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WHY A COURSE ON ADDICTIVE BEHAVIORS?
• Study of Drug Use and Misuse Important
• A part of life in our culture - pervasive
• Affects everyone: we all have choices to make about what
we do and don’t do, what we ingest and what we avoid
• Can have harmful consequences for individual, family,
community, and society
• Substance use disorders are both preventable and
treatable
• We are constantly being presented with information about
licit and illicit substances and activities - how do we
evaluate it?
OVERARCHING PRINCIPLES
• Study of Drug Use and Misuse has Experiential and
Scientific Basis
• Drugs are Neither Good Nor Bad: Context
• The Continuum: Drug Use, Misuse, and Dependence
• All Drugs and Potentially Addictive Behaviors Have a
History and Cultural Context
• e.g., religious, spiritual usage; use for health /
medical reasons
Drug Use, Misuse, and “Addiction”
• What is a drug?
• What is an addiction? An addict?
___________
• Themes associated with “addiction”
• Conceptions and definitions vary
Dependence Potential of Psychoactive Drugs
Very High:
High:
Moderate/High:
Moderate:
Moderate/Low:
Low:
Very Low:
Heroin (IV)
Crack cocaine
Morphine
Opium (smoked)
Cocaine powder
Tobacco cigarettes
PCP (smoked)
Diazedpam (Valium)
Alcohol
Amphetamines (oral)
Caffeine
MDMA(Ecstasy”)
Marijuana
Ketamine
LSD, Mescaline
Psilocybin
Major Stimulants - Cocaine
 street cocaine: coca paste and hydrochloric acid =
type of salt--powder sniffed or snorted
more addictive uses:
 can inject it--IV quicker
 smoking: freebase - powder and ether
 crack - dissolve cocaine salt in baking soda solution,
boil off water, left with rock
 Cocaine - ETOH combo (coca-ethylene)
- may alter metabolics of
cocaine, which may be more cardiotoxic via increased half-life of cocaine
Major Stimulants - Speed
Amphetamines
 ephedrine, principal chemical in these drugs, has been
known for thousands of years; used as Chinese medicinal
herb
 ephedrine first isolated in late 1800's, and synthesized in
1920s when it was named “amphetamine”
 first medically used in 1920's for treating obesity,
narcolepsy, colds, and much later ADHD
 used to enhance performance, decrease fatigue – sport &
military applications (e.g., go and no-go pills)
Classes/Types of Depressants
 1. Anesthetics (ex. ether, nitrous oxide)
 2. Barbiturates
 3. Benzodiazepines (anxiolytics - ex. ? )
 4. Buspar
 Many labels have been used to describe
them, which can be confusing:
-tranquilizers
-anti-anxiety pills
-sleeping pills
-sedatives
Hallucinogens
Types
1. Serotonergic hallucinogens
chem similar to serotonin
2. Methylated amphetamines
chem similar to norepinephrine...alterations in mood without much
change in senses
3. Anticholinergic - (Ach)
 found in plants: belladonna, mandrake, jimson weed
trance or dream-like states
4. Dissociative anesthetics
can remain conscious in surgery; causes euphoria, numbness,
aggressive behavior, and tactile sense disturbances
MDMA
Cannabis
 Negative effects
- withdrawal symptoms that may occur after
heavy use include:
1.
nausea
2.
irritability
3.
sleep problems
- apathy, decrease in motivation
- short-term memory impairment (hippocampus,
2-AG
may play role in memory loss)
- impaired driving
- may trigger paranoia, usually mild forms
Cannabis - Negative Effects
- chronic use associated with low sperm count, abnormal
sperm formation and motility, and possible male
impotence; enlarged breasts in males has also been
reported.
- in females, failure to ovulate has been noted
- if used during pregnancy may be associated with low
birth weight, premature birth (but these women may also
be smokers, drinkers)
- pot as a “gateway” drug (Adolescents tend to use drugs
in this sequence: cigarettes, alcohol, pot, cocaine-heroin)
OPIOIDS
I.
Where do they come from?
 poppy plant: from middle east and Asia
 dried sap from plant is opium; cultivated annually
 major active ingredient in opium: morphine (3-10 x as strong)
/ synthesized in 1803
/ named after the Greek god of dreams Morpheus
/ morphine altered in late 1800s into heroin-a “heroic” TX (10
x as strong as morphine)
/ Fentanyl
OPIOIDS
II.
Medical Uses
 As pain reliever (morphine, demerol, codeine, lortab,
lorcet, percodan, percocet, vicodin)
 with chronic pain or terminal patients
 in some cough suppressants
 treatment of diarrhea, which is dehydrating
ALCOHOL
Alcohol’s Pharmacology
 It is a CNS depressant
 Peak concentrations are reached between
30-90 minutes after drinking is stopped
 Alcohol is distributed to all tissues in the
body and passes to the brain easily
 LD 50 is 25 drinks in 1 hour; BAC of .45 .55
(BAC is expressed as a ratio of milligrams or weight of
most of the consumed alcohol metabolized in liver
broken down to acetaldehyde
(by ADH - alcohol dehydrogenase and
then to acetic acid by aldehyde dehy.)
carbon dioxide and water
excreted by lungs
excreted in urine
Addiction and Withdrawal
Indicators
 Is it Addictive? How do we know?
 Tolerance (cellular & metabolic) develops
 Withdrawal symptoms occur
 BAC can still be above .00 for withdrawal sx to
begin
Long-term Consequences
cont.
 Physical:
 fatty liver, alcohol hepatitis, and cirrhosis
 increased risk of CAD and various types of
cancers
 increased susceptibility to illness; lower
immune system functioning
 GI problems such as pancreatitis
 FAS: small eyes, droopy eyelids, small
head, low intellectual functioning;
associated with low SES
Long-term Consequences
cont.
 Cognitive:
 impairs memory, problem-solving, learning
and reaction time
 neuropsychological damage can be
reversed with prolonged abstinence
 Wernicke-Korsakoff Syndrome
 unable to learn new material due to failure to
transfer
 confabulation
College binge drinking
1997 Harvard Study:
• 43% binged in prior 2 weeks (48% men; 39% women)
• about 65% of the members of frats/sor. Binged
• Reasons for drinking
• “get drunk”
1993
1997
39%
52%
•READ: Alcohol in the Lives of College Women