Chapter 2 Drug-taking Behavior: The Personal and Social Concerns

Toxicity Refers to the potential physical or psychological harm that a drug might present to a user. Acute toxicity-short term or temporary.

Toxicity Chronic toxicity-long-term or acquired over time. Chronic toxicity are examined in the context of drug tolerance and/or drug dependence.

Toxicity (con’t) A dose-response curve is a graph of the percentage of a population that experiences some response as a function of dosage level.

Toxicity (con’t) ED5O" refers to the dosage that produces an response in 50% of the population. LD5O" refers to the dosage that is lethal for 50% of the population. In general, the further apart the.

Toxicity (con’t) Ed-response and ld-response curves, the safer (less toxic) the drug.

Dawn Federal program- ED report incidences of lethal or non-lethal drug-related emergencies in U.S. ED refers to drug-related cases treated in emergency departments.

Dawn ME refers to drug-related cases recorded by the medical examiner. Multiple drugs are mentioned by the patient.

Tolerance The more I get…the more I want. Behavioral tolerance: environment. Physical dependence: the abuser continues the drug-taking behavior in order to avoid physical withdrawal symptoms. Physical dependence is largely based upon the experiences of heroin abusers, since heroin cessation produces significant physical withdrawal symptoms. The cessation of other abused drugs, however, produces little or no physical withdrawal symptoms. In these cases, animals can be shown to demonstrate incessant and intense attraction to the drugs, resulting in patterns of self-administration.  Current experts in the field of drug abuse assert that the distinction between physical and psychological dependence has outgrown its usefulness in understanding patterns of drug- taking behavior. The diagnostic and statistical manual, fourth edition (DSM-IV) of the American psychiatric association identifies two general conditions related to drug-taking behavior: substance dependence and substance abuse. Substance dependence identifies a situation in which an individual displays signs of dependence with respect to a certain drug: tolerance, withdrawal, unintentional overuse, preoccupation with the drug, or continued drug use despite major drug- related problems. Substance abuse identifies a situation in which drug- taking behavior continues despite recurrent social, occupational, interpersonal, or legal problems related to that behavior. Special problems in drug abuse.  A particular problem in drug abuse involves drug-taking behavior of women who are pregnant at the time. The developing fetus is subject to the toxic effects of the ingested drug.  Injecting drugs carry the extra hazard of spreading disease when needles are shared or non- sterile. Hepatitis and HIV infections are two prominent examples of this problem.

Psychological dependence: the continuance of drug-taking behavior is motivated by a craving for the pleasurable effects of the drug. Catheter: device used to deliver intravenous injections. Tolerance (cont’d)

Special Problems in Drug Abuse Pregnancy and drug addiction. Dirty needles-HIV.

Special Problems in Drug Abuse Pharmacological violence: under the influence of drugs. Economically compulsive violence: committed in order to sustain habit.

Systemic Violence Aggressive patterns of behavior, related to the trafficking and distribution of drugs.

Governmental Policy,regulation, and Laws Between 1900 and 1970, U.S. Drug policy changed from a philosophy of laissez-faire ("do as you please") to an increasingly restricted philosophy with respect to drug access and use.

Governmental Policy,regulation, and Laws The Harrison act of 1914 was the first legislation to restrict access to opiate drugs and cocaine. At that time, the U.S. Treasury department was entrusted with drug law enforcement responsibilities.

Governmental Policy, Regulation, and Laws In 1970, the comprehensive drug abuse prevention and control act classified drugs in terms of five schedules of controlled substances.

Governmental Policy, Regulation, and Laws Schedule I drugs include heroin, LSD, and marijuana.No acceptable medical use. Schedule I and II refer to drugs presenting the highest level of abuse, examples, codeine.

Governmental Policy, Regulation, and Laws Schedule III drugs, some potential for abuse (1.8% codeine). Schedule V drugs present the least abuse potential and are the most accessible among controlled substances (laxatives).