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Substance Use and Abuse Chapter 13 Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher Education. All rights reserved. Drugs • Drug = any chemical other than food intended to affect the structure or function of the body • Psychoactive drug = a drug that can alter a person’s consciousness or experiences • Intoxication = the state of being mentally affected by a chemical • Psychoactive drugs are widely used for medical and social purposes Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 2 Nonmedical Drug Use Percentage Using Substance in the Past 30 Days College Students All Americans Any illicit drug 21.4 8.2 Alcohol 64.9 51.1 Binge alcohol use 43.5 22.6 Tobacco (all forms) 36.4 29.8 Cigarettes 31.4 25.4 Cigars 11.5 5.4 Spit tobacco 3.8 3.3 Pipes 0.9 0.7 Marijuana/hashish 18.4 6.2 Cocaine 2.1 1.0 Crack 0.0 0.3 Heroin 0.0 0.1 Hallucinogens 1.8 0.4 LSD 0.4 0.1 Ecstasy 0.6 0.2 Inhalants 0.6 0.2 Psychotherapeutics* 5.8 2.7 Pain relievers 4.4 2.0 Tranquilizers 1.3 0.8 Stimulants 1.3 0.5 Methamphetamine 0.1 0.3 Sedatives 0.1 0.2 *Nonmedical use of prescription-type medications. SOURCE: SAMHSA National Survey on Drug Use and Health Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 3 Addictive Behavior • Addictive behavior = any habit that is out of control, resulting in a negative impact on a person’s health • General characteristics associated with addictive behaviors: – Reinforcement – Compulsion or craving – Loss of control – Escalation – Negative consequences Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 4 The Development of Addiction • Common behaviors are potentially addictive • No single cause of addiction – Individual characteristics • Coping abilities – Environmental factors or aspects of the specific behavior or substance Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 5 Examples of Addictive Behaviors • Compulsive or pathological gambling – An increasing problem – High suicide rate • Compulsive buying or shopping • Internet addiction Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 6 Drug Use and Abuse • Dependence/addiction is most commonly associated with psychoactive drugs MDMA (ecstasy) Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 7 Use, Abuse, and Dependence • Drug (substance) abuse = a maladaptive pattern of use of any substance that persists despite adverse consequences; pattern may be intermittent, with or without physical dependence – Recurrent drug use, interfering with responsibilities – Recurrent drug use in potential physically hazardous situations – Drug-related legal problems – Continued use despite social and interpersonal problems Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 8 Use, Abuse, and Dependence • Drug (substance) dependence = a cluster of symptoms that occur in an individual who continues to use a substance despite suffering significant problems, leading to significant impairment or distress • Three or more of these seven symptoms: (1) Developing tolerance to the substance = lower sensitivity to drug so that a given dose no longer exerts the usual effect and larger doses are needed (2) Experiencing withdrawal = symptoms that follow the interrupted use of a drug Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 9 Use, Abuse, and Dependence (3) Taking the substance in larger amounts or over a longer period than intended (4) Expressing a persistent desire to cut down on or regulate substance use (5) Spending a great deal of time obtaining the substance, using the substance, or recovering from its effects (6) Giving up or reducing important school, work, or recreational activities because of substance use (7) Continuing to use the substance in spite of recognizing that it is contributing to a psychological or physical problem Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 10 Who Uses (and Abuses) Drugs? • All income and education levels • All ages and all ethnic groups • Characteristics of higher-thanaverage risk – Being male – Being young – Having frequent exposure to drugs – Being disinterested in school – Having a risk-taking personality Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 11 Examples of Psychoactive Drugs • Opioids = opium, morphine, heroin, codeine, oxycodone, hydrocodone • CNS depressants = alcohol, barbiturates, Xanax, Valium, Rohypnol, methaqualone, GHB • CNS stimulants = cocaine, amphetamines, nicotine, Ritalin, ephedrine, caffeine • Cannabis products = marijuana, hashish • Hallucinogens = LSD, mescaline, psilocybin, PCP, MDMA (ecstasy), ketamine • Inhalants = aerosols, solvents, nitrites, anesthetics Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 12 Sources of Drugs Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 13 Sources of Caffeine Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 14 Treatment for Drug Abuse • There is no single best method of treatment • Treatment programs – Drug substitution – Treatment centers – Self-help groups – Peer counseling Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 15 Preventing Drug Abuse • Best solution to drug abuse is prevention • For young people – Build self-esteem – Improve academic skills – Increase recreational opportunities – Provide accurate information http://www.youtube.com/watch?v=J46pvxFWNTY Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 16 The Role of Drugs in Your Life • What are the risk involved? • Is using the drug compatible with your goals? • What are your ethical beliefs about drug use? • What are the financial costs? • Are you trying to solve a deeper problem? Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 17 Alcohol Use Among Americans Source: National Center for Health Statistics Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 18 Alcohol Use Among Americans Source: National Center for Health Statistics Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 19 Chemistry and Metabolism • Ethyl alcohol = intoxicating ingredient in fermented liquors • Metabolized in the liver Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 20 Alcohol: Immediate Effects • Blood alcohol concentration (BAC) = the amount of alcohol in the blood in terms of weight per unit volume; used as a measure of intoxication • The body can metabolize about one-half a drink in an hour • Low doses of alcohol induce relaxation and release inhibitions • High doses of alcohol have many dangerous physical and psychological effects • Alcohol is the leading cause of death among people ages 15 to 24 years Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 21 Blood Alcohol Concentration and Body Weight Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 22 Drinking and Driving: BAC and Risk of Motor Vehicle Crashes Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 23 Angels Pitcher Nick Adenhart Killed In Car Crash April 9, 2009 Two people who were with him were also killed when, according to police, a minivan ran a red light at a Fullerton intersection and broadsided the gray Mitsubishi they were in. The driver of the minivan, Andrew Thomas Gallo, 22, of Riverside, was arrested on suspicion of drunken driving, hit and run and manslaughter. © 2010 McGraw-Hill Companies. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher Education. All rights reserved. 24 Effects of Chronic Use of Alcohol • Reduced life expectancy • Cirrhosis = a disease in which the liver is severely damaged • Increased risk of heart attack and cancer • Psychological problems and brain damage • Drinking during pregnancy – Fetal alcohol syndrome = a characteristic group of birth defects – Alcohol-related neurodevelopmental disorder = learning and behavioral problems Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 25 Cirrhosis Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 26 Alcohol Abuse and Dependence • Alcohol abuse = the use of alcohol to a degree that causes physical damage, impairs functioning, or results in behavior harmful to others • Alcohol dependence (alcoholism) = a chronic psychological disorder, characterized by excessive and compulsive drinking – Development of tolerance and withdrawal – DTs (delirium tremens) = state of confusion brought on by the reduction of alcohol intake in a dependent person Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 27 Binge Drinking • Binge drinking = periodically drinking alcohol to the point of severe intoxication – 5 or more drinks in a row for men – 4 or more drinks in a row for women • Reported by 44% of college students; 23% of students are frequent binge drinkers • Binge drinking affects both drinking and nondrinking students and contributes to – 1,700 deaths per year – 70,000 cases of date rape per year – 500,000 injuries per year Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 28 Binge Drinking Percentage of Students Experiencing Problems Alcohol-Related Problem Non–Binge Frequent Binge Drinkers Drinkers Drove after drinking alcohol 18 58 Did something they regretted 17 62 Argued with friends 10 43 Missed a class 9 60 Got behind in schoolwork 9 42 Got hurt or injured 4 28 Had unprotected sex 4 21 Got into trouble with police 2 14 Had five or more of these problems since school year began 4 48 SOURCE: Wechsler, H., and B. Wuethrich. 2002. Dying to Drink: Confronting Binge Drinking on College Campuses. Emmaus, Pa.: Rodale. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 29 Drinking and Responsibility • Examine your attitudes and behavior • Drink moderately and responsibly – – – – – – Drink slowly and space your drinks Eat before and while drinking Know your limits and your drinks Be aware of the setting Use designated drivers Learn to enjoy activities without alcohol • Encourage responsible drinking in others – – – – Encourage responsible attitudes Be a responsible host Hold drinkers fully responsible for their behavior Take community action Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 30 Tobacco • Adult male and female smokers lose an average of 13.2 and 14.5 years of life, respectively, because they smoke • Every cigarette smoked reduces life expectancy by about 11 minutes • A per-pack habit costs about $3000 per year http://www.youtube.com/watch?v=zRQVqlXhN5c Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 31 Tobacco Use: Nicotine Addiction • Nicotine = a poisonous, addictive substance found in tobacco and responsible for many of the effects of tobacco • More than 80% of adult tobacco users started smoking before they were 18 years old Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 32 Health Hazards • Contains hundreds of damaging chemical substances, including acetone (nail polish remover), ammonia, hexamine (lighter fluid), and toluene (industrial solvent). • Unfiltered cigarettes = 5 billion particles per cubic mm • 50,000 times more than polluted urban air • Condensed particles in the cigarette produce the tar (brown, sticky mass) Chapter 8 Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher Education.All AllRights rights reserved. ©2008 McGraw-Hill Companies. 33 Health Hazards (cont) Carcinogens and Poisons • 43 chemicals are linked to cancer (Carcinogen) – Benzo(a)pyrene (yellowish tar) – Urethane (ex: solution used in making foams) • Cocarcinogens – Combine with other chemicals to cause cancer (e.g., formaldehyde) • Poisonous substances – Arsenic (e.g., insectides and weed killers) – Hydorgen cyanide (e.g., flammable liquid used in dye) • Carbon monoxide – 400 times greater than is considered safe in industrial workplaces – Displaces oxygen in red blood cells • Additives – Nearly 600 chemicals Chapter 8 Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher Education.All AllRights rights reserved. ©2008 McGraw-Hill Companies. 34 Chemical Process of Nicotine Addiction Nicotine stimulates the release of dopamine, a neurotransmitter associated with pleasurable feelings SOURCE: Schwartz, S. 2000. Abnormal Psychology: A Discovery Approach. Mountain View, Calif.: Mayfield. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 35 Short-Term Effects of Smoking a Cigarette Figure 13.4 Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 36 Damage to the Lungs from Smoking Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 37 Health Hazards of Cigarette Smoking • Chronic diseases, including heart attack, stroke, hypertension, respiratory diseases, osteoporosis, and many forms of cancer • Tooth decay, gum disease, bad breath, colds, ulcers, hair loss, facial wrinkling, discolored teeth and fingers • Impotence, infertility, menstrual disorders, stillbirth, low birth weight • Motor vehicle crashes and fire-related injuries Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 38 Other Forms of Tobacco Use • Cigars and pipes • Clove cigarettes and bidis • Spit (smokeless) tobacco – Sniff – Chewing tobacco Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 39 Environmental Tobacco Smoke • Environmental tobacco smoke (ETS) = smoke that enters the atmosphere from the burning end of a cigarette, cigar, or pipe as well as smoke that is exhaled by smokers – Mainstream smoke = smoke that is inhaled by a smoker and then exhaled into the atmosphere – Sidestream smoke = smoke that enters the atmosphere from the burning end of a cigarette, cigar, or pipe Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 40 Environmental Tobacco Smoke Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 41 Environmental Tobacco Smoke • Effects of ETS – Cancer – CVD – Asthma, cough, and other respiratory conditions – Headache, nasal discomfort, eye irritation • Children and infants are particularly vulnerable to the effects ETS • Avoiding ETS Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 42 Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 43 Smoking and Pregnancy • Maternal smoking causes an estimated 4600 infant deaths in the United States each year • Smoking during pregnancy is linked to – Ectopic pregnancy = pregnancy in which the fertilized egg implants itself in an oviduct rather than in the uterus – Sudden infant death syndrome (SIDS) – Low birth weight – In infants and children—developmental delays, hyperactivity, short attention span, learning problems Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 44 Action Against Tobacco • Increased taxes • Federal, state, and local laws to regulate tobacco use and advertisement • Legal action Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 45 Giving Up Tobacco • Since 1964, more than 50% of all adults who ever smoked have quit • No single method works for everyone • Many options – Nicotine replacement products – Anti-depressant medication – Support groups Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher All rights reserved. ChapterEducation. 13 46 Substance Use and Abuse Chapter 13 Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 13 ©2007 McGraw-Hill Higher Education. All rights reserved.