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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
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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
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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
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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
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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
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Examples of Addictive Behaviors
• Compulsive or pathological gambling
– An increasing problem
– High suicide rate
• Compulsive buying or shopping
• Internet addiction
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Drug Use and Abuse
• Dependence/addiction is most
commonly associated with
psychoactive drugs
MDMA (ecstasy)
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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
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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
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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
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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
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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
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Sources of
Drugs
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Sources of
Caffeine
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Treatment for Drug Abuse
• There is no single best method of
treatment
• Treatment programs
– Drug substitution
– Treatment centers
– Self-help groups
– Peer counseling
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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
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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?
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Alcohol Use Among Americans
Source: National Center for Health Statistics
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Alcohol Use Among Americans
Source: National Center for Health Statistics
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Chemistry and Metabolism
• Ethyl alcohol = intoxicating
ingredient in fermented liquors
• Metabolized in the liver
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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
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Blood Alcohol Concentration
and Body Weight
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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
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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.
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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
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Cirrhosis
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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
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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
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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.
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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
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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
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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
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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
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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
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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.
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Short-Term Effects of
Smoking a Cigarette
Figure 13.4
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Damage to the Lungs from
Smoking
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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
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Other Forms of Tobacco Use
• Cigars and pipes
• Clove cigarettes and bidis
• Spit (smokeless) tobacco
– Sniff
– Chewing tobacco
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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
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Environmental
Tobacco Smoke
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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
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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
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Action Against Tobacco
• Increased taxes
• Federal, state, and local laws to
regulate tobacco use and
advertisement
• Legal action
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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
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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
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