Adverse side effects include mood swings ("roid
rage"), acne, liver tumors, elevated cholesterol,
hypertension, and kidney disease.
• In women, large doses trigger development of
male attributes; in men, anabolic steroids shut
down testosterone production, causing men's
breasts to grow and testicles to atrophy.
© 2013 Pearson Education, Inc.
Treatment and Recovery
• An estimated 23.5 million Americans
needed treatment for illicit drug or alcohol
abuse in 2008, but only 2.6 million
received treatment.
• Detoxification is an early abstinence
period when the addict physically and
cognitively adjusts to being free from the
addiction's influence.
© 2013 Pearson Education, Inc.
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
© 2013 Pearson Education, Inc.
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 help with recovery.
• A growing number of colleges are offering
special services to students who are recovering
from alcohol and other drug addictions and want
to stay in school without being exposed to
excessive drinking or drug use.
© 2013 Pearson Education, Inc.
Addressing Drug Misuse and Abuse in the
United States
• Drug abuse has been part of human
behavior for thousands of years and is not
likely to disappear in the near future.
• Harm reduction strategies
– Needle exchange programs
– Changing legal sanctions and increasing
treatment services
– Minimizing potential hazards with drug use
rather than the use itself
© 2013 Pearson Education, Inc.