Addictive Behaviors, Licit and Illicit Drugs: Use, Misuse, and Abuse

Defining Addiction Use substance or continue behavior despite negative consequence Must have the potential to produce positive mood change

Defining Addiction Physiological dependence/psychological dependence Inextricably tied together Addiction traditionally based on four criteria: 1) Relief of withdrawal symptoms 2) Continued use despite harm to self and others 3) Unsuccessful efforts to cease using or cut down on use, including relapse 4) Tolerance Increasingly recognized that these four criteria do not characterize all addictive behavior

Signs of Addiction Addictions characterized by four common symptoms 1) compulsion (can include obsession) 2) loss of control 3) negative consequences 4) denial

Compulsive or Pathological Gambling Facts Cravings or highs similar to those experienced by drug users Often seek the excitement more than the money Men are more likely than women to have gambling problems Incidence higher in lower-income individuals, those who are divorced, African Americans, older adults, those living within 50 miles of a casino

Compulsive or Pathological Gambling College students Increasingly involved in gambling due to ease of participation More casinos Internet gambling Often has a detrimental affect on health 38% have cardiovascular problems Suicide rate 20 times higher than that of general population

Compulsive Shopping and Borrowing Facts Money often spent to meet emotional needs not being fulfilled elsewhere College students often open to spending problems due to targeting by advertisers and credit card companies On average, compulsive spenders $23,000 in debt Compulsive spending often leads to compulsive borrowing to help support addiction

ABC News: Addictions and Addictive Behavior Play Video | Addictions and Addictive Behavior Discussion Questions What are some of the other types of addiction beyond drug, alcohol and nicotine addictions? Do you think that compulsive shoplifting should be considered a disease? Why or why not?

How Addiction Affects Family and Friends Codependence Pattern of behavior Person becomes “addicted to the addict” Subsume personal needs in order to meet needs or desires of addict Enabling Knowingly or unknowingly protects addict from consequences of behavior Rarely conscious and generally unintentional

Drug Abuse in the United States Facts Drug and alcohol abuse contributes to more than 120,000 deaths a year Costs $294 billion in preventable healthcare expenses Across the U.S. overall use has fallen Adolescent use has risen in certain drug use

Drugs Abuse in the United States Types of drugs 1) Prescription 2) Over-the-counter 3) Recreational – alcohol, tobacco, coffee 4) Herbal preparations – products of plant origin 5) Illicit (illegal) – all are psychoactive 6) Commercial preparations – household cleaners, pesticides

Drug Dynamics Routes of administration Oral Injection 1) Intravenous- into bloodstream 2) Intramuscular- into muscle 3) Subcutaneous- just under the skin Inhalation Inunction – through the skin Suppositories

How the Body Metabolizes Drugs Figure 7.1

Using, Misusing, and Abusing Drugs Abuse often associated with illegal drugs, but many people abuse and misuse legal drugs Drug misuse – use for purpose not intended Drug abuse – excessive use Misuse and abuse may lead to addiction Evaluation of risks and benefits of use of chemical substances is necessary

Prescription Drugs Types of prescription drugs Antibiotics – fight bacteria Central nervous system depressants- sedative or hypnotic Antidepressants Generic drugs Less expensive Many brand name drugs have generic counterparts

Over-The-Counter (OTC) Facts Nonprescription medicine More than 1/3 of the time people self-treat How a prescription drug becomes an OTC drug 1) At least three years of sales 2) Use has been relatively high 3) Adverse drug reactions are not alarming

Over-The-Counter (OTC) Types of OTC drugs Analgesics – pain relief GRAS (Generally Recognized as Safe) GRAE (Generally Recognized as Effective) Cold, cough, allergy, and asthma relievers Sleeping aids Dieting Aids

Over-The-Counter (OTC) Rules for proper OTC drug use 1) Know what you are taking 2) Know the effects 3) Reading warnings and cautions 4) Don’t use anything for more than 1 or 2 weeks 5) Be careful if you also take prescriptions 6) Ask your pharmacist if you have questions 7) If you don’t need it, don’t take it!

The Over-the-Counter Drug Label Figure 7.2

Drug Interactions Polydrug use Taking several substances simultaneously Synergism Effects are multiplied Expressed as 2+2=10 Example: Alcohol and barbiturates Antagonism Work at same receptor One drug blocks the other Example: Alcohol and antibiotics

Drug Interactions Intolerance When drugs combine to produce extremely uncomfortable reactions Example: Antabuse and alcohol Cross-tolerance Tolerance for one drug creates a similar reaction to another drug Example: Alcohol and barbiturates

Illicit Drugs Users of illicit drugs In 2003, estimated 19.2 million Americans used illicit drugs College use (tried any illicit drug) was 52% Why might use in the college population be high? What do you think would be a successful anti-drug campaign?

Controlled Substances: Stimulants Cocaine White crystalline powder Derived from the leaves of the South American coca shrub Cocaine rapidly enters bloodstream Exposed fetus is likely to suffer Methods of use vary Freebase cocaine Crack Cocaine addiction and society Annual cost of addiction in USA: $3.8 billion

The Ups and Downs of a Typical Dose of Cocaine Figure 7.3

Controlled Substances: Amphetamines Synthetic agents that stimulate the central nervous system Some are used for medicinal purposes Ritalin, Adderall for attention deficit hyperactivity disorder High potential for abuse

Controlled Substances: Amphetamines Methamphetamine Effects brain and central nervous system Euphoria lasts 6-8 hours Methods of use varied: snorted, injected, smoked, ingested Increasingly more common in rural America Ice is a potent methamphetamine

ABC News: Illicit Drugs Play Video | Illicit Drugs Discussion Questions Do you think that the young man and woman had a history of using meth? How did the crystal meth interfere with the young man attempting to get help?

Effects of Amphetamines on the Body and Mind Figure 7.4

Controlled Substances: Marijuana and Derivatives Use goes back 6,000 years Derived from Cannabis sativa or Cannabis indica (hemp) Tetrahydrocannabinol, or THC, is the active ingredient Hashish – derived from the resin of the plant Long-term studies have not been done in the U.S. Studies have indicated that the inhalation from smoking is harmful

Controlled Substances: Marijuana and Derivatives Effects of marijuana use Carbon monoxide to blood-heart works harder Contains high levels of carcinogens Suppression of the immune system Pregnant women at higher risk for stillbirth or miscarriage Driving ability impaired

Controlled Substances: Marijuana and Derivatives Marijuana and medicine Helps with severe nausea and vomiting during chemotherapy Improves appetite of AIDS related wasting syndrome Aids those with multiple sclerosis by reducing pain and spasticity Reduces eye pressure of glaucoma

Controlled Substances: Marijuana and Derivatives Marijuana and driving Reduces reaction time 6-11% of fatal accident victims had THC in their bloodstream Why do you think marijuana is the most popular illicit drug on colleges campuses?

Controlled Substances: Opiates Cause drowsiness, relieve pain, and induce euphoria Called narcotics Derived from opium – from poppy Include morphine, codeine, heroin, and black tar heroin Depress CNS Lower heart rate, respiration, and blood pressure Decreases sex drive

Controlled Substances: Opiates Black tar heroin Pure, inexpensive, sticky, dark brown form Relatively pure and inexpensive Heroin addiction Heroin withdrawal is distinct 3.7 million people have used heroin in their lives

Controlled Substances: Opiates Treatment of opiates Methadone Blocks effects of opiates Potentially addictive; trade one substance for another? Naltrexone Opiate antagonist Lose compulsion to use heroin Buprenorphine Blocks cravings for heroin Non-addictive

Controlled Substances: Hallucinogens (Psychedelics) Hallucinogen facts Known as psychedelics Scramble messages coming to reticular formation Synesthesia – mixing of the message May “hear colors” and “smell tastes”

Controlled Substances: Hallucinogens (Psychedelics) LSD (lysergic acid diethylamide) Common hallucinogen used to unlock mind Used to “turn on” and “tune out” world 1970’s – placed on controlled substances list Over 11 million Americans have tried acid Commonly sold as a “blotter” on paper

Reticular Formation Figure 7.5

Controlled Substances: Hallucinogens (Psychedelics) Mescaline From peyote cactus Native Americans still use Typically swallow 10-12 dried peyote buttons Generally induce immediate vomiting Psilocybin or “magic mushrooms” Effects generally wear off in 4-6 hours Cultivated from spores or harvested wild Similar to LSD in effect

Controlled Substances: Hallucinogens (Psychedelics) PCP (Phencyclidine) Originally used as a dissociative anesthetic Side effects like amnesia led doctors to abandon use Interrupt neurotransmitter glutamate in the brain May cause euphoria or dysphoria Known to cause hallucinations, delusions and overall delirium

Controlled Substances: Designer Drugs (Club Drugs) Ecstasy (MDMA) most common club drug Hallucinations Paranoia Amnesia Death in some cases, especially when combined with alcohol Chronic use can damage the brain GHB, Ketamine (Special K), and Rohypnol Includes “date rape” drug

Inhalants Facts Inhale chemicals Legal to purchase Includes: glue, paint thinner, rubber cement Amyl nitrate – “poppers” or “rush” Abused to enhance sexual function Nitrous oxide Dental anesthesia Pain relief “Silly feeling”

Controlled Substances: Steroids Ergogenic drugs Used to increase strength, power, bulk, speed, performance 17-20% of college athletes once estimated to use them Now estimated at 1.1% Recent survey shows increased usage in high schools since 1991

Controlled Substances: Steroids Anabolic steroids Ergogenic drugs Available as pill or injectable Adverse effects occur 1990 Anabolic Steroids Control Act (ASCA) “Performance-enhancing” steroid alternatives Gamma-hydroxybutyrate (GHB) Clenbuterol Androstenedione (andro) Who is commonly associated with steroid use and why?

Illegal Drug Use in the United States Facts Costly habits: estimated $180.9 billion Half of crime expenditure Solutions to the problem Often “scare tactics” unsuccessful Drug abuse has been around for thousands of years It is unlikely to change in the near future Must target at-risk groups Stricter border control Need for better educational programs Do you think employers should do random drug testing?