AGENDA Drug News Questions from 1st day? Chapter One Remember, next (this) Monday is Labor Day, School Holiday Wednesday, 1st homework assignment, Newspaper article due Up to Slide 70

Chapter One Chapter One Intro to Drugs and Society Instructor Edward Ramirez

Various Drugs

Chapter One Chapter One is an overview of all the chapters and what we will cover in class during the lectures! It will cover the various drugs, history, affects, dependency and identity of the various classifications of drugs

The Production of Drugs The production of drugs may be divided into three categories: Those processes which require only plant products, Those involving a semi-synthetic process where natural materials are partly changed by synthetic substances to produce the final product and (??) Example? Processes which use only man made chemicals to produce consumable drugs. Examples of these three are (a) opium gathered in the fields for home use, (b) coca bush leaves processed to make cocaine and (c) narcotic or psychotropic drugs made entirely in the laboratory or factory

Introduction An Overview Anyone can become dependent and addicted to a drug. Most people do not realize that drug use causes at least three major simultaneous changes Social and Psychological Pharmacologically Desire We will cover these

What are they? The Three Major Simultaneous changes are: The Social/psychological-basis of the attraction to a particular drug. Feeling rewarded or satisfied from social pressures Pharmacologically-alters body chemistry. Slows down or distorts the reception and transmission of reality Desire- The desire may satisfy an inborn or genetically programmed need or desire

What we will cover What constitutes a drug? What are the most commonly abused drugs? What are designer drugs? How widespread is drug use? What is the extent and frequency of drug use in our society? What are the current statistics and trends in drug use?

Cont’d What types of drug users exist? How does the media influence drug use? What attracts people to drug use? When does drug use lead to drug dependence? When does drug addiction occur? What are the costs of drug addiction to society? What can be gained by learning about the complexity of drug use and abuse?

The Dimensions of Drug Abuse Class, what do you think of drug use in our society? Worst or better than from years ago, examples Let’s take a few moments to discuss this!

We will cover this in a moment! What is a Drug? Take a few moments to think this through! Take out a piece of paper and, “Please write your definition of what a drug is in your own words” We will cover this in a moment! Slide #17

Dimensions of Drug Use Drug users are found in all occupations and professions, at all income and social class levels, and in all age groups. No one is immune to drug use, which often leads to drug dependence. Thus, drug use is an equal-opportunity affliction.

Insiders/Outsiders Insiders- People on the inside, those who approve of and/or use drugs Outsiders- People on the outside, those who do not approve of and/or use drugs

Drug Use Why? We as a society use: Prior socialization, family upbringing, siblings, peer pressure from friends Exposure to drug use Age of initial exposure Attitude change (acceptance or rejection of using drugs)

Four Principle Factors That Affect Drug Use Biological, genetic, and pharmacological Factors: How does a drug affect the body? How do drug ingredients interact with the body and the nervous system? Cultural Factors: Society’s views, determined by custom and tradition, affect our initial approach to and use of a particular drug. phar·ma·col·o·gy   (fär′mə-kŏl′ə-jē)n. 1. The science of drugs, including their composition, uses, and effects. 2. The characteristics or properties of a drug, especially those that make it medically effective.

Cont’d Social Factors: What are the specific reasons why a drug is taken (curing an illness, self-medicating, peer pressure, family upbringing, membership in drug-abusing subcultures, etc)? Contextual Factors: How do physical surroundings (rock concerts, nightclubs, or fraternity and sorority parties) affect drug use?

What is a Drug? Let’s take a look at what we as a class said/indicated a drug is: Any substance that modifies (by enhancing, inhibiting, or distorting) mind and/or body functioning

Substances that affect both mind and body Although substances that affect both the mind and body functioning are commonly called drugs, researchers in the field of drug or substance abuse use a more precise term: Psychoactive drugs (substances)

Psychoactive Withdrawal Symptoms How drugs affect the body. How drug substances have an effect on the Central Nervous System (CNS) & Brain Addiction Withdrawal Symptoms Generally speaking, any substance that modifies the CNS and states of consciousness is a DRUG

Dimensions of drug use cont’d For many substances, a user is at risk. Whenever the drug is not supplied, a chronic user may then risk addiction and experience withdrawal symptoms that are physical and/or psychological in nature whenever the drug is not supplied

Addiction Generally refers to the psychological attachment to a drug(s); addiction to “harder” drugs such as heroin results in both psychological and physical attachment to the chemical properties of the drug, with the resulting satisfaction (reward) derived from using the drug in question

Withdrawal Symptoms Psychological and physical symptoms that result when a drug is absent from the body; physical symptoms are generally present in the cases of drug dependence to more addictive drugs such as heroin, physical and psychological symptoms of withdrawal include perspiration, nausea, boredom, anxiety, and muscle spasms

Psychoactive Drugs Psychoactive drugs are classified as either: Licit (Legal) Examples may include coffee, tea, alcohol, tobacco, and over-the-counter drugs. Illicit (Illegal) Examples may include marijuana, cocaine, LSD, etc.

© Yeko Photo Studio/ShutterStock, Inc. Figure 00.01 © Yeko Photo Studio/ShutterStock, Inc.

© Yeko Photo Studio/ShutterStock, Inc. Figure 00.03 © Yeko Photo Studio/ShutterStock, Inc.

© Mariusz Szachowski/ShutterStock, Inc. Figure 00.04 © Mariusz Szachowski/ShutterStock, Inc.

© iStockphoto/Thinkstock Figure 00.05 © iStockphoto/Thinkstock

© Nikita Starichenko/ShutterStock, Inc. Figure 00.06 © Nikita Starichenko/ShutterStock, Inc.

© Mikael Damkier/ShutterStock, Inc. Figure 00.07 © Mikael Damkier/ShutterStock, Inc.

© Comstock Images/Getty Images Figure 01.UN01: Examples of illicit drugs that can become costly once drug dependence occurs. © Comstock Images/Getty Images

Over the Counter OTC Drugs sold without a prescription

Page 7 Table 1.1 Figure 01.T01A: A Sampling of Slang Terms Relating to Drugs and Drug Use Reproduced from Office of National Drug Control Policy (ONDCP). Street Terms: Drugs and the Drug Trade. Washington, DC: ONDCP, 2010. Available http://www.expomed.com/content/drugterms.pdf.

Figure 01.T01B: A Sampling of Slang Terms Relating to Drugs and Drug Use

Gateway Drugs Stimulants Gateway drugs are types of commonly used drugs that are believed to lead to using other more powerful mind-altering and addictive drugs, such as hallucinogens, cocaine, crack, and heroin. Alcohol, tobacco, and marijuana are the most commonly used gateway drugs. Table 1.2 Page 9

Gateway Cont’d The word gateway suggests a path leading to something else.( when used excessively, may lead to using other and often stronger and/or more addictive drugs) Alcohol, tobacco,and marijuana are the most common uses drugs. Almost all abusers of more powerfully addictive drugs have first experimented with these three substances

Figure 01.01: The average American is twenty-five times more likely to die from tobacco-related illnesses than to die from illicit drug-related illnesses. Data from Mokdad, A. H., J. S. Marks, D.F. Stroup, and J. L. Gerberding. “Actual Causes of Death in the United States, 2000.” Journal of the American Medical Association (JAMA), 291 (10 March 2004):1238–1245; Centers for Disease Control and Prevention (CDC). Tobacco-Related Mortality. Atlanta, GA: Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, 2011. Available http://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/tobacco_related_mortality/

Figure 01.T02: Commonly Used Terms

Major Types of Commonly Abused Drugs Six types of major drugs in use: Prescription Drugs Over the counter Recreation Drugs (coffee, tea, alcohol) Illicit Drugs Herbal Commercial (paints, glues, etc) Page 10

Examples of ILLICIT DRUGS Stimulants (Cocaine, Methamphetamines etc) Hallucinogens (Ecstasy, PCP, Mushrooms) Depressants (Quaaludes, Valium) Opioids (Heroin) Cannabis Illicit is Illegal!!

Similar effects as amphetamines and cocaine Stimulants BATH SALTS Designer drug containing substituted cathinone Similar effects as amphetamines and cocaine

Stimulants cont’d

Hallucinogens/Psychedelics

Depressants These drugs depress the CNS (Central Nervous System) Relieve boredom, stress, and anxiety Barbiturates, Valium, Quaaludes, Rohypnol (roofies)

Depressants cont’d

Alcohol Alcohol is a depressant that mainly affects the CNS Known as a gateway drug, ethanol is a colorless, volatile, and pungent liquid resulting from fermented grains, berries, and other fruits and vegetables Alcohol is a depressant that mainly affects the CNS

Nicotine Also a gateway drug. Very addictive, colorless, highly volatile liquid alkaloid found in all tobacco products Long-term use of tobacco products can lead to several different chronic respiratory ailments and cancers

Nicotine Cigarette smoke is a complex mixture of chemical compounds which are created by the burning of tobacco leaves. Cigarette smoke includes tar and 4,000 other chemicals, including 43 substances that cause cancer. Others include gases, such as carbon monoxide. Carbon monoxide interferes with the blood's ability to carry oxygen to the body's tissues. However, addiction to smoking is caused by another substance called nicotine.

Nicotine

Tobacco

Cannabis Marijuana and Hashish Cannabis is the most widely used illicit drug in the United States. Cannabis Sativa and Indica plants

Marijuana

Synthetic Cannabis K-2/Spice- Genericized trademarks as “legal herbs” K2 contains synthetic cannabinoids that affect the body in similar fashion as marijuana.

Figure 01.HN01: Here and Now: Current Use of Spice/K2

Anabolic Steroids Steroids are a synthetic form of a the male hormone testosterone. They are often used to increase muscle size and strength Medically, steroids are used to increase body tissue or to treat allergies.

Steroids

Inhalants Organic Solvents Are also considered gateway drugs and very attracted/popular to preteens and younger teenagers Gasoline, model airplane glue, paint thinner Generally, things around the house or garage

Inhalants

Narcotics/Opiates Opium, morphine, codeine, Demerol From opium, we get what???

Heroin

Opium What is Opium? Opium is a naturally occurring substance found in the seeds of the opium poppy. Opium, which contains morphine, is extracted from the poppy seeds and used to produce heroin. Heroin is an illegal, highly addictive drug and its use is a serious problem in America. It is both the most abused and the most rapidly acting of the opiates.

Designer Drugs/ Synthetic Drugs Innovations in technology have produced new categories known as designer drugs/synthetic drugs or synthetic opioids MDMA, known as “Ecstasy” Designer drug is a term used to describe drugs which are created (or marketed, if they had already existed) to get around existing drug laws, usually by modifying the molecular structures of existing drugs to varying degrees,

Designer Drugs Cont’d These relatively new types of drugs are developed by people who seek to circumvent the illegality of a drug by modifying the drug into a new compound.

Overview of Drugs in Society Many people think that problems with drugs are unique to this era. However, drug use and abuse have always been a part of nearly all, past and present Egypt Evidence of wine only appeared as a finished product in Egyptian pictographs around 4000 BC China The earliest evidence of alcohol in China are wine jars from Jiahu which date to about 7000 BC. This early drink was produced by fermenting rice, honey, and fruit.

Drug Misuse Drug misuse is the unintentional or inappropriate use of prescribed or over-the-counter (OTC) types of drugs. © Photos.com

Six Examples of Drug Misuse Taking more drugs than prescribed Using OTC or psychoactive drugs in excess without medical supervision Mixing drugs with alcohol or other types of drugs

Six Examples of Drug Misuse Cont’d 4. Using old medicines to self-treat new symptoms of an illness 5. Discontinuing prescribed drugs at will and/or against physician’s orders 6. Administering prescribed drugs to a family member without medical consultation and supervision

Dimensions of Drug Abuse Drug abuse is the willful misuse of either licit or illicit drugs for the purpose of recreation, perceived necessity, or convenience. Drug abuse refers to a more intense misuse of drugs—often to the point of addiction. Also known as chemical or substance abuse.

How Widespread is Drug Abuse? As mentioned earlier, drug abuse today is more acute and widespread than in any previous age Drug use is an “equal-opportunity affliction” (No one is immune from the use and /or abuse)

Three Types of Drug Users Experimenters 1st category of drug users Begin using drugs largely because of peer pressure and curiosity, and they confine their use to recreational settings Compulsive users 2nd category of drug users Devote considerable time and energy into getting high, talk incessantly (sometimes exclusively) about drug use, and become connoisseurs of street drugs Floaters or “chippers” Focus more on using other people’s drugs without maintaining as much of a personal supply

Figure 01.CP01: Case in Point: Ignoring the Signs of Drug Abuse: A Hard Lesson Learned

Media Influence on Drug Use The alcohol industry spends more than $1 billion on yearly advertising. The advertising budget for Budweiser beer exceeds the entire budget for research on alcoholism and alcohol abusers. Alcohol companies spent $4.9 billion on television advertising between 2001 and 2005. Since the “Friends Don’t Let Friends Drive Drunk” Ad Council campaign began, 79% of Americans have stopped a friend from getting behind the wheel while intoxicated.

Why Are People So Attracted to Drugs? People use drugs as a means to temporarily: Experience pleasure or heighten good feelings Relieve stress, tension, or anxiety Forget one’s problems and avoid or postpone worries Relax after a tension-filled day of work Fit in with peers or as a rite of passage Enhance religious or mystical experiences Relieve pain and some symptoms of illness

When Does Use Lead to Abuse? The amount of drug taken does not necessarily determine abuse. The motive for taking the drug is the most important factor in determining presence of abuse. Initial drug abuse symptoms include: Excessive use Constant preoccupation about the availability and supply of the drug Refusal to admit excessive use Reliance on the drug

Figure 01.HN05A: Type of illicit drug combinations used in the past year among adults aged 50 or older who used illicit drugs in the past year, by gender: 2007 to 2009

Drug Dependence Both physical and psychological factors precipitate Physical dependence refers to the need to continue taking the drug to avoid withdrawal symptoms, which often include feelings of discomfort and illness. Psychological dependence refers to the need that a user may feel for continued use of a drug in order to experience its effects and/or relieve withdrawal symptoms.

Figure 01.08: Stages of drug dependence

Stages of Drug Dependence Relief—satisfaction from negative feelings in using the drug Increased use—involves taking greater quantities of the drug Preoccupation—consists of a constant concern with the substance Dependency—a synonym for addiction, is when more of the drug is sought despite the presence of physical symptoms Withdrawal—the physical and/or psychological effects from not using the drug

Costs of Drug Use to Society Illness Shortened lifespan Broken home Fetal alcohol syndrome Criminal behavior Drugs in the workplace Cost of Assistance programs (e.g., Employee Assistance Programs [EAP’s])

Drugs, crime, and violence There are two views: Criminal behavior develops as a means to support addiction Criminality is inherently linked to the user’s personality and occurs independently of drug use

Drugs, crime, and violence Cont’d Does drug addiction cause a person to engage in criminal behavior such as burglaries, theft etc. to pay for their drug use? Or does criminal behavior stem from an already existing criminal personality (Answers to these questions have never been clear)

Figure 01.T05: Percentage of State and Federal Inmates Reporting Being Under the Influence of Drugs at the Time of Their Offense: 2004

Drug Cartels Large, highly sophisticated organizations composed of multiple drug trafficking organizations (DTOs) and cells with specific assignments such as drug transportation, security/enforcement, or money laundering Drug Trafficking Organizations (DTOs)

Drugs in the Workplace The loss to U.S. companies due to employees' alcohol and drug use and related problems is estimated at billions of dollars a year. From 2002 to 2004, over half of all past month illicit drug users (57.5%) and past month heavy alcohol users (67.3%) aged 18 to 64 were employed full time (SAMHSA 2007B). Among the 19 major industry categories, the highest rates of past month illicit drug use among full-time workers aged 18 to 64 were found in accommodations and food services (16.9%) and construction (13.7%); (see Fig. 1 in 10th edition text). The industry categories with the lowest rates of past month illicit drug use were utilities (3.8%), educational services (4%), and public administration (4.1%).

Drug Testing Used to identify those who may be using drugs Urine, blood screening, or hair analysis Duration of Detection /“Cut-Off” Levels Urine Analysis: Amphetamines—24–72 hours Cocaine/Metabolite—24–72 hours Opiates—24–72 hours PCP—24–96 hours THC/Metabolite—24 hours–3 weeks (depends on frequency of use) Note: Hair analysis 1 to 3 months for all drugs listed above

Drug Testing (continued) Approximately 70% of large companies test for drug use; 50% of medium companies and 22% of small companies drug test. Over 90% use urine analysis, less than 20% use blood analysis, and less than 3% use hair analysis. Most drug using youth do not cease drug use when they begin working. Almost done 

Holistic Self-Awareness Approach Holistic philosophy that advocates that the mind, body, and spirit work best when they are drug-free

Holistic Self-Awareness Approach Defines as, emphasizes that non-medical and often recreational drug use interferes with the healthy balance among the: MIND BODY SPIRIT

The End