1. Copyright © 2005 Pearson Education, Inc., publishing as Benjamin Cummings PowerPoint ® Lecture prepared by Jan Campbell T H E B A S I C S SIXTH EDITION Licit and Illicit Drugs: Use, Miuse, and Abuse 7 7

2. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Drugs in the U.S. Contribute to 120,000 deaths a year Cost $294 billion U.S. overall use has fallen Adolescent use has risen

3. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Drugs in the U.S. 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

4. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings How the Body Metabolizes Drugs Figure 7.1

5. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Drug Dynamics Routes of Administration of Drugs Oral Injection 1) Intravenous 2) Intramuscular 3) Subcutaneous Inhalation Inunction – through the skin Suppositories

6. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Drug Dynamics Defining Drug misuse – use for purpose not intended Drug abuse – excessive use Addiction 1) Use despite negative consequence 2) Must have the potential to produce positive mood change

7. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Using, Misusing, & Abusing Defining Addiction Physiological Dependence/Psychological Dependence Inextricably tied together Addiction based on three criteria: 1) Withdrawal 2) Associated pattern of pathological behavior 3) Relapse

8. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Using, Misusing, & Abusing Addictions characterized by four common symptoms 1) compulsion 2) obsession 3) negative consequences 4) denial

9. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Prescription Drugs Types of Prescription Drugs Antibiotics – fight bacteria Sedatives – central nervous system depressants Tranquilizers – central nervous system depressants Antidepressants

10. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Prescription Drugs Generic Drugs Less expensive Many brand name drugs have generic counterparts Have you used a generic drug instead of a brand name?

11. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Over-The-Counter (OTC) Facts Nonprescription medicine More than 1/3 of the time people self-treat How a prescription becomes an OTC drug 1) At least three years of sales 2) Use has been relatively high 3) Adverse drug reactions are not alarming

12. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings The OTC Drug Label Figure 7.2

13. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Over-The-Counter (OTC) Types of OTC Analgesics – pain relief GRAE (Generally Recognized as Effective) Expectorants Antitussives Decongestants Anticholinergics

14. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Over-The-Counter (OTC) Types of OTC (continued) Cold, cough, allergy, and asthma relievers Stimulants Sleeping aids Dieting Aids

15. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings 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 2 weeks 5) Be careful if you take prescriptions 6) Ask if you have questions 7) If you don’t need it, don’t take it!

16. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Drug Interactions Polydrug Use Taking several substances simultaneously Synergism Effects are multiplied Expressed as 2+2=10 Worst combination: alcohol and barbiturates Antagonism Work at same receptor One drug blocks the other

17. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Drug Interactions Inhibition Effects of one drug eliminate or inhibit another Intolerance Drugs react poorly in the body May produce nausea and vomiting

18. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Drug Interactions Cross-Tolerance Tolerance for one drug creates a similar reaction to another drug Alcohol and barbiturates

19. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Illicit Drugs Who Uses Illicit Drugs? In 2002, estimated 19.5 million Americans used illicit drugs College use (tried any illicit drug) was 52% in 2002

20. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Table 7.1

21. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Illicit Drugs Why might use in the college population be high? “Just Say No” has not worked What do you think would be a successful anti-drug campaign?

22. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Table 7.2

23. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Controlled Substances Facts Classified into 5 schedules Schedule I and II are illegal to grow, manufacture and sell

24. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Controlled Substances Cocaine Schedule II White crystalline powder Derived from the leaves of the South American coca shrub Methods of use vary Cocaine rapidly crosses the placenta Fetuses exposed are likely to suffer

25. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings The Ups and Downs of a Typical Dose of Cocaine Figure 7.3

26. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Controlled Substances Cocaine Freebase cocaine Crack Cocaine addiction and society Controlled substances

27. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Controlled Substances Amphetamines Schedule I Stimulate the CNS Speed is in the category

28. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Table 7.3

29. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Controlled Substances Newer-Generation Methamphetamine Effects brain and central nervous system Lasts 6-8 hours Ice is a potent methamphetamine

30. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Controlled Substances Marijuana Use goes back 6,000 years Derived from Cannabis sativa Tetrahydrocannabinol, or THC, is the active ingredient Hashish - resin of the plant Long-term studies have not been done in the U.S.

31. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Controlled Substances Marijuana (continued) Studies have indicated that the inhalation from smoking is harmful Use as a medicine Driving ability impaired

32. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Controlled Substances Marijuana (continued) Effects of Chronic 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

33. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Controlled Substances Marijuana (continued) 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

34. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Controlled Substances Marijuana (continued) Marijuana and Driving Reduces reaction time 60-80% of marijuana users drive while high 6-12% of nonfatally injured drivers had THC in their bloodstream Why is it the most popular illicit drug on colleges campuses?

35. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings 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

36. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Controlled Substances Opiates (continued) Lower heart rate, respiration, and blood pressure Estimated 600,000 Americans addicted to heroin Heroin withdrawal is distinct Methadone treatment is successful for some

37. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Controlled Substances Heroin Addiction Estimated 600,000 addicted Black Tar Heroin Pure, inexpensive, sticky, dark brown form

38. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Controlled Substances Oxycontin: Synthetic Opiate Epidemic in 2002 4% of high school seniors reported illicit use

39. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Controlled Substances Treatment of Opiates Methadone One treatment for those addicted to heroin – blocks effects of opiates Naltrexone Opiate antagonist

40. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Reticular Formation Figure 7.4

41. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Hallucinogens (Psychedelics) Facts Scramble messages coming to reticular formation Synesthesia – mixing of the message

42. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Hallucinogens (Psychedelics) LSD (lysergic acid diethylamide) Common hallucinogen used to unlock mind 1970’s – placed on controlled substances list Over 10 million Americans have tried acid Commonly sold as a “blotter” on paper

43. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Hallucinogens (Psychedelics) Mescaline From peyote cactus Native Americans still use Typically swallow 10-12 peyote buttons Generally induce vomiting Psilocybin or “magic mushrooms” Effects generally wear off in 4-6 hours If harvested the person must know what they are doing Many mushroom varieties are poison

44. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Dissociative Drugs Facts Distort perception of sight and sound Interrupt neurotransmitter glutamate in the brain PCP (Phencyclidine) is the most known Originally used as an anesthetic Side effects led doctors to abandon use

45. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Designer Drugs or Club Drugs Ecstasy (MDMA) most common club drug Hallucinations Paranoia Amnesia Death in some cases Chronic use can damage the brain

46. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Inhalants Facts Inhale chemicals Legal to purchase Includes: glue, paint thinner, rubber cement Amyl Nitrate – “rush” Used to alleviate chest pain Nitrous Oxide Dental anesthesia Pain relief “Silly feeling”

47. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings 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?

48. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Illegal Drug Use in the U.S. 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%

49. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Illegal Drug Use in the U.S. Facts Costly habits: estimated $97.7 billion Half of crime expenditure Drugs in the Workplace 9.4% of Americans use at work Use the highest in construction, food prep, and transportation

50. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Illegal Drug Use in the U.S. 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 Do you think employers should do random drug testing?