Download Illicit Drugs

Chapter 13
Substance Abuse
Substance Abuse: What Is It, and
Why Is It Important?
• Substance abuse: the overuse, misuse,
or addiction to any chemical substance
• There are many forms of substance
abuse, including the single greatest
preventable cause of deaths in the
United States
Key Terms
• Drugs
• Recreational drugs
• Drug misuse
• Drug abuse
• Psychological dependence
• Tolerance
Drugs and the Law
• The lines between drugs that are legal and illegal
can change.
– Prohibition
– LSD and heroin were developed for medical use
– Marijuana is legal in some situations in 12 U.S.
states, but illegal at the Federal level
• Many drugs that are legal can still be very harmful
and easy to abuse (alcohol, tobacco, prescription
drugs)
Effects of Drug Use
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Physiological changes
Mental dependence
Conflicts in interpersonal relationships
Drug-related crime
Creation of treatment facilities
Loss of individual productivity
Care for children of drug-dependent parents
Policing of illicit drug availability
Treatment of medical complications
Substance Use and Abuse
Sociocultural Dimensions
Factors increasing likelihood of drug abuse
• Significant life stressors
• Sexual and physical abuse
• Low self-esteem, self-deprecation, anxiety,
conflict
• Lower socioeconomic status
Legal Dimensions
• Illicit drug use disproportionately affects people of
color.
• Hispanic and African American drug offenders have
a greater chance of being sentenced to prison than
white offenders; African Americans also receive
longer prison sentences than do white offenders.
• Compared to 35 years ago, nearly 10 times the
women are currently incarcerated for drug use
• Drug use during pregnancy: new laws focusing on
punishment rather than treatment
Economic Dimensions:
Illicit Drugs
• Illicit drug use causes about 50,000 deaths a
year and costs $200 billion a year in the U.S.
(includes direct and indirect effects)
• $26 billion a year in federal spending to
prevent drug use, offer treatment services,
fight drug trafficking, and improve drug
enforcement and development in other
countries
Economic Dimensions: Legal drugs
• Tobacco use causes about $200 billion in
economic damages every year (directly and
indirectly) and about 440,000 deaths per year (9x
deaths from illicit drugs)
• Pack-a-day smokers spend more than
$1,000/year on cigarettes
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Economic impact of alcohol
abuse: $225 billion a year,
mostly through lost
productivity
Who Is Smoking?
Most smokers begin their habits
during the years of high school,
often before it is legal to do so.
Legal Dimensions of Tobacco Use
Examples of recent smoking legislation include:
• Taxes (2009 SCHIP increase)
• Youth access
• Tobacco product vending machine sales
• Advertising and promotion
Discuss: What are the short-term and long-term
goals of each of these efforts? What are the pros
and cons for each?
Health Consequences
Physiological Effects of Cigarette Smoking
Cigarette smoking
during pregnancy also
has serious
consequences for a
growing fetus.
U.S. Deaths (Male and Female)
Attributable to Cigarette Smoking
Cigarette smoking is a
major cause of heart
disease, cancer (lung
and other kinds), and
respiratory diseases.
Quitting Tobacco
• Often the best decision a woman can
make for her health
• Not easy, but it can be done (often on
2nd, 3rd, or 4th attempt)
• Many options available: nicotine
replacement therapy, medications,
support groups, and therapy.
• 1-800 QUIT NOW for more resources
Alcohol
• Alcohol: a colorless
liquid obtained by
fermentation of a sugarcontaining liquid (ethyl
alcohol)
• Moderate drinking (1
drink a day for women)
may reduce the risk for
heart disease.
• Heavier drinking
(especially binge
drinking) can have
serious harmful effects
on health.
Epidemiological Trends and Issues
• 47% of females age 12 and older report current
alcohol use
• 57% of women aged 18–25 report current alcohol use
• Underage drinking:
– 24% of female teenagers drank within the past
month
– 14% engaged in recent binge drinking
– 4% had many recent binge drinking episodes
• Alcohol use is higher in the Northeast (58%), Midwest
(55%), West (51%), South (48%)
Complications from Chronic
Alcohol Consumption
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Cancer
Cardiovascular effects
Organ damage
Diabetes
Fetal alcohol syndrome
Impotency and infertility
Diminished immunity
Sleep disturbances
Alcoholism
Warning signs of alcoholism
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Having five or more drinks per day
Needing a drink to start off the day
Denial of alcohol problem
Changing brands to control drinking
Depression and paranoia
Failure to recall what happened during a drinking
episode
• Dramatic mood swings
• Doings things while drinking and regretting them
afterward
Alcohol Use: Gender Differences
• Men metabolize alcohol faster than
women
• A person’s size also influences the
effects of a given amount of alcohol
• Hormones affect alcohol metabolism
• Alcohol consumption can affect
pregnancy
Illicit Drugs
• Stimulants (caffeine, cocaine, crack,
amphetamines, anabolic steroids)
• Depressants and antianxiety drugs (alcohol,
barbiturates, benzodiazepines such as Xanax
and Valium)
• Cannabis (marijuana, hashish)
• Psychedelics and hallucinogens (LSD)
• Narcotics (opium, heroine, morphine, codeine)
• Inhalants
• Designer drugs (MDMA or ecstasy)
Illicit Drugs
Epidemiological Trends and Issues
Who Uses Illicit Drugs*?
• About 45% of Americans drug over the age of 12 have
tried an illicit drug.
• Women are less likely to have tried a drug than men
(41% vs 50%).
• Whites (49%) and Native Americans (59%) are more
likely to have tried a drug than people who are black
(43%), Asian (24%) or Hispanic (35%).
• About 8% of Americans (6% of women) have used an
illicit drug in the past month.
*Illicit drugs include marijuana, cocaine, crack, heroin,
hallucinogens, inhalants, methamphetamines, and prescription
drugs for nonmedical purposes. Source: SAMHSA
Physiological Effects of Drugs
Stimulants: Increase heart rate, blood pressure,
strength of heart contractions, blood glucose level,
muscle tension
Depressants: Relax the CNS and decrease functions
Cannabis: Causes alterations in perception and
reactions; increases heart rate
Psychedelics and hallucinogens: Alter perception,
thoughts, reality, mood, sensation, heart rate, body
temperature; possible acute anxiety attack
Physiological Effects of Drugs
Narcotics: Slow respiration, pain levels; high potential for
abuse; over time, heart infections, skin abscesses, lung
congestion
Inhalants: Slow bodily functions; over time, liver failure,
kidney failure, respiratory failure, destruction of bone
marrow and skeletal muscles
Designer drugs: Chronic use may cause brain damage,
significant impairment in visual and verbal memory
Prescription Drugs
Three classes most commonly abused
• Opioids prescribed for pain, which include morphine,
codeine, oxycodone (OxyContin, Percocet, Percodan)
• Depressants for anxiety and sleep disorders, such as
benzodiazepines and barbiturates (Valium, Librium,
Xanax)
• Stimulants for sleep disorders and attention-deficit
hyperactivity disorder (Dexedrine, Ritalin)
Every year, more than 6 million Americans reported using
prescription drugs for nonmedical purposes.
Drug Dependency
Treatment Dimensions
Detoxification: Supervised withdrawal with or without
medication
Therapeutic communities: Highly structured, drugfree environments
Outpatient drug-free programs: Self-help programs
such as Narcotics Anonymous (NA) or Pills
Anonymous (PA)
Gender differences in treatment programs: Only
about 60% of U.S. substance abuse treatment
facilities provide special programs or services for
women
Informed Decision Making
Personal Responsibilities
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Virtually everyone has used some drug at one
point or another
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Have you ever noticed a harmful consequence
of a drug you ingested?
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What other consequences can drug use bring?
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How do you decide how to keep yourself at a
safe, acceptable level?